Patients surprised by large lab bills related to contract dispute

KING 5's Danielle Leigh reports.

Following a KING 5 report in May about a woman forced to pay a chunk of her lab bill out of pocket because the medical lab and her insurance company were temporarily in a contract dispute, KING 5 heard from roughly two dozen others who complained they too had received surprising bills when Cellnetix temporarily fell out of network with Premera.

"They want $608.62. It looks like," said Bob Foulds as he read a medical bill he received months after having a colonoscopy.

"It was all supposed to be free," Foulds said.

Foulds had met his yearly out-of-pocket maximum and checked to make sure the procedure was covered by his insurance.

He had no idea that even though the doctor and the facility he visited had a contract with his insurance company, Premera, the lab that tested the samples from his procedure did not.

"I hear all these horror stories where the doctor is in network and the anesthesiologist isn't and you have to pay all these fees," Foulds said.

Now he was living his own version of that horror story, and he wasn't alone.

A viewer named Sarah emailed KING 5 about a Cellnetix bill for roughly $200 following a cervical test.

Lillian complained about a more than $800 bill for a bone marrow test, and a liver test cost LouAnn more than $700.

When patients receive services from a provider not covered by their insurance the bills are often higher and the patients are left to pay the difference.

"And I got a big bill because of that," Foulds said.

"We want to keep them out of that situation," said Premera spokesperson Beth Johnson.

When KING 5 talked to Johnson back in May, she revealed Premera had protected some people in certain isolated regions from unexpected bills during their dispute with Cellnetix, but not in Seattle.

"In markets where there are alternatives we chose to reimburse at a standard rate. We did identify areas where our customers had no alternative access and we chose to pay them at 100 percent of the bill charges in order to keep the member protected from the balance bill," Johnson said.

Now KING 5 wanted to know if Premera and Cellnetix could reach a similar agreement for everyone else.

After all, none of the patients who emailed us had any idea they needed to be looking for alternative labs until it was too late.

"It doesn't seem fair," Foulds said.

Both Cellnetix and Premera agreed to help.  Company spokespersons asked for a list of everyone KING 5 had heard from and in an email promised to, "resolve any outstanding bills."

Bob said he's grateful for the refund and called it one less thing to worry about.

Cellnetix and Premera have now reached a new agreement that will protect their customers from these surprising.

Cellnetix said customers with billing concerns related to out of network charges during the Premera-Cellnetix dispute, should email Shannon Hall at shall@cellnetix.com.

Those with concerns can also file a complaint with the Washington Office of the Insurance Commissioner and the Office of the Attorney General.

This circumstance is a good reminder to find out every person above and beyond your doctor who might be involved in your care and determine whether they are in your insurance network before having a procedure.

Copyright 2016 KING


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