cunningham panel price after insurance?

[pr40]

I want to know approximate price before I order the panel for our kids. How much did your insurance cover if at all?

we have Harvard Pilgrim, if you happen to have it to and did the panel, could you, please, comment?

 

[Mayzoo]

Tinytreasures provided this information. Call you insurance company and ask them how much they cover for each of these cpt codes, whatever they do not reimburse, you are responsible for. That way you are not guessing.

 

 

83520 - 4 times
88230 - 1 time
86352 - 1 time

[pr40]

thanks, Mayzoo.

I contacted my insurance, Harvard Piligrim and this is what I learned -- just in case someone else is looking for similar info.

with POS, insurance covers 80% of out of network labwork.

[Mayzoo]

My insurance does that too, but they only cover 80% of what THEY deem to be reasonable and customary. I just had some work done for kiddo and the charge was over 400.00. The insurance company stated just over 100.00 of that was reasonable, so they will reimburse around 80.00 of the 400.00 meaning I owed 320.00 of the bill. The way to know for sure what they will cover is to call them and ask what do you cover for these specific CPT codes. Then they will tell you how much they believe is "reasonable", and they will pay 80% of only what they deem reasonable (MAC=maximum allowable cost).

 

Out of network labs that you use can charge what ever they want to, and if you agree to the service, you agree to the charge. An in-network lab can only collect what the insurance says is reasonable since they are the ones who agreed to the contract.

 

Good luck. Right now we are not doing the Cunningham because we already had about 5000.00 of lab work recently, and so far, the insurance has agreed to about 300.00 of it. Some is still pending. All the out of network----I called on first with the cpt codes so I would know in advance how much I was going to be responsible for. I do not like surprises when it comes to bills.