I had an ear infection 3 months ago. The Dr. performed a culture to see what type of infection it was.
Yesterday I received a bill for almost $900 for the lab work. I’ve Learned about the No Suprises Act from Clark. I’m considering filing a claim.
Has anyone submitted a claim for suprise medical billing before. If so can you share your experiences?
Thanks,
No surprises applies pretty much only to unexpected out of network bills. Was the lab out of network? Did you check to make sure the lab actually submitted the bill to your insurance? Not uncommon for labs not to have insurance info. If they did submit, did the insurance pay anything? Does the EOB say you owe the amount you were billed and what was the reason given for that decision?
I had an out of network lab charge me when I went to an in network doc, and the doc didn’t notify me in writing or verbally to seek my consent to send it there. It was like $1700.
I called the lab, and asked them for an itemized bill for a formal No Surprises complaint submission, and the telephone rep asked, “Can you hold a moment?”
She came back two minutes later, and declared, “The bill has been forgiven”.
Apparently they don’t want to catch a case! I was super, super, super pleased.
My doc was in network, lab was out of network.
The bill was discounted b/c of insurance. According to the EOB my insurance paid ZERO to this lab. The reason I owed was due to the following: “This is the amount you owe after your discount, what your plan paid, and what your accounts
paid. People usually owe because they may have a deductible, have to pay a percentage of the
covered amount, or for care not covered by their plan. Any amount you paid when you received
care may reduce the amount you owe”
So it reads that I’m responsible but if I have protections for a suprise bill for an event that happened 4 months ago without my knowledge, I’m going to take advantage of it.