Aetna denied one line item – what would you do?

Hi everyone. Looking to get your advice on what you'd do in a situation I am facing.

Situation: I went in for my annual physical last month. As part of the annual lab tests, my doctor asked if I want to do the STI testing as well. I said "Yes, sure" given I am active. A month later, I got a bill in the mail for $176 from the lab testing company. Apparently, the line item specifically for chlamydia testing was denied by Aetna, my insurance company. Note – both the physician (my primary care provider) and the lab company that ran the tests are in-network. I inquired as to why the chlamydia test was denied and apparently it's because Aetna does not cover that for asymptomatic males. I had no reasonable way of knowing this before hand though because the specifics of what procedures/tests are or are not covered in different situations are not available to me as an average patient. My PCP just asked generally if I want STI testing done, I said yes given I typically get this done every year and all my previous insurance companies have generally covered it under preventive care.

By the way, if Aetna did cover the claim, I saw on their app that the post-Aetna discount price for this claim is only $50 ($126 discount) but given the line was denied, the lab company billed me for the full amount. I explained this to them, and they were willing to settle for $88 but I still think this is unfair because Aetna really should have just covered this claim, in my opinion. And if Aetna covered the claim, the lab company would have only received $50. They shouldn't hold the patient liable for things the patient could not have reasonably known to begin with, right?

Anyway, I explained this to the Aetna customer service rep and while they sympathized with my viewpoint and helped me submit an appeal on the claim, they said that due to Aetna's policies, the appeal likely won't be granted. They even acknowledged patients don't have access to the resources that explain the detailed Aetna policies too and really it should have been the in network providers who should have known not to order that test in this situation.

That being said, if the appeal is denied, what should I do? I reckon these are my options:

Pay the $88 price the lab company is willing to settle for
Let the lab bill go to collections and just not pay it, more due to the principle of the matter (I already own my home and would be buying any future car with cash)
Ask my employer's HR to intervene, given it's a self-insured plan (I suggest this because my employer is always touting how great the health insurance is, maybe they are sympathetic to doing the right thing from an employee experience perspective)
Any thing else you suggest? submitted by /u/toyotafan463
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