labwork billing

[alex999]

So i've had two ANA blood tests within the last 6 mos

here is the billing ordered from by my doc for the first one. This is just the bill from the lab that was sent to insurance and does not include the Dr appointment.

$350
-262.31 insurance adjustment
87.69 balance that i owe

here is the second ANA test. This time i didn't go through my insurance and instead went through directlabs.com a private company

$54

now the only difference is where these were taken. The more expensive was taken at the hospital lab and the cheaper was taken at labcorp.

I still can't help feeling i'm getting hosed by either the hospital lab, my insurance company or both.

Labcorp is my normal lab for blood tests and the one i usually go to for tests ordered by my DR. And what i've found depending on the test it is actually cheaper for me to go to a private company instead of insurance even when i use the same lab.

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[psy]

Your hospital bills for 350 because the insurance only pays a fraction of that. They tell you the maximum amount but they don't show you the actual amount they paid to the hospital lab. Also, getting your blood test done in a hospital would cost more due to higher overhead costs of operating in a hospital vs. private company. My guess is that the actual cost to do your test would be roughly equal if you factor in overhead, cost of filing papers, and hassle of dealing with the insurance that pays only a fraction of what they get charged.

 

[alex999]

Your hospital bills for 350 because the insurance only pays a fraction of that. They tell you the maximum amount but they don't show you the actual amount they paid to the hospital lab. Also, getting your blood test done in a hospital would cost more due to higher overhead costs of operating in a hospital vs. private company. My guess is that the actual cost to do your test would be roughly equal if you factor in overhead, cost of filing papers, and hassle of dealing with the insurance that pays only a fraction of what they get charged.

yeah i figured the hospital labwork was more because of that but check this out. I usually go to labcorp. It's a very big company that does labwork..you've probably heard of it. Anyway...i was just looking at my bills tonight and i had a vitamin d blood test that cost me $116 after insurance. After i was put on 50,000 IU of Vitamin D i needed to get my levels checked again but my Dr was on vacation. So i went to directlabs.com and the vit d test is $69 so i bought that and then had my results sent over to my dr for when he gets back from holiday. For both tests i used the same lab (labcorp) yet when i went through my insurance i paid a lot more.

that's a head scratcher isn't it?

i'm not trying to plug the private labs in my post...have to mention them to make my argument.

 

[psy]

Yep. the same can be said for fee-for-service primary care. Insurance charge shows about 100+ per doc visit, but if you go to a fee-for-service where they do not accept any form of insurance then you pay like 30-40 bucks at most. The family doc I used to go to does this route and he charges 20 per visit for no insurance. Again, the problem with the insurance reporting to YOU how much they paid is that they will give you the full amount the doctor charges them, but they don't tell you how much they actually had to pay which is often a few percent above medicare (medicare only pays a portion of what they get charged). There is the additional problem of paperwork and the times when the insurance companies won't reimburse for certain treatment plans or tests. The docs/labs have to charge more when you have insurance to cover those things, but if you go cash you just saved them a lot of hassle.

BTW The cash payment savings would not apply to a hospital system due to federal and state law. The hospital has to charge you the max amount regardless if you have insurance or not. Because of this, many people who had to shoulder hospital bills without insurance found themselves heading to bankruptcy.

 

[alex999]

doesn't seem like this is free market healthcare. Ideally in the marketplace a consumer knows what he is paying for. If there was real competition I don't think you'd see some of this shady billing.

looks like this lab that is affiliated with a hospital is passing off hospital costs to the customers at the lab. Since noone really knows what costs are once you've had blood drawn it's too late.

 

[psy]

Healthcare in the US stopped being a free market healthcare the moment medicare came into being. Medicare determine the base rate that private and public health insurance use to pay for the patients. Medicare usually pays a fraction of what is charged and the health insurances pay a few percent above that. This is why you see docs and hospitals get panicky when the government plans on cutting medicare reimbursement. If medicare is cut even lower, then the rest of the health insurance programs out there will lower their payments as well.

 

[Davisr]

Direct Labs exposes private medical records to the public. If you create an online account with DirectLabs so that you can order your own medical lab tests, Direct Labs will email your unencrypted login ID and password to your email account. If you change your password for your DirectLabs account, Direct Labs will repeatedly email your new unencrypted passwords to you.

Every ethical healthcare professional knows this is plain bad practice! Any 14 year-old with access to a computer could hack an email account, then log in to your Direct Labs account and download your medical file and lab results. There have been numerous reports in the mainstream media about Gmail, Yahoo, AOL and other mail accounts being hacked.

Would you want your confidential medical results handed over to a hacker, private investigator, government agent or ex-spouse, thanks to Direct Labs shoddy IT practices?

Would you expose your patients' confidential medical records to this risk?

Guard your privacy, and respect your patients. If you want your patient records to remain confidential, do not do business with Direct Labs. There are better options available.