Lab Costs - What Insurance Pays to Labs.

[Saul]

I was at the blood lab (labcorp) recently and due to some insurance changes, the lab work was not covered by insurance but I found out what I believe Blue Cross Blue Shield pays for lab work - at least what it says. Interesting how low it is. Also interesting what a good deal DiscountedLabs.com is for TT and FT. DiscountedLabs.com is the same price for TT and FT as what it appears Blue Cross - a huge insurance company - pays (or in this case does not pay). Maybe I am reading it wrong.

 

[Vince Carter]

I dont have one in front of me to say it with specifics but my insurance covers labs 100%, no deductible/no copay and the charges that I see are outrageous. Depending on what I've had done it runs in to the thousands of dollars and you take that and compare it to discountedlabs and it's appalling the difference.

 

[Deleted member 16042]

Yep the whole system of outrageous billing charges and negotiated payment rates by insurance companies is one of the most corrupt industry scams in history.

 

[HealthMan]

The insurance company itself pays way lower rates. I remember one case that i had a MRI done and the insurance company said they would not pay because I didn’t get pre-approval and the hospital sent me a bill for almost 5k (this was 8 years ago). Later i found out the insurance company rate was a little over 800. But me stupid patient was being asked to pay over 5x more. I argued with the hospital about the difference and told them i was willing to pay the 800 not the 5k. They didn’t accept. At the end the insurance company end up paying. Such a joke

 

[Saul]

I dont have one in front of me to say it with specifics but my insurance covers labs 100%, no deductible/no copay and the charges that I see are outrageous. Depending on what I've had done it runs in to the thousands of dollars and you take that and compare it to discountedlabs and it's appalling the difference.

That is what I had happen in the past. I saw the prices and was shocked at how much it cost, thinking what a great deal insurance is, then saw what insurance paid. Huge difference. I get and accept there is a difference between retail and wholesale prices. I am of the opinion that not every aspect of life should be profit driven. The upside here is that even though these are not covered by insurance, I get the insurance prices, making the cost very reasonable, albeit it the insurance costs a huge amount and now does not even cover preventative labs (the CBC labs).

It would be interesting to know whether the hospitals/labs would make more money or less if they offered these prices to everyone and not just those with insurance.

 

[Vince Carter]

Ive held bills in my hand from one blood draw was kind of a lot of tests but adding them up I was in the $3K range...

 

[Sean Mosher]

It's very strange indeed that you can purchase a product ("labwork") from a doctor's visit and have no idea what the cost is of what you just bought until months later.
Then you get an Estimation of Benefits (EOB) stating you "may " owe such and such to your provider and then you may or may not get a bill further down the road.
Insane system for sure and often very crooked.