Insurance claim help

Hello Everyone,

I am fairly new to the US health care system. I need some help navigating my insurance claim.

So I have been in the US for 5 years and this year finally I decided to do an full body check up. I originally come from a place that has sunlight throught the year. During the check up I volunterally asked my doctor if I can do a Vitamin D test as, I have lived in complete north of US for last 5 years and I felt I might be pretty prone to lower Vitamin D being a fairly darker skin person and because of weather change, and he told me If he was not sure if the insurance would cover. Then later, I told, it's kind of fine and he wrote for the Vitamin D test too. The place I visited was an in-network hospital as per insurance.

I now have received an full bill as my insurance did not cover the test claiming they did not have enough evidence to do the test. My doctor during my visit kind of also told me by guessing that I might not be deficient. But the test results now show I am severely deficient.

Is there a way now I can have a chance to ask the insurance to cover it since, the test results were severely deficient in vitamin D. In the after lab work consultation he written a prescription for me to have vitamin D tablets daily.

1) Now is there a way, I can ask my insurance to cover by appealing for it with these evidences ? 2) Just for this one test I received a out of network price for the entire test which was close to 180$. Now later I found that CVS has a sime Vitamin D kit for 50$. 3) will I be able to negotiate the bill with the hospital for an in network price or a discount as the bill charged for me looks like 3-4 times normal than a in- network price. I checked www.fairhealth.org and my out of network price is almost same as what I have been billed, but I feel since this was an in network hospital I should not be charged an out of network price. 4) I had multiple other regular sugar and lipids test along with this, when I searched online I found a code called code 59 through which we can reduce bill for all concurrently conducted test.

I want some suggestions on how I can approach this? Should I first appeal to insurance or negotiate my bill with the hospital or would the insurance help me get a discount ?

Thanks in advance for your valuable suggestions.

submitted by /u/Lazy-Environment7669
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