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Old 08-23-2010, 08:35 PM
 
Location: Ayrsley
4,714 posts, read 8,659,556 times
Reputation: 3815

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Quote:
Originally Posted by pinetreelover View Post
If the doctor's office made an error and checked the wrong box on the lab form, they should be willing to contact your insurance company and the lab about their error and make it right. If the lab ran the wrong test then they should write off the charges. Either way, if it was an error and you are calm, polite and knowledgeable, I bet you will find someone willing to help you out.
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Old 08-23-2010, 11:44 PM
 
Location: Canada
3,432 posts, read 3,609,741 times
Reputation: 2186
Its going to cost you alot more than 400.00 to get a good attorney....just let it go.
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Old 08-24-2010, 04:02 AM
 
Location: Southport, NC
3,858 posts, read 9,952,351 times
Reputation: 4506
It may not be that your physician ordered the "wrong" tests, but may have coded them wrong. Every blood test or x-ray order, must be attached to a billing code (ICD 9 code) that links the order with a problem or reason it is being ordered. An ICD 9 code may be an actual diagnosis such as hypertension or a symptom such as vomiting. Call the insurance company, ask why it is being denied, then contact the ordering physician.
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Old 08-25-2010, 05:08 AM
 
688 posts, read 1,056,272 times
Reputation: 765
Let me clarify.
I regularly go to a lab to get my cholesterol checked and there has never been a problem. On my last visit they said they are able to do blood tests in house now. I thought that was great and the discussion went into how they are now able to check cholesterol etc. There was no discussion of them sending anything "Out" because they said they can check cholesterol in-house. So checking things like Vitamin D and a bunch of other "Coded" tests that I have never had done before were never part of the discussion.

Its like brining your car to the oil change place and them charging you for battery acid tests and other things that were never discussed.

I never signed anything, I am a regular patient.

So, now they are going to re-code things to get this covered under my insurance company. Will this mean 5 years down the road I wont be able to get coverage because I find out my doctor filed some code that says I got some rare disease in order to get a test paid under insurance?

I didn't authorize it, I wasn't informed about it.

My "Policy" is that I do not pay for something I didn't order. Maybe their policy is different.
Going to visit the doctor office today to dispute.
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Old 08-25-2010, 05:48 AM
 
3,112 posts, read 6,680,633 times
Reputation: 6047
If they never discussed the labs with you, you should not have to pay for them. You could give them a reasonable chance to try to get the labs paid for by the insurance, but only if they are able to explain to you how these labs were necessary for your care.

When doctor's offices have in-house labs, pharmacies... they do tend to be more aggressive about using those services. Though they don't need your consent for every lab test (I'm sure you signed some sort of a global consent), it is the standard of care to explain to a patient what tests are to be done and why they are being done. If they don't have documentation in their notes of that conversation, then the conversation did not happen and they should reverse the charges.

Remember: calm, pleasant, polite and firm.
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Old 08-25-2010, 06:25 AM
 
688 posts, read 1,056,272 times
Reputation: 765
Someone needs to pay $700 and it better not be me, that's all I can say!
yeah, I better back off on the caffiene. ;-P
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Old 08-26-2010, 08:02 PM
 
Location: TX
3,947 posts, read 4,855,268 times
Reputation: 4455
Better to work with the doctor if possible to get it worked out. Personally, I trust my doctor unless there's an obvious reason to not trust him. When the insurance had a problem with a certain lab one time, it was handled and worked out eventually.

Last edited by Lee W.; 08-26-2010 at 08:11 PM..
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Old 08-26-2010, 11:21 PM
 
Location: Anaheim Hills
11 posts, read 22,155 times
Reputation: 10
at this stage you can ask an explanation to the doctor.....tell the doctor those tests are unnecessary for me...you have full rights to ask for a justified answer....you can take strict action against this....
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Old 08-27-2010, 08:58 AM
 
4,267 posts, read 5,445,256 times
Reputation: 3579
Quote:
Originally Posted by Sky1 View Post
Going to visit the doctor office today to dispute.
I think this is your best solution. I had this happen to me once and I disputed it and I didn't have to pay for the tests in the end.
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Old 09-04-2010, 04:13 PM
 
688 posts, read 1,056,272 times
Reputation: 765
Great, now here it the EOB for my visit. After my co-pay I am now responsible for another $325.

So AFTER insurance (That I pay $800 per month) It cost me $800 for a physical?

THis is crazy!!
Anyone know a good attorney in the Raleigh area?
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