Patients are grappling with unexpected lab bills that can occur when tests are performed by out-of-network lab facilities, according to a Bloomberg report.
Five things to know:
1. Patient payments are a focus for lab companies amid the rise in popularity of high-deductible health plans.
2. If samples are collected remotely and not at a lab company's standalone facility, patients may not completely understand the payment process, according to the report. For instance, samples may be collected at a physician's office, but the patient may not know samples are sent to an out-of-network lab facility. This can result in unexpected bills from the lab company.
3. Mark Guinan, executive vice president and CFO of lab company Quest Diagnostics, told Bloomberg a majority of the company's customers do not have contact with Quest until the bill arrives.
"A lot of times the reaction we might get is, 'Who's Quest? I never went to Quest,'" he said.
4. There are physicians who try to ensure testing is covered by the patient's insurance and sent to an in-network lab facility, according to the report. However, Martin Makary, MD, a professor of surgery at Baltimore-based Johns Hopkins Medicine, told Bloomberg: "There's no formal training for some of this stuff,'' and "by and large, patients do not have navigators."
5. Patients are increasingly frustrated at these unexpected lab bills, according to the report. One patient cited by Bloomberg, Charles Bulson, 44, took his issue to Congress after he was charged more than $1,000 for blood tests his health plan didn't cover. At issue was an incorrect code. Mr. Bulson tried to resolve the issue with testing firm Laboratory Corp. of America Holdings, insurer Blue Cross Blue Shield and his New York-based physician's office, but the bill amount was ultimately sent to collections. Mr. Bulson contacted Sen. Charles Schumer, D-N.Y., last year, and didn't heard from the collections agency after the case made it to New York regulators.
Mr. Bulson didn't blame any one party, telling Bloomberg: "It's this entire medical system that needs to be picked up, thrown down into a thousand pieces, and put back together again."
Access Bloomberg's full report here.
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