A GC student has noted that she has been overcharged by NYSHIP for labs multiple times. The way our lab copayment works on NYSHIP, no matter how many lab tests are ordered during a given doctor’s appointment, you should only pay the $10 co-pay if labs are ordered during a doctor’s visit, or the $15 co-pay if labs are ordered in a hospital or outpatient setting, and you should only pay it once (in other words, you should not be charged $10/$15 per lab, or any more than $10/$15, as long as the labwork goes to a NYSHIP covered lab). This student, however, noticed that NYSHIP had been charging for more than $10 during doctor’s visits where she got multiple labs, and she is now wondering how many other GC students this might be happening to; it’s also made me curious.
This student found out that she had been overcharged by hundreds of dollars over the years by checking her bills and discovering the errors. She suspects this means that others have also been overcharged, but have overlooked it or not noticed it on their bills. With that in mind, please check your bills, both old and new, and if you do find out you have been overcharged, please contact NYSHIP liaison Scott Voorhees (email@example.com) as well as NYSHIP. In addition, please contact me (firstname.lastname@example.org): if this is happening to several people, we at the DSC would like to collect that information so that is NYSHIP is overbilling several people, they can be held accountable.
UPDATE 10/11/2015: Good news! It seems many people who did discover overcharges on labs were actually refunded for these overcharges after an audit by UnitedHealthcare. However, it’s still good practice to keep tabs on your claim summaries to check for any unexplained charges.
Additionally, a note from Scott Voorhees: “Keep in mind however that some lab tests may not be included in the $10/$15 co-payment fee if considered not necessary or applicable to the patient’s condition or not part of the NYSHIP plan. In that case the patient would have to communicate with the doctor’s office manager or billing manager concerning those additional incurred fees as well as possibly having to submit a claims appeal to NYSHIP.”