Little things

There are so many little things about which I have an opinion and have contemplated using as a blog topic. One showed up in the mail yesterday. We got a bill from Lab Corp. for $10.02.

My wife and I do attempt to make regular trips to our dentist and/or physician for check ups. My wife recently had her yearly physical. Our health insurance is set up so that we have a $15 co-pay at the time of the visit. All other expenses are supposed to be covered 100%.

Last week or so, I got a benefits explanation. It showed that the insurance company paid for all but $10.02 of the routine lab work. My coverage says 100% beyond the co-pay. This is not the first time I have had this problem.

Previously, I had a dental appointment. My dentist is supposed to have a "negotiated rate" for services rendered. They billed my insurance company a particular amount, and the insurance company that was supposed to pay 100% did not pay the full amount. Their explanation was that they pay 100% of what they feel is a "usual and customary" fee. If my doctor bills a penny over what they feel is the appropriate amount, they refuse to pay any extra and stick me with the remainder.

That seems to be the problem with this small bill. Ten bucks won't hurt us at all. That is less than a trip for the both of us to Subway. But still, it is the principle that I am paying for coverage that states a $15 co-pay, not a $25.02 copay.

The lab company is billing us directly. We did not contract for their services. We contracted the physician's services. The physician in turn decides what lab company to use. The insurance company has negotiated rates with the physician. The insurance company has an understanding with the doctor, we have an understanding with the insurance company. Any differences in price should be disclosed up front and the party responsible revealed ahead of time. Our costs were given to us ahead of time as $15. Period.

Either the negotiated rates are too low or the lab company or doctor (whichever is the case) is charging too much. In this case, the lab company charges a ten spot too much or the insurance company is ten bucks too cheap.

Either way, it is just plain immoral and inappropriate to spring a bill on a customer for services not directly contracted. If I can't trust a company to handle the small things like this properly, what will they do for huge bills should we have a real issue?