Is this a typical hospital bill for lab work?

[Rem]

I had my first labs drawn at a university ID clinic on May 8th, and I just received the hospital bill. 

Pharmacy: 349.65
Laboratory: 8,180.00
Laboratory Pathological: 169.00
Clinic: 366.00
Preventive Care Services: 43.00
Anthem Adjustments: -5,680.38
Anthem Payments: -2,769.36
Coinsurance: 657.91
Amount Due: 657.91

These charges are separate from my $50 office visit co-pay and doctor bill ($409, which my insurance covered).  I'm a bit shocked as I didn't think it would be this expensive.  I know I have a 20% coinsurance payment, but what in the hell costs $9,107.65?!

These were my initial labs, but is this what I should expect each time I go to have bloodwork drawn?  Is this typical?

There's no way I can afford this every month and, according to my case manager, I'm not eligible for any financial assistance. 

How do all of you handle your monthly hospital/doctor bills?  What do you typically pay based on your insurance/medical assistance?

I'm kind of at a loss as I try to wrap my brain around having to shell out so much money. 

[Miss Philicia]

It's expensive because you had it done in a hospital instead of the blood being sent to some place like LabCorps or Qwest. You need to check your insurance coverage benefit package as they may have an arrangement with one of those two companies where if your blood work is sent there it's paid in full. It's up to the patient to know what is in their insurance benefit book -- have you read it?

Perhaps you should make an appointment with a case manager to go over your insurance arrangement, have it analyzed by someone who is familiar with these things, and see what gaps you need to have filled and if you qualify for any financial programs. I would have thought during medical intake your doctor would have referred you to such a thing. Were insurance issues discussed with you none at all?

[Rem]

Thanks, Miss Philicia. 

I met my caseworker for the first time last week.  At that point in time, I had no bills.  My caseworker told me that I was not eligible for any financial assistance for hospital/doctor bills because my income was too high ($42,000).  If I needed help with medication payments though, she had resources for that.  However, with the ViiV co-pay assistance, I don't pay anything for my medications.

I thought I had gone through my insurance benefits quite closely, but I guess not.  I've never even heard of LabCorps or Qwest (let alone knew there was a difference between hospital labs and independent labs). 

Will I need to find a new doctor, or can I just request that my doctor send my bloodwork to LabCorps or Qwest?

I will call my insurance company tomorrow and ask about labs as I can't find any information on their webpage.

I guess I'll need to be more diligent in bridging the gaps between my insurance company, the ID clinic, and my case manager.  Unfortunately, it's my first ride in this rodeo and I'm learning on the go.  That's why appreciate all the information provided by all of you.  It helps immensely!     

[Dan0]

If your doctor has a regular nurse, ask her, too. They've seen everything and dealt with these issues probably more than the doctor.

With some insurance, the doctor part of this is covered more than the lab work. Depending on who you have, you may have to go to a specific clinic or hospital to get your blood drawn in order to be cover to the full extent. With mine, if I get my blood work done in the same hospital as my doctor was in, I pay through the nose for the blood work. If I got to a different hospital which the insurance provider is more closely associated with, the bill comes to less than $100 (and depending on how much of the deductible is paid, sometimes covered fully). Why the doctor and not the lab one floor down? No %#^#%]}{ clue.

Check with the nurse, she's probably seen and heard it all. Then the insurance provider may have some preferred labs they could give you the information on. The insurance company will give you the clinical answer and the nurse will probably tell you like it is because they're just as frustrated as the patient.

A bill like that, I've only seen when I went somewhere completely foreign to the insurance when I was in a bind for time. I did it once and about passed out when I opened it.

[Rem]

That's very helpful info, Dan0.

I'm quite surprised this wasn't explained to me, or at least processed in the optimal manner, automatically on my first visit.  My doctor is part of an enormous ID clinic that serves thousands of HIV patients.  One would think they would have billing and insurance down to a tee.  He also has a regular nurse, so I will be sure to talk to her about this as well. 

If I recap all this, I have to figure out where I can go to get my blood drawn and labs completed so that my insurance company pays for it.  This should result in little to no cost on my end.  But, it may not be the same organization that my doctor belongs to.  So, I may have to have two separate appointments (one for the blood work and another with my doctor) each month? 

It looks like I have many phone calls to make tomorrow.  Hopefully I can get this sorted out so it doesn't occur on my next appointment. 

[Dan0]

Your doc will probably give you a lab sheet that you have to hVe done before your next visit. It's up to you where you go to get the draw, the results are sent  to him.

[Rem]

Your doc will probably give you a lab sheet that you have to hVe done before your next visit. It's up to you where you go to get the draw, the results are sent  to him.

This makes sense, I guess.  However, wouldn't it make more sense for me to just find an inclusive doctor and lab covered by my insurance to just do all this in one fell swoop?  If possible, that is.

[zach]

just want to echo and pound on what dano said

love your nurse like your mother, seriously

trust your doctor, if you don't, find a new one

treat your case manager like an old friend

[Dan0]

This makes sense, I guess.  However, wouldn't it make more sense for me to just find an inclusive doctor and lab covered by my insurance to just do all this in one fell swoop?  If possible, that is.

If you can - great! I would concentrate on the doctor. The labs you should be able to do at multiple locations depending on your insurance. Pretty generic. A lab is a lab. If you find a doc (and nurse) you trust and like, you can work around the labs.

[bocker3]

Even at a hospital lab $8,000+ billed is a huge amount (for outpatient blood work).  What tests were done?  did you have a resistance test drawn -- that is a pricey one.  I can't imagine that your routine lab work will be that much money.

Do contact your insurance company and see if there is a "preferred", i.e. cheapest, way to get labs done.

Mike

edited to add:  I just notice the $169 for Pathology....  did you have anything else done?  I can not see a Pathologist needing to be involved in any routine HIV blood work.  Something is either missing here or you are being charged for stuff that shouldn't have happened.  Of course, insurance companies are good at picking up those sorts of things and denying them, so that may already have happened.

[Rem]

Ugh, this is all so frustrating...

I found out that if I use LabCorp everything is covered 100% by my insurance.  However, because the labs were processed at the hospital, I am responsible for the 20% coinsurance. 

I understand that the patient is responsible for understanding their insurance, but geesh, why didn't anyone warn me about this?  In the midst of I just found out I'm HIV positive and I'm at a doctor for the first time and people are asking me 1,000 questions and telling me about medication and drawing 17 vials of blood and telling me everything is going to be okay and giving me case manager numbers,  I guess I made the mistake of trusting that this institution knew what they were doing and would process me in the optimal manner.  There really needs to be an HIV 101: How Not to Get Fucked course somewhere.     

I guess I'm stuck with paying the $657.91.  Moving forward, I will have to get a prescription from my doctor and go to a LabCorp site. 

Even at a hospital lab $8,000+ billed is a huge amount (for outpatient blood work).  What tests were done?  did you have a resistance test drawn -- that is a pricey one.  I can't imagine that your routine lab work will be that much money.

Do contact your insurance company and see if there is a "preferred", i.e. cheapest, way to get labs done.

Mike

edited to add:  I just notice the $169 for Pathology....  did you have anything else done?  I can not see a Pathologist needing to be involved in any routine HIV blood work.  Something is either missing here or you are being charged for stuff that shouldn't have happened.  Of course, insurance companies are good at picking up those sorts of things and denying them, so that may already have happened.

Here's a rundown of what is listed on my visit summary from that bill:

CBC
Chlamydia/Gonorrhoeae DNA Urine
Comprehensive Metabolic Panel, Serum
Differential
HIV GenoSure
HIV RNA, quantitative, PCR
HLA B*5701 Typing
Hepatitis A Total Antibody
Hepatitis B Core Antibody
Hepatitis B Surface Antibody
Hepatitis B Surface Antigen
Hepatitis C Antibody
Lipid Profile
Lymphocyte Subset Panel 1
Quantiferon TB Gold
Syphilis Screening (Trepia)
Urinalysis x/Reflex to Microscopic
 

[zach]

nah man, you got screwed, talk to someone on your care team

[Miss Philicia]

I agree that he got screwed, in that someone on staff should have inquired about insurance preference for labs as it's not an unusual issue and as it's a university hospital HIV clinic (I assume from his first post) that they routinely deal with this.

However, I kind of expect they'll think it was fundamentally the patient's responsibility to know and won't just write-off the cost. But I could be wrong. I would be very pissed off though.

[Irish Eyes]

I have Obamacare, Bronze level with Anthem Blue Cross, and also am eligible for ADAP.
My doctor is part of university medical system where I get all my blood draws and meds.
ADAP covers all my doctor visits, insurance premiums of $284.42 and meds (Stribild) but not for lab lab/blood work.
My initial lab/blood work of about 11 vials, cost $1200.00.
The second set which excluded CD4 cost $ 185.00.
Third set cost $207.00 totaling $1562.00.

Aparrently, according to member Abso, ADAP should cover lab work, but it's a small price to pay for the healthcare I receive, and due to convenience, have paid the lab bills myself.

NB the above amount is the total out of pocket amount I have paid for all my HIV medical care since end of Jan. '14 including 3 months of Stribild.

[vertigo]

The first set of labs is going to be far & away the most expensive.  Namely because of the genotyping.  Also because your doc is gonna screen for every other STI under the sun.  Expect your follow-on labs to be a lot less money.

[le_liseur]

These numbers all seem so astounding, how do you all do?

Do you actually have to pay from your pocket for regular blood test every time you need them and that you go to the clinic ? What happens when someone can not pay for their blood tests?   

[NewAdventure1]

Genotyping is the reason it was so high.

My first set was a little over 2K. But since my labs have dropped to about $180 and my insurance pays for all said labs.

[bmancanfly]

Also,  I wouldn't consider any bill from a hospital like this as chiseled in stone.  There is often room for negotiation if you plead your case effectively.  Just look at the adjustment they made for your insurance company.

This becomes even more so as the outstanding balance begins to age.

[cozinator]

My Labs were done thru Lab Corp and it was only 900.00