My wife has Blue Cross Blue Shield of Alabama. In her policy, they have a WELLNESS benefit. My wife wanted a local physician because her physician was located in another city. She contacted Dr. Bellelo's office and arranged an appointment. She was referred by a co-worker in her office. At the time of making the appointment, my wife requested how much her out of pocket expense would be. They advised her there would be none, because it is a WELLNESS benefit. When she attended the appointment, my wife again requested how much she could anticipate out of pocket and again, Dr. Bellelo's office indicated there would be no cost for the visit. My wife is the picture of health as she is an athlete and health enthusiast. Dr. Bellelo requested lab work as is customary with new patients and WELLNESS. My wife went to Lafayette General's lab immediately after the visit and was NPO for the lab work. I then received a bill from Lafayette General for $929.00. I contacted Dr. Bellelo's office to asked if they contacted our insurance carrier to determine if the cost of services is covered. I did not get a return phone call. My wife called them two additional times. She then spoke to the Office Manager who was very perplexed about why Blue Cross / Blue Shield of Alabama would not pay. To make a long story short, Blue Cross Blue Shield would have paid for the lab work if the blood was taken in Dr. Bellelo's office. Dr. Bellelo's office did not make a clarification check as to where the blood work was to be taken. I called Blue Cross Blue Shield of Alabama and they informed me because of the Affordable Healthcare Act, (Obamacare), all insurances must hold all contracts to the letter of the law, and I should have contacted them to verify benefits availability at Lafayette General; of which I didn't. I then contacted Lafayette General to determine if they would be interested in accepting a lower fee for this mess because I believe it should be customary for all medical providers to be able to at least estimate the cost of services. Dr. Bellelo's office as well as Lafayette General did not. I contacted Dr. Bellelo's office suggesting they contact Lafayette General to maybe arbitrate a settlement but that was to no avail.
I will pay Lafayette General as they will certainly begin adding interest if I don't pay. I believe I'm not the only a victim here but also Dr. Bellelo's office, Lafayette General and Blue Cross Blue Shield of Alabama as no one can consider compassion or a willingness to fix misunderstandings especially when it comes to money. If the venue of services even when all venues are approved results in benefits not being paid, then we are all subject to loop-holes in the law which make all of us victims.