By MATTHEW HOLT
Navigating the Labcorp and Blue Shield of California Billing Maze
I find myself once again entangled in a billing conundrum with Labcorp and Blue Shield of California, specifically regarding an enigmatic $34 copay. For those interested in the backstory, you can catch up on the details by clicking here.
The Final Notice Dilemma
This past weekend, I received a final notice from Labcorp regarding my bill—one that they were unable to clarify without requesting information they already possessed.
A Call to customer Service
I reached out to labcorp’s customer service team based in the Philippines. The representative was courteous but informed me that there was a requirement for documentation from my ordering physician due to insurance protocols. When I inquired about what specific documentation was needed, she mentioned it was a letter detailing updated codes. This seemed illogical since I had already received those codes from a representative at Brown & Toland Physicians; surely they must have been submitted alongside Labcorp’s claim! At this point, I’m hesitant to involve my doctor’s office further (watch out though, Andrew Diamond!). So for now, I’ll let that issue rest.
The EOB Confusion
Labcorp indicated they had received an Description of Benefits (EOB) from my PPO plan with blue shield of California—despite being an HMO member. Interestingly enough, this EOB contained my correct member number but did not originate from Brown & Toland Physicians as I had specifically asked. The document stated that my copay amounted to $34.94; though, Labcorp could not link this amount to any one of the five lab tests performed—all of which should be considered preventative under ACA guidelines—though perhaps one might not qualify.
A Second Submission and Further Inquiries
I provided them with another copy of the EOB after sending it five days prior just to ensure clarity.
Diving Deeper into blue Shield’s Communication
the next step involves contacting Blue Shield directly about their communication with Labcorp stating that my copay is $34.94 when their own records indicate it should be $0! Additionally, it’s worth noting that according to my plan details, standard lab copays are set at $50—not $34.94!
A Grievance Opens Up New Channels
Upon logging into my member portal on Blue Shield’s website, I discovered a message indicating they had initiated a customer grievance on my behalf! Following instructions in their correspondence led me to call their grievance hotline where I learned there is no chat option available for consumers—a stark contrast compared to providers who have access for grievances.
An Efficient Resolution Process?
I anticipated long hold times but was pleasantly surprised when Susie—a helpful representative—answered within just 15 minutes after verifying my identity.
Status Updates on My Grievances
Susie informed me there are two separate grievances filed: one concerning an appeal related to the lab test results and another addressing procedural complaints—which likely stemmed from outreach by someone in their executive office who contacted me previously. While she could only provide updates on the appeal status at this time, she assured me that an appeal coordinator would follow up regarding the complaint within 30 days—and even provided me with direct contact information! I’ve since sent them an email…let’s see how things unfold!