I’m wondering if I have reason to be pissed off at my insurance company or not. Here’s the deal: my insurance provider states that for in-office lab work I pay a $30 copay. For out-of-office lab work I pay 20% of my co-insurance.
So, for example, a mammogram is offered annually for a $30 copay. IF it is done in-office. But do any doctors have mammogram machines and techs in their office anymore? Because my gyno doesn’t and would have sent me to the lab across the parking lot at the hospital in the medical complex. Where my “$30” mammogram becomes a $220 mammogram because now it’s out-of-office.
Similarly with some blood work my psychiatrist wants done… She doesn’t have a lab in her office, so she’d have to send me to a lab and therefore I’d have to pay 20% coinsurance.
Out of curiousity, I called my internist to see if I have her office draw the blood instead, could I get it done for the $30 copay. Apparently not, since my blood would be sent out to a lab.
But do any docs standardly have labs in their offices anymore?
IOW, sure my insurance can say “we offer you all these great services at your copay!” (If they’re in-office, except in practice it’s impossible to get services in-office because nobody does that anymore! Hell, we could say we’d pay YOU if you use in-office lab work plus a pony! Good luck trying to find an in-office lab, though!)
Am I right to be pissed? Are there doctor’s offices that have labs/mammogram machines in-office, I just need to find one?
(BTW - I’m in a major metropolitan area if it makes any difference.)
Some doctors have offices in hospitals. I wonder if that would be “in house”? I can’t think of any doctor who would do his/her own blood work. They would always send it out, unless they are part of a big clinic or a hospital. Then it sounds like your insurer is using the policy to make a sale (with cheap procedures) but then never having to pay for them.
In my experience certain doctors perform a limited number of lab tests in their office. Urinalysis, strep cultures, maybe a blood count. Those tests would have the 30 dollar copay. With all the expense, restrictions and contracting involved with running a full lab, I doubt it would be profitable or practical to do so.
Thanks. That’s pretty much what I figured. I just didn’t want to get all up on my high horse of righteous indignation before I confirmed my assumptions.
What is frustrating, of course, is it doesn’t matter if we somehow get our policy written next year to include lab work for the copay, because I assume that means BCBS will just screw us on the premium amounts.
Many doctors don’t actually have the lab in their office, in spite of the fact that they bill the work out. Speaking from experience, having once worked in the billing department for the country’s largest medical laboratory.