Review your doctor bills (and hospitals)

[TexasHusker]

Wife had surgery 3 weeks ago. While she was there, they told her to let her doctor know that she had elevated liver enzymes. Fair enough.

We went to her internist, and he said it was "probably" due to the pain killers she had been on, plus the possibility that she had been fighting off an infection. "But let's do some lab work to check those liver enyzmes."

So we did lab work, and got the bill - over $400. Rather than just check liver enzymes, the doctor decided to check iron, glucose, and a host of other things. He also billed for an ultrasound that they didn't do.

I called the office and said "Gee, if you wanted to run all this lab work, why didn't you just do a Complete Metabolic Panel (80053) and call it good? I can go to Quest Diagnostics and get that done for $60 cash."

"I don't know, I'm not a doctor, I'm sure he had a good reason."

I told her flat out that I'm not paying the bill until I get some more answers.

We are seeing this doctor again today for followup, but I told them we aren't doing any more labwork there. I'll have AnyLabTestNow do a CMP for $49 and we will have the results sent over.

[disneysteve]

So we did lab work, and got the bill - over $400.

I can go to Quest Diagnostics and get that done for $60 cash.

Why was the price so high? It sounds like they may have sent it to the wrong lab instead of the one your insurance requires. We do labs in our office every day but our phlebotomist has a master list so she knows which lab to use for each patient based on their insurance plan. Some use Quest. Some use LabCorp. If it accidentally gets sent to the wrong one, there would be a big bill.

I'd definitely fight that. It isn't your fault that their office screwed up.

And if they billed for a test they didn't do, obviously don't pay that.

[TexasHusker]

Why was the price so high? It sounds like they may have sent it to the wrong lab instead of the one your insurance requires. We do labs in our office every day but our phlebotomist has a master list so she knows which lab to use for each patient based on their insurance plan. Some use Quest. Some use LabCorp. If it accidentally gets sent to the wrong one, there would be a big bill.

I'd definitely fight that. It isn't your fault that their office screwed up.

And if they billed for a test they didn't do, obviously don't pay that.

Steve, I'm not as concerned about the charges as I am about what they charged for. They billed 7 different lab codes for various asundry things, 6 of which seem unrelated to liver enzymes. To me that is uncalled for. Don't know why you go testing her thyroid when you are concerned about AST and ALT.

Then they tossed on a charge for an ultrasound which they didn't do.

Also, am I assuming correct that a CMP would catch all of the basic lab stuff under one code? 80053.

Looks like they unbundled to make more $$$.

[FLA]

I just got tested for liver stuff. There were some tests that aren't in a CMP. but they were only done after a CMP showed abnormal results. Luckily, if I use a preferred lab, there's no co-pay. I'd fight it.

if I had a $1 for every time a doc wanted to do a TSH or vitamin D level, I'd have at least 10 dollars, lol. I have to constantly say, I just had that, look in my records.

[disneysteve]

if I had a $1 for every time a doc wanted to do a TSH or vitamin D level

I honestly have no idea why doctors insist on doing vitamin D levels. I've been in practice for 24 years. I have NEVER, not a single time, seen a normal vitamin D level in a patient who was not already on a supplement.

When my patients ask me to do a vitamin D level, I tell them to skip the test and just go get a supplement.

[HundredK]

I honestly have no idea why doctors insist on doing vitamin D levels. I've been in practice for 24 years. I have NEVER, not a single time, seen a normal vitamin D level in a patient who was not already on a supplement.

When my patients ask me to do a vitamin D level, I tell them to skip the test and just go get a supplement.

Ha, that's a really good point. I've had extremely low Vit D levels in the past, and I had to get several injections at my doctor's office. Now, I just make sure to get plenty of sunshine and take a supplement, just like you said, and there's not been any problems since.

[TexasHusker]

I just called the doctors office and we cancelled our afternoon appt.

For one reason, I'm highly pissed. I know people get conned all of the time, but a highly-reputable physician office practice here, I'm very disappointed.

For the second reason, her liver levels are almost to normal now, and I'm not going to bust out another $600 for him to tell me that and run more tests.

[HundredK]

Yeah, maybe wait until you're less upset to go in. Your angst reminds me of this article that I read a couple of days ago, about how being rude to your doctor can be a really really bad thing (even if they deserve it).

http://www.miamiherald.com/news/nation-world/national/article126992594.html

[TexasHusker]

Many medical care providers haven the philosophy "Let's bill everything under the sun and see what sticks."

In fact, most of it sticks. Only difference with me is I was in that business for 24 years and while I am not a coding expert, I could tell something wasn't adding up.

Most people simply don't know. It's complicated.

[Nutria]

Ha, that's a really good point. I've had extremely low Vit D levels in the past, and I had to get several injections at my doctor's office. Now, I just make sure to get plenty of sunshine and take a supplement, just like you said, and there's not been any problems since.

Sunshine is Good Enough. Stop taking the supplement and save some money!!