The expenses of medical services in the States are outrageous, but insurance is supposed to help cover these costs, right? Well, as long as the fees are within the insurance’s ‘network’ — however, a California doctor deliberately had a patient run an unplanned lab test that went to an unknown third party outside their ‘network.’ Now, they’ve received a bill for $1,200 out of the blue. “This feels like I’m being robbed,” the patient groans. “I can’t afford to pay this. And this feels so unexpected and out of nowhere. I didn’t even know this was going to happen.”
The patient clarified that they visited said doctor specifically because they were in their insurance’s network. However, “[he] didn’t tell me the name of the company or anything about them” when he sent in the spontaneous lab test. “There’s no way in hell your doc or one of their partners has a financial interest in that outside lab, right?” a Reddit user asks. In other words, there is a strong possibility that the doctor has a connection with the lab he used, which would serve as a means to obtain extra money from the patient.
Regardless of the reason behind the doctor’s shady behavior, the fact still remains that the patient is stuck with an unaffordable lab fee they didn’t consent to. Or that is to say, they didn’t give permission or have a say in which lab was used, as they likely expected the doctor’s services to remain within their insurance’s network. A top commenter on the patient’s Reddit complaint recommends that they appeal the expense to the insurance company, if not to the California Department of Insurance. “I’ve had a surprise bill paid after complaining,” the user claims.
“You’re not stuck. File that complaint, and don’t let them scare you with that bill,” another Redditor says encouragingly. “The [insurance] system counts on people not knowing their rights, but you’ve got options.” A second agreed, saying, “Contact your insurance. You went in network and cannot control where it was sent. Legally you are only responsible for the in network cost.” Unfortunately, OP got back to the commenters with bad news after speaking to the insurance company. It claims the patient is still responsible for the entire $1.2K expense. “Such a terrible system,” a user remarks.
There might be light at the end of the tunnel, as there are many commenters claiming that they got their “surprised bills” paid for. While the patient should have done their due diligence with the doctor’s ‘lab partner,’ it was the doctor who should have been more transparent with the fees.
