Venipuncture as additional billing item on office visits

I never go out of network because the prices are just too outrageous. If I go to a lab recommended by the doc then I don't have to pay anything. I have Blue Care Network of Southeastern Michigan.

^{@--->--SHERRY--<---@}

^{Left sided Uc -'92 - Colazal, Canasa, 6mp, Prilosec, Biotin, Forvia}

^{Secondary Reynauds Syndrome - '04 - Norvasc}

^{Fibromyalgia - '06}

^{PLEASE HELP HEALINGWELL CONTINUE TO HELP OTHERS BY CLICKING HERE: DONATE}

^{@--->--Moderator for Allergies/Asthma and Co-moderator for UC--<---@}

http://www.myspace.com/82595818

ks1905

Veteran Member

Joined : Sep 2005

Posts : 5291

Posted 9/18/2007 4:48 AM (GMT -7)

I'm in NY; I stay in Network for my blood work..... going out of Network can be a nightmare. I hate insurance companies!!!!!!!!!!!!!!!!!!!!! When I stay in network and just go for regular blood work I do not have to pay at all ($0 co-pay). Blue Cross & blue Shield.

--Keith

DX'd with Pan-Colitis June 2005

Current Status: Flaring since May

Current Meds: 6-mp & Colocort

Supplements: None

Irish_Mom

Regular Member

Joined : Apr 2007

Posts : 385

Posted 9/18/2007 8:18 AM (GMT -7)

Old Hat

This thread caught my eye since I'm a coder/biller for a doctor's office. It seems to be an insurance to insurance thing, but I have noticed that the majority of times this happens that the patient has a union-based insurance. We have a lot of patients with UFCW (United Food and Commercial Workers) that is handled by Blue Cross, and they don't pay for venipunctures.

Breast Cancer at 36. Diagnosed in 2000. Bilateral mastectomy with reconstruction.

Total colectomy in September for colonic inertia.

Son diagnosed with Crohn's at 17 (now 20). Taking Asacol and 6MP with Prednisone and Rowasa added during flareups.

Old Hat

Veteran Member

Joined : Feb 2007

Posts : 5198

Posted 9/18/2007 9:21 AM (GMT -7)

Thanks to all who replied so far-- I also try to stay in network, BUT my IBD subspecialist gastro does not participate in any insurance plans, typical of these doctors in my area, bills venipuncture as a separate charge, and wants me to have the bloods tested 3 times annually. I get out of one blood test annually because my in-network internist does it-- so that leaves me with 2 uncovered by insurance. The unions are probably right to oppose paying for it as an extra charge; now if only we patients affected could get the doctor to stop billing it that way! It annoys me especially because I read last yr in major newspaper that some doctors, hospitals, & labs are profiting handsomely from research use of the blood that we give for routine medical tests. If they are profiting, then they certainly should not be charging us for venipuncture, kinda like getting a gift & asking the giver to pay you for taking it, besides.

/ Old Hat (nearly 30 yrs with left-sided UC; currently on 3 X 3 Colazal daily for July flare in descending colon; should be back in remission soon)

ks1905

Veteran Member

Joined : Sep 2005

Posts : 5291

Posted 9/18/2007 1:28 PM (GMT -7)

My GI doesn't care where I get my blood work done, just as long as I get it done. He is also 60 miles away from me so I am not going to get blood regular blood work done at his office. I would just tell your GI that you want to have your blood work done in Network.

--Keith

DX'd with Pan-Colitis June 2005

Current Status: Flaring since May

Current Meds: 6-mp & Colocort

Supplements: None

ledaebel

Regular Member

Joined : Jul 2006

Posts : 339

Posted 9/18/2007 7:02 PM (GMT -7)

My insurance pays for all my medical bills in the system. You have to be very careful when having labs drawn in an office because they might ship the specimens to a lab out of mnetwork. In the hosital where I work they have always charged extra for venipuncture. I worry about those people who do not have insurance or have minimal insurance.

^LINDA

Prescriptions: Lialda (on a study) ~~asacol~~, hycosamine, protonix, synthroid, zyrtec, avalide, nasocort, Miacalcin spray and Trazadone for sleep.

OTCs: Usana multivitamins and multiminerals, Usana Procosa, Usana Mega Antioxidants, Omega 3, Vit. E, Healthy trinity probiotics, Calcium Citrate

Old Hat

Veteran Member

Joined : Feb 2007

Posts : 5198

Posted 9/19/2007 9:53 AM (GMT -7)

Keith-- I refused blood draw on most recent office visit to gastro. I was then charged the venipuncture amount in the billing slot beside "occult blood feces screen" which has always been left blank. (As if "occult blood" test was always considered part of basic office visit charge). I know it was not the biller's doing because she 1st read over the form my gastro had filled in, then she got up from her desk & went to doublecheck with gastro before totalling charge for that office visit. So the total charge equalled what it would have been IF I had consented to the blood draw. Let me just add that the additional charge brought the total over $300 for a 10 to 15-minute exam/consultation. This is not spare change for me! THANKS AGAIN, ALL for contributing your thoughts/experiences with the venipuncture billing issue. I feel bad about this-- like my gastro/patient relationship all comes down to the bottom line. I guess we should figure as much when the doctor declines to participate in any insurance plans. / Old Hat (nearly 30 yrs with left-sided UC; currently on 3 X 3 Colazal daily for July flare in descending colon; should be back in remission soon)

dakotagirl

Veteran Member

Joined : Apr 2006

Posts : 3402

Posted 9/19/2007 5:14 PM (GMT -7)

Interesting that your doctor doesn't participate in ANY plans! Then decides to charge an arm AND a leg for an office visit! Sounds like highway robbery to me :(

However, having the right medical team is SO important!

I wonder, if you questioned the charge, would they remove it?

Pan-colitis and GERD diagnosed May 2003

Asacol 12 per day, Azathioprine 75mg, Rowasa and Canasa as needed

Aciphex, Effexor XR, BCP, Rhinocort nasal spray

Culturelle, Biotin, Folic Acid, Forvia, Calcium, and B12

Osteopenia (hip and spine) from prednisone use. Started Azathioprine because I was steroid dependent.

Co-Mod for the UC forum

Keep HealingWell running smoothly: www.healingwell.com/donate

ks1905

Veteran Member

Joined : Sep 2005

Posts : 5291

Posted 9/19/2007 6:54 PM (GMT -7)

I do not know how they can charge you for something that they didn't perform; is that legal?

I guess that I got a really good deal today when I was at my GI's office for a 30 minute visit, he only charged me $215. He doesn't take insurance either.

--Keith

DX'd with Pan-Colitis June 2005

Current Status: Flaring since May

Current Meds: 6-mp & Colocort

Supplements: None

Pitz

Regular Member

Joined : Jul 2007

Posts : 84

Posted 9/19/2007 8:23 PM (GMT -7)

I'm currently being monitored for 3 different meds by 3 different doctors (6-MP, Coumadin and Hydrea). I was having some done at my hematologist's office and the rest at my PCP's office. I wouldn't be charged for the CBC at either office. However, when having my INR tested for the proper Coumadin dose, my PCP's office was charging for an office visit (which resulted in a copay for me) when I wouldn't even see the doctor, just have my blood drawn. They told me it was because the doctor had to check the results, determine what Coumadin dose I should be on, and then someone would call me with that dose. Hello!!! The doctor has to look at the results of EVERY lab test! There are times when I have to have this done every week depending on the results. They never charged me a copay for CBCs, though. My hematologist's office never charges me for any lab work unless I actually see the doctor.

The next time I saw my PCP, I talked to him about it and he agreed that it didn't make sense for me since I needed it so often and they agreed that I would only be charged once per month, no matter how many times I needed my INR checked. He said it didn't make sense for me to be charged each time since I needed it so often. However, I've since decided to get all my labs done at the hematologist's office, which my PCP agreed to. Things just got too confusing trying to remember what to have tested, and where and how often. It's making things so much easier (and cheaper for me, too!). They just fax all results to both my GI and my PCP.

Ulcerative Pancolitis (dx'd 6/2002)

Pentasa (4gm/day)

6-MP (100mg/day)

Prednisone (currently 10mg/day & tapering by 2.5 every 7-10 days)

various meds for other conditions

ks1905

Veteran Member

Joined : Sep 2005

Posts : 5291

Posted 9/19/2007 8:31 PM (GMT -7)

Pitz--

Old Hat didn't have any blood drawn and was still charged for it. You had blood drawn and they charged for the doctor to look at the results, I can (sort of) understand the charge. Old Hat's Charge is baffling.

--Keith

DX'd with Pan-Colitis June 2005

Current Status: Flaring since May

Current Meds: 6-mp & Colocort

Supplements: None

Post Edited (ks1905) : 9/19/2007 9:31:08 PM (GMT-6)

Pitz

Regular Member

Joined : Jul 2007

Posts : 84

Posted 9/20/2007 6:49 AM (GMT -7)

But my problem is that if they were going to charge for one, they should charge for them all. The INR is the only lab work I ever had a copay for. I mean, the doctor has to look at results of every lab test, anyway, so their reasoning didn't make sense to me. All my lab draws require a call back from someone to adjust my medication. I never see the doctor when I have lab work - I'm only there a max of five minutes.

Ulcerative Pancolitis (dx'd 6/2002)

Pentasa (4gm/day)

6-MP (100mg/day)

Prednisone (currently 10mg/day & tapering by 2.5 every 7-10 days)

various meds for other conditions

Old Hat

Veteran Member

Joined : Feb 2007

Posts : 5198

Posted 9/20/2007 8:34 AM (GMT -7)

I get your point, Pitz-- & am glad to read that your PCP "saw the light". Unfortunately, DakotaGirl, a $300 office visit fee for senior specialist in my area is not unusual-- I guess we patients have to compensate for 401K retirement plans! (Ha!) So, yes, Keith-- you did get a "bargain". It could be that my gastro is burning out after a couple decades treating IBD & wants to take the patient bucks + switch to full-time teaching/research. That gives opportunities to consult on the most complicated IBD cases, which are likely more interesting to veteran specialists than patients like me who respond to existing meds. / Old Hat (nearly 30 yrs with left-sided UC; currently on 6 Colazal daily for July flare in descending colon; should be back in remission soon)

✚ New Topic ✚ Reply

Forum Information

Currently it is Monday, December 10, 2018 9:18 PM (GMT -7)
There are a total of 3,026,504 posts in 331,024 threads.
View Active Topics

Venipuncture as additional billing item on office visits

Forum Information

Who's Online