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nitrofate06 | Why could be LabCorp be denying our insurance? |
So back in March I found out that I was pregnant. My husband and I didn't have insurance then and was paying $500 out of pocket every monthly doctor's visit until we finally got insurance with Blue Cross Blue Shield 4 months later in July because of my husband's assistant manager position at Papa John's.
Unfortunately the $500 we were paying only covered the visit itself, not any of the lab work we had done the same day of the visit (urine sample, blood, blah blah blah) and that was a separate bill from LabCorp that cost just as much. Our hospital told us that once we got insurance all of the money that we had already payed out of pocket ( about $1,500-$2,000) would be reimbursed to us after if we owed LabCorp or the hospital any more money from what our insurance would cover and take out.
Since July we have not gotten a bill from LabCorp or the hospital, only statements saying THIS IS NOT A BILL and showing us what our insurance covered and what we owed afterwards which has been $0 because of all the money we payed out of pocket before we had insurance.
NOW I have gotten a bill from LabCorp for $501 and our insurance has covered NONE of this bill (again, I haven't received a bill fromn them since July) because at the top it says "your insurance company has denied any payments because the patient cannot be identified or payments were not eligible on the date of the last appointment".
Ok, well first of all I can be identified because my name is the same and hasn't changed and I don't see why the payment wasn't "eligible on that date of appointment" because my husband has been paying $160 since July so we can have insurance so they better pay what they normally cover!
I am going to call about it tomorrow but since everything is closed at this time and out of frustration I am just curious as to why this could be? I am 22 and just moved into a new apartment so we are kinda low on money and this bill is pissing me off to no end because I don't understand why our insurance company is denying payments! |
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sarah314
 |
Your insurance will not cover any services that took place before your policy began. Period. (You wouldn't expect your auto insurance to cover an accident that happened before the policy began, would you? Same principle applies with health insurance.)
As far as what the hospital told you, it sounds like you misunderstood things. I would bet money that this is the situation:
You didn't have insurance when you first got pregnant. So, the hospital set you up on a payment plan for all of your future prenatal/birth expenses as an uninsured, cash paying patient. This means that you were pre-paying for the delivery itself.
If you got insurance after setting up that payment plan, then of course the hospital would have to review your account. You were paying in advance for childbirth expenses...now you have insurance, and your insurance company will be liable for some of the stuff you already paid for.
This does NOT mean that your insurer will cover services that were performed before the policy began. It means that you'll get a refund for stuff you paid for in advance, because insurance will pay towards some of that. You still owe the money for anything that happened before your policy began. |
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Mitch
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Insurance pays for conditions and treatments that occur AFTER you get the coverage, not BEFORE. If it worked the other way around, nobody would ever need to buy insurance until they need it. |
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Lori S
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Sounds like there may be a clerical error. Which is common. Contact the lab, hospital and your insurance company to be sure that the info they have is correct.
The insurance will only cover services received after your effective date. The OB doctor usually will bill for services after you deliver and only those charges after your effective date will be considered covered. |
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Anna E
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Is this bill that is being denied from LabCorp from before you had insurance. I don't know of many health insurance companies that pay for expenses incurred before the coverage started. The statements you received stating "this is not a bill" is because they were waiting for the insurance company to make a decision on payment. Also, Blue Cross Blue Shield is one of the worst companies as far as paying on time and denying coverage. I had it years ago when I had my daughter and the hospital actually wanted me to pay up front and be reimbursed by BCBS. Fortunately, I didn't have to because they only administered my health plan. But, the hospital had failed to have me sign a form BCBS needed, and rather than let me know, six months later, they just denied my entire bill. When I called them, they told me that I just needed to sign that form. It was a nightmare. I'm sorry your husband doesn't have different insurance available. |
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v b
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The insurance covers you only while your husband is on the plan. It cannot retroactively cover expenses incurred before he got onto the insurance plan. |
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mbrcatz
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OK, there was clearly some misunderstanding on the adice you got from the hospital. Insurance doesn't pay any bills, before it goes into effect. So, those statements meant that LabCorp TRIED to bill your insurance. Then, it got denied, because you didn't have any coverage in place at the time the tests were done.
You need to compare two dates: 1. The date the coverage went into effect (which might NOT have been July, even though money was taken from his check in July!) and 2. the date the service was rendered. If the service was rendered AFTER the date coverage started, have LabCorp resubmit the bill. If it was BEFORE coverage started, it's not going to be covered, sorry!!
It can take insurance companies up to six weeks to enter your information into their computer, to show you were covered.
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