KINGS MOUNTAIN, N.C. (WBTV) - A local woman is trying to figure out how a urinalysis test ended up costing her more than $1,000 dollars.
After fighting the bill with her insurance company and hospital for two years, she reached out to WBTV for help.
Michelle Boyd has been going to Southeast Pain and Spine Care for required yearly urine screenings for 10 years.
Her tests have always been covered by insurance. You can imagine her shock when she got a bill for $1,085.40.
“I feel like it’s ridiculous to have to pay this much for a urine sample,” said Boyd.
Boyd is required to take a urinalysis test at Southeast Pain and Spine Care at Atrium Health Kings Mountain.
The tests have always been covered by her insurance, but after her test in 2019, her insurance only paid $788.
She thinks the test was coded wrong.
“(The hospital’s) words were my drug screen benefit was maxed out,” Boyd said.
Confused, she got in touch with her insurance.
“Blue Cross Blue Shield called me back to let me know there were 27 codes that Atrium needed to change on this one drug screen before Blue Cross and Blue Shield would pay for this test,” Boyd said.
Boyd sent an appeal to Blue Cross in April 2020, which was denied.
In a letter, Blue Cross said, “Because your health care plan covers a maximum of one drug test each day, the other 27 instances of drug testing were not covered services under your health care plan.”
Blue Cross also said, in the past, her providers submitted different codes for lab services.
“I’ve had this same test done every - once a year since 2008, and it’s been covered. This is the first time I’ve ever had this instance happen to me,” Boyd said.
WBTV contacted Atrium Health to try to explain Boyd’s concerns over the coding issue and to ask if the bill could be re-examined and the coding issue resolved.
Atrium Health, however, as of tonight, has not returned our request for comment.
WBTV also reached out to Blue Cross Blue Shield of Michigan, and they said the service is not generally billed by a lab as individual tests.
According to Blue Cross Blue Shield of Michigan, “These were billed as more than 15 separate tests on the same day when it could have been billed as only several tests, which would have resulted in a lower out-of-pocket cost to the patient.”
Ultimately, Boyd paid her bill because she didn’t want her credit to be ruined, but she worries about a bill the next time she needs a urinalysis test.
“I would love to continue coming to this facility, and I just don’t want this to happen to anyone else, and I do not want this to continue to happen to myself,” Boyd said.
Whenever you’re getting labs done, make sure to ask what you’re being tested for. In this case, Blue Cross Blue Shield is stressing that if the tests were coded differently, all the tests would have been covered by her insurance.