Recently we have been doing some medical procedures related to fertility treatment. We went into it with 2 options: 1) Have the procedure as normal, through my insurance 2) Go through a "study" procedure in which everything is covered for $3,000
We decided on #1, because our out of pocket max was $3,000, and we were already $1,000 in. So we figured it didn't make sense to pay $3k when we could just pay $2k. We asked the financial personal at the office and they agreed. Apparently they were full of it..
So basically on the day of the procedure, they oblige to tell us that the laboratory costs will be out of network for us. We did not know this going into the procedure at all. We're talking 1.5+ months of going in for visits, ultrasounds, status reports, etc... and we we're under the impression from our first appointment with the financial group that everything was covered in-network. That was what we were told.
So my insurance covered it to a certain degree since I have PPO. I believe they covered 70%, however since it was out of network I had to fill up the out of network deductible first, and the insurance denied a couple smaller items. All told, we're being billed for about $3.5k. Ouch. Now we wish we went with #2.
1) Do I have any recourse on this? Applicable laws that may help (State of TX), or organizations/arbitration that can help with this kind of issue? 2) Can I leverage them writing off most or part of this? I don't have any experience here, but have heard from reading around that plenty of places will do anything to get debt off the books. With other debts, this is really taking a toll on us, plus I have to deal with a spouse that's pissed off about the whole ordeal. 3) Anyone else have any advice related to these types of issues with fertility treatment procedures?
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Senior Member - 10K
posted: Sep. 9, 2016 @ 8:30a
1) Not really, you are responsible for double / triple checking all coverages. 2) You can ask them for a discount / payment plan / or just don't pay (And lose your credit raiting) 3) Sorry, I suspect that #2 would've been a big pain in the rear, and you would've wished that you went with #1.
PS you put #1 twice, I think the 2nd one 'Ouch Now we wish we went with #1' should be #2
Senior Member - 1K
posted: Sep. 9, 2016 @ 8:46a
Usually they give you a choice of where (Quest or Lab Corp) to send the lab work. You need to make sure you tell them the one that is covered by your insurance company.
Senior Member - 2K
posted: Sep. 9, 2016 @ 12:32p
Stop trying to destroy the earth.
posted: Sep. 9, 2016 @ 1:55p
Depends on what kind of labs we are talking about... is the embryologist work? Or just blood tests and all that?
Most places have in-house embryologists these days.... you definitely should have been informed, but you also should have checked.
Little recourse legally, it is on you to check -- you probably even signed something that says so.
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