Would you pay for a test that didn't need to be performed?

[CJ2008]

I went for my annual women's wellness exam - and found out after the fact that the doctor performed a pregnancy test, when I got my statement.

Let's just say that for various reasons - would be TMI here - the test did not need to be performed.

The charge after the insurance coverage is minimal - under $10 - but it really bugs me that I have to pay for something that did not need to be performed. The office's explanation is that a pregnancy test is their protocol - and the girls running the test didn't know all the reasons the doctor and I had discussed that would mean the test didn't need to be performed.

Being that it's such a small amount would you just pay it and forget about it? Or what would you do?

(this was my first time at this Dr.'s office - aside from this annoyance right now I would probably go back...the Dr. seemed OK.)

 

[Gypsy]

Re: Would you pay for a test that didn't need to be performe

I would probably talk to the doctor about it. Not the staff.

 

[CJ2008]

Re: Would you pay for a test that didn't need to be performe

I thought about that after I hung up...

And then I thought...am I going to bother the Dr. over $10?

But...they'd certainly bother me over $10...

So maybe I will...it *is* bugging me...

 

[April20]

Re: Would you pay for a test that didn't need to be performe

I would absolutely talk to them. They wouldn't let $10 go if the situation was in reverse. I would be peeved too. It sets a bad precedent.

 

[liaerfbv]

Re: Would you pay for a test that didn't need to be performe

I've never been to a gyn that didn't give me a pg test as part of their protocol. I also don't need them done, but I'm not going to make a fuss about it.

 

[marymm]

Re: Would you pay for a test that didn't need to be performe

Isn't it your doctor who specifies which tests should be performed? I mean, my doctor will check off various tests on a form (or enter same into the computer system) and then I go have the tests done... if you and your doctor already discussed that a specific test was unnecessary, wouldn't that be reflected in your medical records/ordered-tests summary?

If this was my 1st visit with a new doctor, I would already have questions/concerns about the practice - sure, it may be easy to shrug off this particular test and associated cost, but what if it was a different, more invasive test and/or one with a higher co-pay? For sure I'd want an explanation from the doctor as to how this occurred, if only for reassurance it won't happen again in the future - or to decide to look further for a new doctor.

 

[CJ2008]

Re: Would you pay for a test that didn't need to be performe

I've never been to a gyn that didn't give me a pg test as part of their protocol. I also don't need them done, but I'm not going to make a fuss about it.

I probably wouldn't if it weren't for all the factors I mention...

But believe me, I get where you're coming from, because it doesn't feel comfortable to make a "fuss" over $10...but...I probably will. Or at least try to talk to the doctor and see how it goes.

 

[CJ2008]

Re: Would you pay for a test that didn't need to be performe

Isn't it your doctor who specifies which tests should be performed? I mean, my doctor will check off various tests on a form (or enter same into the computer system) and then I go have the tests done... if you and your doctor already discussed that a specific test was unnecessary, wouldn't that be reflected in your medical records/ordered-tests summary?

If this was my 1st visit with a new doctor, I would already have questions/concerns about the practice - sure, it may be easy to shrug off this particular test and associated cost, but what if it was a different, more invasive test and/or one with a higher co-pay? For sure I'd want an explanation from the doctor as to how this occurred, if only for reassurance it won't happen again in the future - or to decide to look further for a new doctor.

Right...I think that's what bugs me about it...ALL the reasons the Dr. and I discussed that would have made that test completely unnecessary...obviously there was a lack of communication between the Dr. and whoever ran those tests...

 

[missy]

Re: Would you pay for a test that didn't need to be performe

I would call the gyn and find out why the test was done CJ. Even though it was only $10 as you said they wouldn't let that go. Not sure why they did that test if there was no possibility. Seems like a way to get more money from the insurance company and if that is true that pisses me off. Abuses like this make it difficult for all of healthcare and is what causes the expense of healthcare to become astronomical.

This spring I was under the care of an esophageal specialist for a health issue. And I was charged a $30 copay two days in a row when the second day we just dropped off the equipment and did not have an office visit with him. Literally just went in the day after he placed it in my nose and throat and handed it back to him. We didn't have or need an appointment as the day before he said just come to drop it off the next afternoon. Then we get billed for another copay. We had the copay for the day of the actual visit which was correct and then a copay for dropping it off. Which is ridiculous IMO. Anyway, I asked my dh to take care of it as I was going though a very difficult time regarding my health and was in a lot of discomfort and didn't want to deal with it but it was the principle too so I didn't want to let it go. Also the more long term important reason being the insurance company abuse which makes health insurance unaffordable for so many . So for all those reasons I asked my dh to find out why they billed for a visit when there was none.

So my dh called and tried to find out why we were charged and in the end he just paid the copay. Lesson learned. Never ask your dh (at least if he is like my dh that is) to take care of any small amount money issues because it isn't worth their time. My take because if it was for a larger amount he would have spent more time dealing with it. Still not sure if it was a legit charge or not but again because of what I was going through I didn't have the energy. I normally would have followed up on that to see if it was fair or not.

Hope you get some satisfactory (real and not bs) answers CJ.

 

[movie zombie]

Re: Would you pay for a test that didn't need to be performe

I would not pay for the dr's failure to communicate with staff.
and I would not pay for a staff error of just doing business as usual w/o checking the orders.

 

[msop04]

Re: Would you pay for a test that didn't need to be performe

I'm not sure about every GYN, but a pregancy test has been protocol with every GYN office I've been in contact with (both personally and professionally). It's important for them to know "for sure" -- especially when it comes to any diagnostic issues (to rule things out) and prescribing (to ensure safety).

Not that this applies to the OP, but you wouldn't believe how many women swear that "there's no way" they could be pregnant when they come into our clinic... and they are. So, although it seems pointless, it's just a good precautionary measure for the GYN (or other doc) to take -- just in case.

Just speak with the doctor is it bothers you that much...

 

[CJ2008]

Re: Would you pay for a test that didn't need to be performe

I'm not sure about every GYN, but a pregancy test has been protocol with every GYN office I've been in contact with (both personally and professionally). It's important for them to know "for sure" -- especially when it comes to any diagnostic issues (to rule things out) and prescribing (to ensure safety).

Not that this applies to the OP, but you wouldn't believe how many women swear that "there's no way" they could be pregnant when they come into our clinic... and they are. So, although it seems pointless, it's just a good precautionary measure for the GYN (or other doc) to take -- just in case.

Just speak with the doctor is it bothers you that much...

I could see that they need to make sure...

However - let's just say that one of the reasons was that the doctor SAW during the exam I couldn't possibly be pregnant.

Now...it's also possible the staff ran the test before that?

I think what's making me hold on to this more is that the person who called me from the office could have been...better...she wasn't bad but at the end she asked me if I wanted her to take payment over the phone - even though she could tell I was not too convinced or thrilled with the explanation...which to me seemed like a subtle passive aggressive thing for her to have done...(the bill is not old or past due.)

ETA: and msop04 does your office (and others that you've dealt with) run the tests without ASKING first? Or at least having a discussion? I think at least in my situation, given my conversation with the Dr. and what she found during the exam, it should have been talked about (unless again, it's possible they ran the test right after I provided the sample, BEFORE I talked with the Dr. and before the exam? Not sure how tests are normally run, if they're done in-house, etc.)

 

[azstonie]

Re: Would you pay for a test that didn't need to be performe

No I would not. Patients authorize the doctor to submit orders for tests. No provider should EVER order tests without that auth.

I also would find a different doc and practice. That one has problems. You saw only the tip of the iceberg. You're lucky, act on that.

 

[packrat]

Re: Would you pay for a test that didn't need to be performe

So...if it's routine, then an 80 year old woman would have it run too? And a woman who'd had a hysterectomy? That's ridiculous. For me to be pregnant right now I'd have to be about ready to give birth, so I'd be pissed if I was charged for a test.

I was charged for a circumcision when London was born. Even tho she's a girl. And it was only a random reason that I found out b/c I happened to remember a Dear Abby column from years ago when people would write in all the crazy stuff they were charged for in hospitals, so for shits and giggles I went thru it to see if I was charged for plastic gloves and tongue depressors. Nope, but I sure got a surprise. Office manager tried to argue w/me about it too, when I called.

Doesn't hurt to check w/them again and see what the deal is, maybe they'll take that charge off. And now you can be more aware if/when you go back or if you find a different place to go next time.

 

[April20]

Re: Would you pay for a test that didn't need to be performe

I've never been to a gyn that didn't give me a pg test as part of their protocol. I also don't need them done, but I'm not going to make a fuss about it.

I've never been to a GYN that did a pg test as part of a routine appt. It seems like maybe the protocol varies pretty widely.

 

[Munchkin]

Re: Would you pay for a test that didn't need to be performe

I just assume I will be given a pregnancy test when I go to my OBGYN visits...unless I'm already pregnant. Further, I know many offices that have the office staff dip a urine for pregnancy during patient set up. Honestly, it's quite likely that the practice has standing orders for room set-up procedure and the test was completed long before you saw your doctor. Given that it was your first appointment, info like being post menopausal or post hysterectomy might not be part of your record yet. In the future, that kind of info would be documented and there may be a different set of standing orders. (Granted, this is all speculative, but I wasn't sure if this had occurred to you.)

Also, as a prescriber, I have my policies for some things. IE, even if a girl has assured me she has never been sexually active, I will not write for hormones (like the pill for bad periods) without a documented negative test. I make that clear to the patient and their parent. I wonder if a similar policy could have come into play if you were being written any kind of prescription?

 

[Tacori E-ring]

Re: Would you pay for a test that didn't need to be performe

I've never been to a gyn that didn't give me a pg test as part of their protocol. I also don't need them done, but I'm not going to make a fuss about it.

I've never been to a GYN that did a pg test as part of a routine appt. It seems like maybe the protocol varies pretty widely.

I haven't either. It would bother me to be charged for something I did not need, however, for less than $10 I probably wouldn't bother saying/fighting it. I hate confrontation.

 

[Gypsy]

Re: Would you pay for a test that didn't need to be performe

I would not pay for the dr's failure to communicate with staff.
and I would not pay for a staff error of just doing business as usual w/o checking the orders.

Absolutely. That is cost they need to absorb.

You have to stand up for yourself. You can BET they would send you to collections for 10 bucks. So make them absorb it. And if they give you any gruff call your insurance and tell them that you are going to call your insurance and tell them they were charged for something as a result of office error, and they will make their lives hell.

So they can either remove the charge NOW. Or they can deal with your insurance over it.

 

[Snowdrop13]

Re: Would you pay for a test that didn't need to be performe

Don't you have to give consent to all these tests? I'm not at all sure how it works in the US but that sounds like an easy way of making extra cash for the clinic! I wouldn't pay.

 

[sonnyjane]

Re: Would you pay for a test that didn't need to be performe

In my life there have been a few times when I was required by a doc to take a pregnancy test even though I knew I was not, however this was before an x-ray or other type of procedure that might be harmful. Was this the case here?

 

[CJ2008]

Re: Would you pay for a test that didn't need to be performe

I just assume I will be given a pregnancy test when I go to my OBGYN visits...unless I'm already pregnant. Further, I know many offices that have the office staff dip a urine for pregnancy during patient set up. Honestly, it's quite likely that the practice has standing orders for room set-up procedure and the test was completed long before you saw your doctor. Given that it was your first appointment, info like being post menopausal or post hysterectomy might not be part of your record yet. In the future, that kind of info would be documented and there may be a different set of standing orders. (Granted, this is all speculative, but I wasn't sure if this had occurred to you.)

Also, as a prescriber, I have my policies for some things. IE, even if a girl has assured me she has never been sexually active, I will not write for hormones (like the pill for bad periods) without a documented negative test. I make that clear to the patient and their parent. I wonder if a similar policy could have come into play if you were being written any kind of prescription?

Thanks, Munchin, for your take on this as a prescriber.

Well, what I didn't mention is that I asked the girl I talked to "how can I prevent this from happening next time?" and she said "You can't. It's protocol" (or something along those lines). And that's what I mean about her...not that she wasn't being honest or accurate necessarily - maybe that IS how their office works - but there was something about the way she was talking that gave me the feeling that it was "that's how it works and that's it" and that she'd say whatever it took to just get me to pay for the test...and go away.

But no, there were no prescriptions, etc., at all...

 

[CJ2008]

Re: Would you pay for a test that didn't need to be performe

I've never been to a gyn that didn't give me a pg test as part of their protocol. I also don't need them done, but I'm not going to make a fuss about it.

I've never been to a GYN that did a pg test as part of a routine appt. It seems like maybe the protocol varies pretty widely.

I haven't either. It would bother me to be charged for something I did not need, however, for less than $10 I probably wouldn't bother saying/fighting it. I hate confrontation.

I'm with you Tacori...I hate confrontation. Especially over less than $10, which they might use as a way to make me feel embarrassed that I'm making such a big deal about it...so I am not looking forward to any further phone calls with them (because a part of me WILL feel embarrassed...) But I hate some things MORE than confrontation and feeling embarrassed...and that is feeling taken advantage of...

I have a feeling that if my interaction with the person I had spoken with was any different I may have dropped it...but there was something very "absolute" about the way she spoke to me...and because none of what she said made good enough sense to me it's prompting me to persist.

 

[CJ2008]

Re: Would you pay for a test that didn't need to be performe

In my life there have been a few times when I was required by a doc to take a pregnancy test even though I knew I was not, however this was before an x-ray or other type of procedure that might be harmful. Was this the case here?

No, sonny, nothing like that at all...regular yearly exam...although I DID have a complaint that I spoke about with the doctor...but that she verified was nothing to worry about once she did the exam.

 

[CJ2008]

Re: Would you pay for a test that didn't need to be performe

In my life there have been a few times when I was required by a doc to take a pregnancy test even though I knew I was not, however this was before an x-ray or other type of procedure that might be harmful. Was this the case here?

No, sonny, nothing like that at all...regular yearly exam...although I DID have a complaint that I spoke about with the doctor...but that she verified was nothing to worry about once she did the exam.

 

[CJ2008]

Re: Would you pay for a test that didn't need to be performe

I would not pay for the dr's failure to communicate with staff.
and I would not pay for a staff error of just doing business as usual w/o checking the orders.

Absolutely. That is cost they need to absorb.

You have to stand up for yourself. You can BET they would send you to collections for 10 bucks. So make them absorb it. And if they give you any gruff call your insurance and tell them that you are going to call your insurance and tell them they were charged for something as a result of office error, and they will make their lives hell.

So they can either remove the charge NOW. Or they can deal with your insurance over it.

Right, that was the NEXT thing I was thinking about, if, after I speak to the Dr. what she says doesn't make sense to me...or still feels "wrong." I was wondering how the insurance could come into play.

Which, by the way - my insurance DID tell me - I had just called to inquire about the exams not being covered 100% - that had they CODED those exams as part of the wellness visit, that they would have been covered 100%. When I told the girl on the phone that, she said that the insurance ALWAYS blames the coding, that a lot of times they say they'll cover it if coded differently, then the codes get changed, and they end up NOT covering it. I have not found this to be the case - there have been a few instances where a procedure was recoded and ended up being covered in my favor - however, I do know that insurance companies make mistakes too and that they won't stand by what they said necessarily. I didn't press the issue because my first goal is to question why it was run at all.

 

[CJ2008]

Re: Would you pay for a test that didn't need to be performe

BTW - thank you EVERYONE for your input - even though I didn't reply to each person individually hearing all of your input helped so much.

Thank you all as always

 

[msop04]

Re: Would you pay for a test that didn't need to be performe

I'm not sure about every GYN, but a pregancy test has been protocol with every GYN office I've been in contact with (both personally and professionally). It's important for them to know "for sure" -- especially when it comes to any diagnostic issues (to rule things out) and prescribing (to ensure safety).

Not that this applies to the OP, but you wouldn't believe how many women swear that "there's no way" they could be pregnant when they come into our clinic... and they are. So, although it seems pointless, it's just a good precautionary measure for the GYN (or other doc) to take -- just in case.

Just speak with the doctor is it bothers you that much...

I could see that they need to make sure...

However - let's just say that one of the reasons was that the doctor SAW during the exam I couldn't possibly be pregnant.

Now...it's also possible the staff ran the test before that?

I think what's making me hold on to this more is that the person who called me from the office could have been...better...she wasn't bad but at the end she asked me if I wanted her to take payment over the phone - even though she could tell I was not too convinced or thrilled with the explanation...which to me seemed like a subtle passive aggressive thing for her to have done...(the bill is not old or past due.)

ETA: and msop04 does your office (and others that you've dealt with) run the tests without ASKING first? Or at least having a discussion? I think at least in my situation, given my conversation with the Dr. and what she found during the exam, it should have been talked about (unless again, it's possible they ran the test right after I provided the sample, BEFORE I talked with the Dr. and before the exam? Not sure how tests are normally run, if they're done in-house, etc.)

Hey CJ

If your appt was specifically for that reason (as opposed to just a "yearly" and that's all), then I don't think a pregnancy test should be billed. Like you mentioned, it's possible the staff ran the test prior to that. If it were me, I would ask that the GYN make an annotation to your chart to not do that test unless told otherwise. It sounds like it's just the "standard" and the staff treated it as such. Unless it's required "no matter what" by said office, it's the GYN's responsibility to make any changes to your care. I'm sorry you were treated that way by the staff -- that's not acceptable and borders on bad service, IMO.

As far as my office (clinic, rather), we aren't specialized to GYN -- we are a general care clinic. However we will perform certain tests/procedures/exams upon request of the patient (provided the physician feels chief complaint warrants such at the time). I'm not sure if the physician "asks" the pt, but we do inform them of any/all testing that is ordered prior to doing them. If the pt refuses, then of course they wouldn't be performed... but yes, I would imagine the consent of the patient is needed. I wonder if we (as women) are giving permission for tests deemed "standard" when we sign all the admission forms?? Admittedly, I never read any of the fine (or not-so-fine) print when I complete the paperwork. It would be worth looking into.

It sounds like your situation may be a little different and require some changes made to your chart. I would speak with the doctor and ask why the test was run. It may be for reasons you wouldn't think of (major clinical stuff), or it could have been run as the standard before you spoke with your GYN. We do our pregnancy testing in-house, and it's a super quick test, so there's a possibility that's what happened -- routine for the staff, so they just did it, KWIM? Either way, I would mention it and if the answer is the latter, ask that it not be done in the future. If your GYN indicates that the test wasn't needed, but not documented, then that's an easy fix... however, if the doc does annotate that you shouldn't receive the testing and it accidentally happens again, they absolutely should not bill you for it. Good Luck, CJ!

 

[msop04]

Re: Would you pay for a test that didn't need to be performe

No I would not. Patients authorize the doctor to submit orders for tests. No provider should EVER order tests without that auth.

I also would find a different doc and practice. That one has problems. You saw only the tip of the iceberg. You're lucky, act on that.

I don't think that's a very fair statement, azstonie. You are correct in that a patient must give consent, however, some may have already done so (albeit unknowingly) by signing paperwork upon admission without reading it. However, if the pt has not given consent, then any/all testing or examinations should not be done.

Of course I have no idea of how the OP's GYN office operates, but the most likely explanation is that it was done by staff as a routine test (you have to sign documentation prior to ANY testing - this is usually upon admission or creating your chart as a first time patient). I know it's routine for every "yearly" at my GYN group. Also, people make mistakes. It could have been just that -- a mistake bc it is a routine GYN test. If it wasn't ordered or was a mistake, the OP should absolutely be reimbursed for the charge.

 

[Lady_Disdain]

Re: Would you pay for a test that didn't need to be performe

When I worked in a lab, there were several tests that were packaged together, since they were usually requested at the same time. This allowed the test to be automatized (the test tube would run once through the equipment and all tests were done sequentially, with no input necessary until the results were analysed). This was much cheaper than running the tests separately, where someone had to double check that everything had been done, feed samples into different machines, program, etc.

However, in most cases, the tests had to be billed separately, because of how health insurance processed the payment (each exam had a code, with a few test groups as exceptions). In the end, this was cheaper for everyone but all the tests had to be performed. Might it be something like this?

 

[azstonie]

Re: Would you pay for a test that didn't need to be performe

Here is the skinny:

It is UNETHICAL for a physician to order a test without your KNOWLEDGE AND AUTHORIZATION.

Period.

Would it be okay with you to be given a pelvic exam by multiple residents while anesthetized and waiting for your thyroidectomy? This used to be standard procedure as late as the early 1980s. No 'authorization' from patients.

Would it be okay if you went in to have a fibroid removed and when you wake up, you find out you also received an appendectomy?

Would it be okay if the standard protocol at the office was an HIV test with your knowledge and authorization?

The point here is that no test or procedure is done without your knowledge or authorization and all physicians know this, your insurance company knows this and so does the state's medical board.