When will prevent preventive measures not be prevented? Let's get Labcorp to join! – Healthcare Blog

Matthew Holt

To join me in the fun of having fun with Blue Shield from California and Brown and Toland’s Dr. Blue Shield, the IPA can’t tell me why I have a $34.94 lab work bill (see image) that should be preventable under the ACA, either see $50 co-payment, or have a $50 copy (Image for $50 Ca Screenshot).

After 6 minutes, I got a very confused person. By the way, it is impossible to communicate with Labcorp on the website, and if the invoice number is placed into its IVR system, humans cannot be obtained. The only way to do this is to hang up and start over, don't put in the invoice number and hit 0. Then keep the human body with Muzak and wait for the human. They then ask for your DOB and phone number. The call center is located in the Philippines.

I explained that I want information on what tests are not covered by the ACA. Brown and Toland/Blue Shield's EOB say I have a $0 copay (see image).

Labcorp Rep tells me that in the 5 tests completed (with CPT code and price), 3 tests are not covered. Lipid (85027 $107.10), A1C (80061 – $81.90) Uric acid (84550 $43.05). 2 of these 3 are clearly covered under the ACA. According to my reading of the CMS website, uric acid may not be. Labcorp submitted the bill to Blue Shield. Delegates have always told me that the claim has been sent to the Blue Cross Blue Shield of CA, which does not exist.

Then – 15 minutes – the call dropped. I don't know if they just hung up the phone, but they asked for my phone number. They didn't call me back.

But I was in pain with my butt and I called them back. About 4 minutes later, I got another rep. She told me that all CPT code/lab tests require COPAY. She told me that Blue Shield (not Dr. Brown & Toland) bundles all this code together and that all of this code is paid for all code. What the bill says.

So the only thing I can do is send an email with EOB screenshots, which is from the IPA rather than the Blue Shield. So I did it and I might get a response within 3-5 working days.

I know you're on tenterhooks. Let's see what happens next, but there's absolutely no content like consumer transparency or access to relevant information that makes Paul Markovich laugh at everything he says on stage.

Matthew Holt is the founder and publisher of THCB