When is preventive care not preventive? Let’s go to Labcorp to participate! – The health care blog

By Matthew Holt

To participate in the pleasure I have with Blue Shield of California & Brown & Toland Physicians IPA not being able to tell me why I have an invoice of $ 34.94 for laboratory work (see image) which should be covered as avoidable under the ACA, or have co-payment of $ 50 (see the image of the BS of CA Screenshot for the $ 50), I called Labcorp.

After 6 minutes, I had a very confused person. BTW There is no way to communicate with Labcorp on the website, and if you put your invoice number in their IVR system, there is no way to get a human. The only way to do so is to hang up and start again, not put your bill number and hit 0. Then wait with Muzak to get a human. They then ask for your DOB and your phone number. The call center is in the Philippines BTW.

I explained that I wanted information on the tests that were not covered by the ACA. The Brown and Toland / Blue Shield EOB says that I have a co-payment of $ 0 (see image).

The representative of Labcorp told me that out of the 5 tests carried out (with CPT Code and Price), 3 were not covered. The lipid (85027 107.10 $), the A1C (80061 – $ 81.90) Uric acid (8,4550 43.05 $). 2 of these 3 are clearly covered by the ACA. Uric acid may not be based on my reading of the CMS site. Labcorp submitted this invoice to Blue Shield. The representative has always told me that the complaint had been sent to the Blue Cross Blue Shield of CA, which does not exist.

At this stage – 15 minutes later – the call fell. I don’t know if they just hung up, but they had asked for my phone number. They did not call me back.

But I am pain in the ass and I recalled them. After about 4 minutes pending, I obtained another representative. She told me that all the CPT / laboratory test codes were subject to Copay. She told me that Blue Shield (not Brown & Toland Physicians) had gathered all these codes and that there is a salary for all. This is what the bill says.

The only thing I can do is send an email with the screenshot of the EOB, which is IPA and not Blue Shield. So I did this and I can get an answer in 3 to 5 working days.

I know you are on tents. Let’s see what is happening next, but the complete absence of anything that looks like the transparency of consumers or access to relevant information makes fun of everything that Paul Markovich says on stage.

Matthew Holt is the founder and publisher of THCB