Lab Tests – Who is responsible for the bill?

Healthcare and insurance are changing rapidly now that the beginning stages of the Affordable Care Act have gone into effect. We are finding that insurance companies that have paid for virtually all laboratory testing in the past are now being much more selective about the type of tests that they are paying for. We are also finding that many more patients have high deductible insurance plans and are therefore responsible for larger portions of their bills.

Please understand that we cannot know which tests are covered by your individual insurance. We also cannot be responsible when you and/or your employer choose a high deductible insurance plan. Our interest is in providing you with good medical care taking advantage of all the recent technologies and testing that help to insure your good health.

We try, to the extent possible, to inform you when we are aware that a particular test may be expensive. Very often we are unaware of the actual costs for a given test. We know that genetic tests, for example, tend to be expensive and therefore we attempt to inform you of this.

The bottom line answer to the question asked above – is that you are responsible for the bill for tests that are ordered on your behalf. It is your responsibility to know when you have a high deductible insurance policy. When you know that you have a high deductible policy you should ask what the price of tests that are being ordered you may cost. Very often, it is more economical to pay the self pay rate (as if you don’t have insurance) than it is to send the bill to insurance and then pay the full rate when the insurance company denies payment because of your deductible or copay.

Be assured, our interest is solely with providing you with modern, up to date, good care. We are as frustrated by the changes in healthcare policy that lead to these issues as you are. We are on the same side. Please do not attempt to hold us responsible for issues that arise relating to the details of the insurance policy you have. We do not have control over what you and perhaps your employer have chosen for insurance coverage.

As always, we appreciate when you choose us to provide you with your healthcare needs.

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