April 2, 2009

Incentive PPO, Purdue 500 participants must act to correct lab billing errors

Billing errors made for laboratory work received at Clarian Arnett Clinic and Clarian Arnett Laboratories are being corrected, but Incentive PPO and Purdue 500 participants will need to take action to have erroneous charges removed from their accounts.

When the new Clarian Arnett Hospital opened on Oct. 15, 2008, it created a billing error for laboratory claims from the Clarian Arnett Clinic and Clarian Arnett Laboratories. The claims from these facilities began being billed as though the service had taken place at the Clarian Arnett Hospital.

The error resulted in a double whammy for Incentive PPO and Purdue 500 participants. First, the bills charged incorrect -- and significantly higher -- amounts than the usual Clarian Arnett Labs price. Second, charges from a hospital lab are not covered at the 100 percent benefit provided for free-standing, network labs.

As a result, patients who expected their lab tests to be paid in full by insurance instead received expensive bills that were subject to their medical plan’s deductible and coinsurance.

Clarian Arnett is now in the process of correcting these billing errors and has agreed to dismiss any laboratory charges that were applied against the deductible or coinsurance of Incentive PPO and Purdue 500 participants.

Clarian Arnett has set up a special hotline to assist patients who have been impacted by this error. Anyone who Clarian Arnett has billed for deductible or coinsurance for non-hospital lab services received on or after Oct. 15, 2008 should contact (317) 962-4248 to have the balance written off.

In addition to the lab billing error, several providers from the Clarian Arnett physician group were recently misidentified as out-of-network for the Incentive PPO and Purdue 500 medical plans. This error has been corrected, and UMR is reprocessing the affected claims. Please contact UMR at (866) 795-6382 or log in to your member account at fhs.umr.com to check the status of a claim.

Anyone who received a reimbursement from their flexible spending account because of an erroneous Clarian Arnett bill should contact UMR at (866) 795-6382 for options to reconcile their account.