Out of Network Lab Liability

I had it happen with a radiologist that read a scan. The scan was in network...not radiologist. I contacted BCBS to no avail. ended up having to pay!

If you did not sign any agreement of financial responsibility I would do two things - ask BCBS to pay the in-network amount to the out-of-betwork lab, then ask the out-of-network lab to send you an Assignment of Benefits form.  This is a form that says the lab agrees to accept what BCBS sends them as payment in full (as if you were in-network).  I had to do this with Mammaprint testing.  I did not sign anything saying I would be responsible for the billing and the BS surgical coordinator failed to get a referral from my insurance company for this $5,000 test even though she knew that all of my treatment has to be approved by advance referral.  The same person also failed to get the referral for the specific plastic surgeon being requested by my BS and I found this out 5 days prior to BMX - but that is a story for another day - let me just say she owed me her paycheck that day because I ended up doing her job for her.  If she had attempted the referral she would have known that my insurance company considers Mammaprint "experimental" even though it is FDA approved.  They denied it and I received a bill for the test.  The insurance had paid $61 for the shipping, so I asked Agendia Labs to fax me an AOB form, I filled it out and faxed it back.  They had to accept that $61 as payment in full because I had not agreed to take any responsibility for my surgeon's decision to do this particular testing.

Do you have to check on who is doing the wire placement for lumpectomy to make sure they are in network? the hospital is in network and my surgeon.