By MATTHEW HOLT
To hitch in the fun I am having with Blue Shield of California & Brown & Toland Physicians IPA being unable to tell me why I have a $34.94 bill for lab work (see picture) that ought to both be covered as preventable under the ACA, or have co-pay of $50 (see picture of the BS of CA screenshot for the $50), I referred to as Labcorp.
After 6 minutes I acquired a really confused individual. BTW there’s NO option to talk with Labcorp on the web site, and for those who put your bill quantity into their IVR system there’s NO option to get a human. The one means to do this is to hold up and begin once more, NOT put in your bill quantity and hit 0. Then wait on maintain with muzak to get a human. They then ask your DOB and cellphone quantity. The decision heart is within the Philippines BTW.
I defined that I needed info on which check was not coated underneath the ACA. Brown and Toland/Blue Defend’s EOB says I’ve a $0 co-pay (see picture).
The Labcorp rep informed me that of the 5 checks performed (with CPT code and value), 3 weren’t coated. The Lipid (85027 $107.10), the A1C (80061 – $81.90) Uric Acid (84550 $43.05). 2 of these 3 clearly are coated underneath the ACA. The Uric Acid one will not be in keeping with my studying of the CMS website. Labcorp submitted that invoice to Blue Defend. The rep constantly informed me the declare was despatched to Blue Cross Blue Defend of CA, which doesn’t exist.
At that time — quarter-hour in — the decision dropped. I don’t know if they only hung up however that they had requested for my cellphone quantity. They didn’t name me again.
However I’m a ache within the ass, and I referred to as them again. After roughly 4 minutes on maintain, I acquired one other rep. She informed me ALL of the CPT codes/lab checks have been topic to copay. She informed me that Blue Defend (NOT Brown & Toland Physicians) has bundled all of those codes and there’s a co pay for all of them. Which is what the invoice says.
So the one factor I can do is to ship an e mail with the screenshot of the EOB, which is from the IPA not Blue Defend. So I did that and should get a response in 3-5 enterprise days.
I do know you might be on tenterhooks. Let’s see what occurs subsequent however the full absence of something resembling shopper transparency or entry to the related info makes a mockery of all the things Paul Markovich says on stage.
Matthew Holt is the founder and writer of THCB
