Insurance being incorrectly billed
On 4/1/24 I went and had my Pap smear and my obgyn. They also tested for STDs, chlamydia and gonorrhea only. I get my bill and the pap was covered 100% but the STD testing cost me $400. I was surprised it cost that much! But I paid it anyways. I noticed the amount did not go towards my deductible so I called my insurance to find out. After multiple calls from me and the insurance rep, to my insurance, the doctors office, and the lab, we were able to find out the issue. The lab billed it as code 87801, which my insurance does not cover. They DO however cover STD tests billed under their own individual codes. The Drs office did not send the order in with the 87801 code, but with the individual codes for the tests. And the results have the individual procedure codes. The insurance agent said he spoke with the lab and they will resubmit the order. On 7/9/24 I messaged my insurance for an update and they reviewed it but no changes were made so after talking to 3 different people, he found someone to confirm the codes on the medical records and that it would be resubmitted again. On 8/17/24 I messaged again asking for an update and the lab had not submitted anything to insurance yet but the agent told me I could appeal the insurance by providing my record proving the 87801 is not on the order or the procedure codes. I messaged the lab asking for an update and the next day they said it hasn’t been reviewed and they will reach out with an answer. It has now been over a month and still no answer. How can I be billed for a code that is not on my order? Is this fraudulent so the lab gets more money? Is the a time limit this needs to be done by. Is this normal? Any tips on what I should do
