Blood Test Denied As Investigational. But EOB Says I Don’t Have to Pay?

I had a variety of bloodwork done at an in-network clinic (Mayo). Most of it was approved, but one particular blood test was denied for being experimental/investigational by Blue Shield.

The note in the EOB that went along with the procedure reads: "The Health Plan has determined that this procedure is experimental/investigational. The patient is not responsible for payment when services have been provided by a Blue Shield of California Health Plan preferred provider."

Mayo is listed within the EOB as a preferred (ie, In-network) provider with my insurance. My assumption was that this note meant I was not responsible for paying for this blood test. But recently, I got notification that this amount went to collections. Am I reading this EOB incorrectly? Do I actually owe the payment for this? Mayo billed $300 for this test.

This was for service/procedure: Lab 81240.

submitted by /u/wait_what_whereami
[comments]

See also  Taking Expired Medication: Is It a Money-Saver or an Unhealthy Habit?