One can see that effect in prescription generic drugs too, I have a couple of very common generic blood pressure and cholesterol drugs that under a high deductible plan employer plan, cost me under a dollar a month with insurance negotiated prices. There is no way a retail pharmacy is making money with labor costs counting pills into bottles at that kind of rate never mind the wholesale cost of the drug. They have to be making it up on the non-generic high priced stuff. Actually I think they may also make some of it up on people with PPO type plans that have set dollar co-copays for drugs that are actually quite a bit higher.OP here. I actually have good news to report, though it also kind of just makes me more confused than ever about how health insurance, billing, etc. work.
As expected, LabCorp informed me that I had a balance due. I figured that it would be for the lab work they did a couple of months ago, which my insurance indicated would not be covered.
The surprise was that while the total charges were ~$300, the amount I owed was only about $10.
The bill shows "adjustments" of, say, $290, which leaves a $10 balance for me.
I'm of course happy to only be expected to pay $10 to the lab, and not $300, but unless I'm missing something, that is the entirety of the money they will collect.
Reason for Bill (as shown on the invoice): This is the balance due after we filed a claim with insurance. According to [my insurance plan], this amount is the patient responsibility as part of a copay, deductible, or coinsurance.
While I realize that some on the forum may not view at least some of the labs favorably, certainly in this one instance it's hard to see how the labs can have many cases like mine if they are to be viable businesses. (Of course, I realize that they get more substantial reimbursements in other cases, but (for what it's worth) I am still baffled by my particular case here.)
Anyway, as mentioned earlier, I've learned a good amount here so thanks to posters for helping me to get up the curve.
Eta: I don't know, maybe my insurer has a provision where for services not covered, or at least some of them, the lab will charge the lower of the cash rate or the billed rate. I have no idea, but I'm still (pleasantly) surprised by the minimal lab charge.
Statistics: Posted by cleopold73 — Tue Feb 25, 2025 9:59 pm