Sunrise Medical Labs

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Lab Billing Practices
Posted by on
Rating: 1/51
HICKSVILLE -- On March 3, 2011 I was seen by a private physician, who requested labs from Sunrise Medical Laboratories. Apparently, Sunrise billed my old health insurance carrier, BC/BS, for the lab services. My employer switched to an Aetna PPO effective January 1, 2009.

Sunrise, apparently, sent notices to my former address at ……. I moved from that town more than 2 years ago. I checked with my private physician and he has my current address insurance information on file. The office surmised that Sunrise may have taken the billing information from the computer in the specimen room that was not updated.

Sunrise subsequently sent my account to Paul Michael Associates, a collections agency located in Flushing, NY and the agency promptly submitted an adverse credit report to the credit bureaus.
Upon receiving notice of the adverse credit report I called Paul Michael. The representative had no details and asked me to contact Sunrise Medical. She flatly refused to provide a contact number or the name of a person at the lab.

I located the contact number for the Sunrise Labs billing office in Hicksville and explained the issue to a female representative. She was extremely unhelpful and unsympathetic, blamed the physician’s office for providing the incorrect billing information with the callous retort “you have to deal with the collections agency”
A second call to the Paul Michael and they again referred me to Sunrise Labs. Another call to Sunrise Labs and they sent me back to the collections agency.

Upon receipt of the standard denial from BC/BS that the service was provided after termination of the policy the usual and customary billing practice is to ascertain the correct insurance information. A routine call to North Shore would have shown that my insurance carrier has changed. But Sunrise acted with reckless disregard for my credit and simply handed my account to Paul Michael.

I provided my correct insurances to both Sunrise and Paul Michael on December 15, 2011. To date (4/2/12) my insurance has not been billed and my credit unresolved.

I called Sunrise today and they referred me to the collections agency. The agency said that they sent the bill to Aetna. Aetna said that they never received the bill... and the issue is unresolved.
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User Replies:
Alain on 04/04/2012:
Call your state's attorney generals office and see if they don't have some advice on dealing with both the collections agency and Sunrise.
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Out Of Line Fees For Simple Tests
Posted by on
HICKSVILLE, NEW YORK -- If you don't have Health Insurance, don't agree to have any blood tests unless you know what the Medical Laboratories Fees are going to charge you,
because you will get one bill from your medical provider and another bill from the Laboratory.

My personal experience and hope this review will help to inform what is going on out in the medical field.

All I wanted was a simple Vitamin D Blood test. The blood specimen was drawn at a private medical walkin who then sends the specimen to a Private Lab for processing. Problem: You get a separate bill from the lab after the fact of them processing the test and not being informed of the cost with no health insurance.

To make a long story shorter, I received a bill from the lab for $339.00 plus the $25.00 specimen fee that was paid separately to the medical walkin. I felt this high fee was completely out of line and true they can charge whatever they want and get away with it. Upon investigation, I found a local lab by the name of Lab Corp that could have done the same test for $85.00 plus the $20.00 specimen fee. Total: $105.00

Where does Sunrise Medical Labortories located at: 250 Miller Place Hicksville, NY 11801 get off charging three times the amount.

I have sent Sunrise Medical Laboratories a good faith payment of $85.00. For some reason the $85.00 was accepted, but they refuse to waive the balance of $186.00 and have hired a collection agency to followup with me for collection. I did receive a courtesy discount of $67.80 for patients without Health Insurance which left a balance of $271.20 and I sent them a courtesy balance of $85.00 that left a balance of $186.00.

Problem with these private laboratories is that they are not regulated. These high fees that these labs charge for simple blood tests is the reason why we pay high health insurance premiums. The patients are being scammed and the health insurance providers are being scammed that pay these fees.

Don't let anyone compromise your patients rights on simple inexpensive blood tests when you have no health insurance. Due your due diligence before you get a high out of line lab fee from a greedy lab.
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User Replies:
FlShopper on 12/22/2010:
They are under no obligation to waive the rest of your balance. They performed a service at your request, and now you owe them the money for that service.
It is better to just pay the bill and not have it affect your credit, and know that next time you need to have tests done you need to ask upfront about the costs.
Inat on 12/22/2010:
so, in your professional opinion, what SHOULD a lab charge for their services, facilities, materials, time and expertise?
momsey on 12/22/2010:
What do you mean they are unregulated?

Health insurance providers are not being scammed. If they have a contract with that lab, then there are agreed upon amounts that will be paid for each and every test.

Just because you don't like the amount they're charging you doesn't mean you don't have to pay it. This is an informative post to remind people to make sure they know about all costs (this goes for those with and those without health insurane.) But it is not a valid complaint. They charged you for the service you requested.
Obsfucation on 12/22/2010:
You didn't bother to check on who charges what until AFTER you used the service. You owe them this money, plain and simple.
Anonymous on 12/22/2010:
I purchased a pair of Ugg Boots for $150. I found the same boots later for $100. The same item has different prices at different locations for a variety of reasons. Health care costs are the same in this regard. You can get a prescription at CVS that may cost you much more at Walgreens. One surgeon may charge $4000 for a procedure that costs $6000 across town. They are free to charge you what they want to charge you and as a consumer, you need to verify the pricing BEFORE you have the service. It is no different than comparison shopping for a new toaster. So many of us are accustomed to having health insurance and paying uniform co-payments that we have forgotten this. I have insurance with a very high deductible so I basically pay out of pocket all year. I learned to shop around. Pay the bill you incurred and charge it to a lesson learned.
jim247 on 12/22/2010:
Thank you all for your feedback:

Inat Response:

so in your professional opinion, what should a lab charge for their services, facilities, materials, time and expertise.

Answer: Response was in the review, so I'll repeat myself to make it very clear that my charges were three times the amount other labs are charging. This same test could have been done for a total of $105.00. Maybe the Medical Walkin is getting a kickback from the lab for sending all their tests to them. There seems to be a large discrepency gap between $339.00 & $105.00. Also let me clarify that the Walkin Clinic was very clear about their Office Fees with no health insurance, but not clear with lab fees. This vitamin D blood test is not some complicated lab test. It's a basic simple test that can be done at home if you live outside of NYS. If you do a google search, the test can be done for $75.00. You put a drop of blood on a blotter type of paper and send it off to the Lab. NYS does not allow the transport of blood through the mails. $105.00 from another lab was within reason. Hope this has answered your response respectfully.
Skye on 12/22/2010:
Vitamin D blood testing do not fall under the typical blood work category. It's a special type of blood work, and is always an extra charge. It's a special request your doctor has to make, for vitamin D blood testing. I know this for a fact, and also am a someone who has to take 50,000 units (one capsule) per week, of prescription vitamin D. You cannot get this amount of vitamin D from a vitamin, it requires special blood work, then an RX from your doctor.
Anonymous on 12/22/2010:
I just had a Vitamin D test. I am going to see if I can find the receipt. I wonder how much they charged.
momsey on 12/22/2010:
The bottom line is you should have done your research before you had the test. Since you didn't, and you incurred the charges, you should pay them.
Skye on 12/22/2010:
Very true momsey. A vitamin D test, just like a vap test, do not fall under typical bloodwork categories, therefore, they will always cost more. It's just how it is.
jim247 on 12/22/2010:
Fishopper: They are under no obligation to waive the balance for services they performed at my request.

Answer: Do your due diligence and know what you are paying for before agreeing to anything.

I'm going to repeat myself. There is a big discrepency gap between $339.00 and $105.00 for the same test. I didn't get any special red carpet treatment. In fact the test had to be repeated, because the first specimen was misplaced
which required me to go back to the clinic to draw a blood specimen.
jim247 on 12/22/2010:
momsey: Response:

What do you mean they are unregulated.

Answer: That's exactly what I mean. Lab fees should be regulated. When there is a large discrepency gap between $339.00 & $105.00, something is definitely wrong. Health Insurance providers are being scammed by these high fees for this one simple test. A difference of $234.00
and it comes back to bite you in the butt as the one who pays high health insurance premiums.
Anonymous on 12/22/2010:
State and federal regulators are aware of, and readily admit to, the fiscal and quality control abuses that are rampant in the independent lab industry. They view the attempt at regulating them as a nightmare.
jim247 on 12/22/2010:
obsfucation: Response

You didn't bother to check on who charges what until after you used the service. You owe them this money, plain and simple.

Answer: The Walkin Medical Clinic was right up front with office visit fees without insurance, but nothing about lab fees. Whether you agree or not, don't you think there is a large discrepency gap between $339.00 and $105.00 for a simple Vitamin D Blood Test. DUE YOUR DUE DILIGENCE AND MAKE SURE FEES ARE JUSTIFIED.

On that note respectfully, thank you all and have a Healthy, Joyous Holiday.
Skye on 12/22/2010:
Just wanted to say something. Just because someone has health insurance, does not mean lab testing and blood work are free. Believe me, we pay enough in co-pays and our monthly health insurance bill, that it should be free. We pay thousands of dolllars every year, to have heatlh insurance. It's a rough road no matter what.
jim247 on 12/22/2010:
bluediamond98: Response

As a consumer you have to do your comparison shopping like when shopping for a toaster.

Answer: Respectfully I get your point, but medical comparison shopping is not always an option. I had gone to the Walkin Medical Clinic for another medical issue and had requested a vitamin D blood test while I was there to avoid paying another $98.00 for an office visit. The clinic was right up front with the office, injection and blood specimen fees and wasn't informed about any additional lab fees to process the blood which I thought was going to be completed at the clinic also until I received a separate bill from the lab for $339.00. I would have no problem if this was the average fees being charged by all the labs in the surrounding area. Viewers: Do Your Due Diligence and hope I've just saved you a few hundred dollars and maybe the Health Insurance Providers will wake up and start doing their own comparison shopping to start doing business with labs that have more fair realistic fees and maybe Health Insurance Premiums will be lowered.
Anonymous on 12/22/2010:
very true Skye. I get calls all the time from people who think that lab work is always coverd at 100%. Certain tests are, but it all depends on how it was submitted too and what diagnosis codes were used. Some codes are not covered by insurance.
Anonymous on 12/22/2010:
I think the routine labs I have done at my yearly exam are 100% covered, but the others are 80%. I agree with Skye. Sometimes I think we'd be better off not paying the huge premiums and putting that money into our own medical fund. Makes you wonder. Of course, that would be the year I had a hospital visit and I guess that's what we're really paying for--the what-if's. I hate all insurance because it seems like they sometimes do whatever is necessary to keep from paying anyway.
jim247 on 12/22/2010:
Thank you ript2010 for making my point very
clear that there is abuse going on and there
is not a dam thing being done about it and maybe
some ass warmer in Washington will see this post
and make change(s). Doubt it.
Anonymous on 12/22/2010:
A note to the OP: if the lab bills the insurance company $339.00, that insurance isn't going to pay that exact amount. They pay an allowed amount, which is a contracted agreement, and then the lab would either agree to write off the difference or bill the patient that amount. So no, insurance companies are not being scammed
jktshff1 on 12/22/2010:
I want the ass warmers in washunton to keep their hands out of my health care.
momsey on 12/22/2010:
I do not want the government mandating what a lab can charge. Of course the costs are unregulated. That's because we don't have socialized medicine (for now, thank God.)
Fufu487 on 12/22/2010:
I quite enjoy free health care :) However, checking if there are additional fees involved in labwork seems like common sense to me.
Disaster Worker on 12/23/2010:
On-line poster: I think the doctor's office should have told you up front what the cost would be. I'm in the medical profession, and I agree that $300+ is an outrageous amount. Hope you get it worked out.
jim247 on 12/23/2010:
Thank you Disaster Worker. Beginning to see some light at the end of what seems to be a dark tunnel. These out of line greedy fees that Sunrise
Medical Labs is charging will catch up to them through expensive legal litergation one of these days and that's when I'll see bright lights at the end of a lighter tunnel. Have A Joyous Holiday.
jim247 on 12/23/2010:
I agree we don't want big brother meddling.
Something needs to be done to keep the fees
in check (fair realistic). Independent not
for profit advocate might work. Also to make
it mandatory for the clinics to follow a
protocol of a itemized list of what you are
going to be charged for, any and all services
before you the patient signs off on it.
Exceptions would be for medical emergencies
that require immediate attention.
tnchuck100 on 12/23/2010:
We are all victims of the greedy medical profession. Do you think they could be a subsidiary of the Shell Oil Company?

The elimination of lawyers and non-negligence based law suits MIGHT help a little.

I have believed for many years my deductibles and co-pays have paid for the actual medical care. The rest is all gravy for the greedy people at the top.
jim247 on 12/23/2010:
Message For LittleShorty:

Labs Protocol: The Lab sends the bill directly
to the patient. Patient sends the bill to their
Health Insurance provider. No Health Insurance,
you the patient pays. I agree with your point
about the insurance company negotiating with the
lab. I should be able to do the same thing with
no insurance. The lab did take 20% off ($67.00),
because I have no Health Insurance, but so did
the other lab that charges $105.00 complete.
I know this discussion onboard will open some
eyes that are presently closed. Respectfully, I
do appreciate all the feedback. You are making
and wish the same for all of you that take the
time read these reviews and support each other
for better for worse.
Anonymous on 12/23/2010:
Actually the lab sends a claim to the insurance company, not the patient
Anonymous on 12/23/2010:
The labs I have used send the claim to my ins. co. first, then the lab bills me for any difference if any, after the ins. co. pays the covered portion.
Anonymous on 12/23/2010:
Rip, that's the protocol for labs. Jim247 is incorrect
Anonymous on 12/23/2010:
My health insurance has always paid for any lab work I have had done.
momsey on 12/23/2010:
Just want to reiterate: if you have health insurance, the lab bills your insurance company, not you. If you have no insurance, of course the bill comes to you.
jim247 on 12/23/2010:
Thank you momsey, that's what I meant to
say. Let me correct myself before I get a lot
of hate mail. If you have no insurance, the
bill is sent directly to the patient by the
Lab for you know what ($$$).
Anonymous on 12/23/2010:
No hate here jim, only got love for you man.
jktshff1 on 12/23/2010:
lol rip
jim247 on 12/23/2010:
Thank you Ript2010. "YOU ARE THE MAN"
Hope to do the same for you someday.
JB on 04/25/2014:
I had a similar problem. My daughter went to visit the place in Syosset. She had a yeast infection. She had not been sexually active for the past year. I told them that we were between health insurance coverage and asked exactly what it would cost. They said 150 dollars. A few weeks later we received two separate bills for another 800 dollars. I did not order this test, and the tests are VERY expensive for what they did. They ran her through a complete STD profile, etc...none of which was quoted or required. I am filing a small claims case, and I recommend that anyone who has had the same experience do the same. What if the bill came back for 1 milllion dollars? Should I still pay it? I also suspect collusion/kickbacks from the lab to the companies that send them the business. I wouldn't even be surprised if they had common ownership.
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