Toddler blood work bill way higher than expected…what are my options?

Claims/Providers Forum
1

I took my child for blood work as recommended by the doctor due to possible exposure. We went to the Children’s Hospital, which is where the pediatrician referred us. I got the bill, and it’s way more than the estimate shown through my insurance app. I called the insurance company, and they said this is because the labs were done at the hospital as outpatient work. It’s in-network and listed as a Tier 1 provider. Any advice on what to do next? Do I have any options besides just paying the bill?

State: CO
Approximate income: 110k

2

Thanks for posting. As a reminder, if there’s a medical emergency, call 911. Also, including your age, state, and income can help others provide more specific advice. Having your EOB (explanation of benefits) handy is useful too.

3

Unfortunately, when you have labs done at a hospital, the costs are higher compared to an outpatient provider like Quest or LabCorp. Depending on your insurance plan, you may need to pay a deductible and coinsurance for lab work. Check if the hospital offers financial assistance programs.

4

@Arin
Yeah, that’s how my plan works.

5

Koa said:
@Arin
Yeah, that’s how my plan works.

$550 isn’t too bad. I thought you were talking about thousands. If you’re making six figures, is $550 really that big of an issue?

6

In my experience, Quest is usually about a third of the cost compared to the local hospital for lab work.

7

Lucypiper said:
In my experience, Quest is usually about a third of the cost compared to the local hospital for lab work.

So in the future, I should tell the doctor where I want the labs sent?

8

@Koa
No, you should get the labs done at an outpatient lab, not the hospital. The hospital is usually the most expensive option. In your case, since it was done at an in-network hospital, that’s why it’s more expensive.

9

@Porter
Depends on the child’s age. I went through Children’s Hospital because my kid didn’t even notice the blood draw thanks to their specialists. It was worth the cost for us.

10

@Porter
How is the average person supposed to know this stuff?

11

Grier said:
@Porter
How is the average person supposed to know this stuff?

I’ve been in healthcare for 25 years, and even I learned about the cost difference between hospitals and labs like Quest after seeing patient complaints. It’s not something that’s obvious or easy to find out.

12

@Lucypiper
It’s designed to be confusing. The healthcare system isn’t very transparent, so most people have no idea what they’re signing up for or how much they’ll pay.

13

Grier said:
@Porter
How is the average person supposed to know this stuff?

It’s in your insurance terms, but most people don’t take the time to read the fine print. It’s important to understand your policy because it can make a huge difference in your bills.

14

@Porter
Thanks for the advice. I didn’t have the option to do it at my doctor’s office, so I didn’t realize I had other choices.

15

Koa said:
@Porter
Thanks for the advice. I didn’t have the option to do it at my doctor’s office, so I didn’t realize I had other choices.

Depending on your child’s age, you might not have had a choice. Some labs won’t do blood draws on very young children.

16

Koa said:
@Porter
Thanks for the advice. I didn’t have the option to do it at my doctor’s office, so I didn’t realize I had other choices.

For specialized or urgent tests, it’s common to go to the hospital. It’s not always realistic to choose an outpatient lab for immediate needs.

17

@Zev
That could be the case here if the doctor needed the labs done quickly for potential exposure. It’s not always something you can plan around.

18

Arin said:
@Zev
That could be the case here if the doctor needed the labs done quickly for potential exposure. It’s not always something you can plan around.

Exactly, sometimes you don’t have the luxury of choosing a cheaper lab, especially if the hospital needs the results right away.

19

Koa said:
@Porter
Thanks for the advice. I didn’t have the option to do it at my doctor’s office, so I didn’t realize I had other choices.

Even if the doctor’s office did the blood draw, they might still send it to the hospital for processing, and you’d be in the same situation.

20

@Koa
Yeah, unfortunately, it’s one more thing to keep track of when you’re already worried about your child.