My health center sent my blood test to an outside lab and now the lab has billed me full price. Is the sliding scale supposed to cover that?

Thyroid check, the twice a year one. I paid my $25 at the health center like always, they took the blood, I went home.

Three weeks later, a bill from a laboratory company I have never heard of, for $186. It has the health center's name on it as the ordering provider. I rang the lab and they said I am self pay, so that is the price.

Last time, in March, I did not get any bill like this. I have no idea what is different. I thought the sliding scale covered everything I did at the center. Is this right? Do I have to pay it?

I hate to be the one again, but the sliding scale is the health center's discount on the health center's own charges. If the blood went to another company, that company bills on its own. It is one of the most common shocks there is. That does not mean you have to just pay it though.

Ask the health center first, not the lab. When this happened to me, it turned out the center had a deal with a lab for sliding scale patients and the order had just gone to the wrong one. They sorted it with one call.

And ask the lab for its self pay price and whether it has its own assistance policy. Mine knocked a lot off just because I asked, and it was a lab, not even a hospital.

Rang the health center. Cyn was right, or nearly. They do send most blood work to a lab they have an arrangement with, and that lab bills the center, not the patient. In September a new nurse used the wrong requisition form and it went to the other company. The billing lady said this happens "now and then".

She has asked the outside lab to void the bill and rebill through the center. I have it in an email. I am not paying anything until I hear back.

Good. Get the lab to confirm in writing too. Two emails are better than one when two companies are involved.

Closing the loop. Letter from the lab today, balance zero, "billed to client". Total cost of the September thyroid check is the same $25 it always was.

What I will do from now on is ask, while they are taking the blood, where it is going and who will bill me for it. It takes ten seconds and I did not know it was a question.