bills for tests MW's office did without my permission

[jsh7809]

Okay. I had a long rant about this that got moved to the "finances" category but I wanted to try a different approach/ shorter post here again. The short version of my story is that the midwife I used to be with (I've been with three practices throughout this pregnancy for insurance/ distance reasons) sent me a bill for some STD tests I didn't need or approve (or want). They're demanding payment for $205 for these tests - although I had already had the same tests done at a different practice two weeks before. I brought all of my bloodwork and information from the first doctor's office to the subsequent midwife's, and said "here are the tests I've had and don't need to rerun." So I thought the bill was just a mistake on their end -especially since they never took any blood or did a pelvic exam, since they weren't necessary - but after months of trying to get straight answers, they are now telling me that they ran these tests from my urine sample - the one I thought was just for the standard ever-visit protein testing - and I have to pay for tests that I did not require, need, want, or approve.
Besides the money (which is not small potatoes - we are really struggling right now), it infuriates me that they can just say "well, this is our standard of care, we run these tests no matter what." I brought the necessary documents and was really clear with the midwife that I didn't want to do any testing or procedures without full consent or approval first. Or at least I thought I was! I feel kind of violated that they would even run these tests without telling me... not that I'm worried about the results, but it was never clear to me what they were doing. I had no idea these tests were even run until 2 months ago (and they were run in August!). I certainly never got any kind of lab results paperwork in response - and I didn't need it, because I had just had totally clear tests for EVERYTHING like 2 weeks before! Not to mention I've been with the same man for 10+ years, grr....

So, my question is - has anyone had luck with dealing with a provider/ medical office that just treats you like a number and not a human? I am no longer with this midwife, so it's kind of moot except for the bill for $205 that I refuse to pay. But trying to clarify to the office and their billing agency, I just end up going in circles - and getting told again and again that it's their "standard of care". I am disgusted that the standard of care is to run tests without permission or necessity, but I imagine that legally I signed something at my first visit saying that I approved their standard of care or whatever...

I'm so angry and at a loss for a next step... many phone calls and a letter haven't done anything, and I'm trying to think of a new approach.

[thefreckledmama]

Assuming you haven't already-approach it from a "I did not CONSENT to these tests" angle. Throwing around a lack of consent can hold a lot of weight in the medical field...sometimes.

Honestly, if it were me, and I no longer had a relationship with this office, I would probably tell them I wasn't going to pay it, and just make sure you have a a record of having had the same tests previously in this pregnancy, in the event you would ever be sued over it. Then you can show that you didn't consent to the tests, and had already had them, so there was no need for them to give them to you.

[jenniferadurham]

We just had a similar situation happen to us. We called into the kids DR office bc we thought DS might need to go in. DH talked to the front desk lady and she said I will make you an appt for the end of the day and if you decide not to come, just call and let us know. DH said no, not to make the appt that id we needed to come in, we'd call back or call tomorrow. So about 4or so that day she called back to check on DS, we told her we wouldn't be coming in. I get a call a few weeks later from her asking where I am, if I'm coming in for DS's appt...wha??? I didn't make an appt...she said that the day that DH called in he made an appt for DS to come in this day. I said "NO...he doesn't make the appt's...I do bc I'm the one bringing the kids in if we WERE to make one..." We ended up getting a bill for a canceled appt...$45...so we called the Better Business Bureu(sp?) and they contacted the DR's office. The ended up taking the $45 charge away...

I would suggest calling the BBB and letting them know what happened...may be worth a shot.

BTW...totally LUDACRIS that this DR's office did that to you...I would be LIVID. To my understanding...they can't test w/out your knowledge...

Good luck...I hope it all gets settled!

[lovebug]

To my knowledge, when you consent to being a patent there you consent to their standard practice of care. So in a way you did consent. However, if it is not a test that insurance covers or that you have to pay out of pocket they should warn you of that. Being that you just had the test done, your record should be proof enough to NOT have the test again.

I would call the Drs office and demand the charges be removed. It is not ok to do test, even if they are the standard of care if you have to pay for them out of pocket. They should have put you in contact with the person that does the billing or given you some kind of ‘this will be the amount you will owe after x,y and z takes place.

I would also point out that you had your records transferred for a reason, so this kind of stuff does not happen!

[khaoskat]

By the way, I would stop dealing with them on the phone. I would do everything by mail, so you have a paper trial.

1) I would continue to deny that you owe the money. That you were never informed that these tests were being run, that you never consented to the tests being done; that the tests were done already by your previous provider and you supplied them with the documentation.

2) I would demand a copy of the lab report for these tests they allegedly administered using your urine.

Even though it is their standard to do the testing, you as a patient have rights, and those rights allow you to refuse any test or procedure you do not want, even if it goes against their standard of care.

If you told them that you did not consent to the testing, because it had already been performed, or even that you did not want it performed, then they had an obligation to honor your wishes or terminate you as a patient. They legally could not perform the test without your consent.

[HappyMommy2]

I agree with putting it in writing. Also tell them that you told your mw, and your mw agreed, that you would not be getting those tests.

Since somebody else didn't read the charts, and just did their SOC, it is not your fault. You were clear, and the person you spoke to was clear about it.

It is not your mistake, it is theirs.

[wildturkeyleg]

I had this happen to me in my first pregnancy. I was told I would not be tested for cystic fibrosis, then received a $500 lab bill for a CF test. When I called the Doctor's office about it, they weren't going to do a thing until I brought up patients rights. You have the right to informed consent. I had to right a letter to the Doc's office, just stating everything that happened, and they covered the lab bill. I would right a letter, explaining what you explained to us here, and bring up that your right to informed consent was violated. Also, state what you want them to do to make it right (i.e. cover the bill for you). It's amazing how the attitude changes and how accomodating they become when you bring up patients rights. Good luck with getting this resolved!

[jsh7809]

Thank you so much for the advice! And for sharing in my outrage... I guess if it wasn't a financial issue, I wouldn't care that much, but it does add to my overwhelming sense of being just a number/ faceless patient/ being forced, er, "recommended" to do things the way they want me to
And while I am really happy with the office I'm with now, it's a huge HMO so that "just a number" thing has not necessarily gone away. It's just that now I know more of what to expect, since I've been with this HMO for most of my life, whereas the last midwife was through Blue Shield, and I had a $5000 deductible, so nothing was covered by insurance.
But that midwife was also someone I knew socially and really like, and I thought I made it abundantly clear to her that I needed to forego any and all tests and procedures that were not 100% necessary, or to at least find out completely how much they would cost first. Part of the reason we transferred to the HMO through DH's work, though I loved this midwife, was because when we tried to figure out how much it would cost to have a normal, hospital birth OR to birth at the birth center, NO ONE could give us a straight answer. The answers varied from $2500 to $8000 and up. Whereas with the HMO (Kaiser), it's $250 for the hospital birth. $5 per prenatal visit. No charge for lab fees. It is a tradeoff for some things, but it is really, really hard to beat the certainty and reassurance that comes knowing I will only ever be responsible for those charges, and I get all kinds of emails and web alerts and clear mailers telling me what is expected next by my current midwife. It's a less personalized mode of care, but it also tells me what the hell to expect, and I feel confident about using our doula to help us advocate in the hospital, etc.
Ugh, I hate that I've been seeing first how just how messed up our health "care" system is!
I did decide to stick with letters, because I have a hard time getting the same person on the phone, and with a letter I feel confident that I can be clear and angry without being tearful and "irrational". I'm saying (AGAIN) that I will not pay for tests I didn't need or authorize, that I haven't seen the results of, and that I wouldn't know anything about without this bill. It disgusts me that they took my urine and did whatever they wanted with it... I'm not really a paranoid person, so I never thought I'd have to go "wait, what are you going to do with my pee? Is there a fee for that?", particularly at a time when I was feeling so scared, anxious, and ambivalent about being pregnant.

...Calming breath...

My hope is that the paper trail will help me advocate for myself, and will help me feel like I am doing all that I can. I know that when I got the original blood tests done (which I DID pay for), they just started filling up like 6 vials and I asked what they were all for, and got a sort-of clear answer. I'm fairly certain that you can't be tested for STDs/ HIV without explicit permission (I know this for a fact because my current midwife/ the HMO had me sign something giving permission - after the fact but nevertheless), so while I probably did sign something somewhere along the line during the intake, it was definitely not clear.

I never thought of the BBB for a doctor's office, good idea! Unfortunately the medical office is part of a big health corporation so I don't know how far that would get me, but definitely worth a shot.

Thanks again, ladies!

[bjorker]

Wow, I would be livid. I'm glad others had some advice, because I have no clue. But what I do know is that I knew exactly what my midwives were testing me for, and they rightfully stuck to it.
Whether or not they are able to get away with that, it's still very poor form and disrespectful, to say the least. Good luck!

[lmk1]

I have never heard that you can use urine to test for STDs!!! Which tests did they do exactly? I would google each one and make sure that's even possible. Then, is the Dr's office demanding payment or the lab? Who actually did the testing? Did you ever get results from the testing? If the lab did the testing, then I would contact the lab to make sure this actually happened. Honestly, in all my life, I've never heard of urine being sent off to a lab to do any kind of STD testing.

[jsh7809]

Ugh, I'm not even sure that you CAN do STD tests from urine? When it first appeared I thought it was a mistake, seeing as how they never did a blood test. When I told the billing lady that, she said "they must have done a pelvic." I said, NO no pelvic was done either. Weeks later someone else said they did a urine test... but it sort of seemed like they didn't know what they were talking about. So who knows!
Payment is being demanded by Sutter Health, which is a massive medical conglomerate... it says that the lab is where the invoice initiated from, though I've never visited their lab in my life. No one can give me a straight answer!!

Now I'm wondering if maybe I should call them again, after all, to see if it's even humanly possible to test from urine. It is so incredibly frustrating. I'm mailing the letter out tomorrow so we'll see... but of course any response I get can take months and months, and meanwhile I am being sent to collections. Disgusting!

[lmk1]

Originally Posted by jsh7809

Ugh, I'm not even sure that you CAN do STD tests from urine? When it first appeared I thought it was a mistake, seeing as how they never did a blood test. When I told the billing lady that, she said "they must have done a pelvic." I said, NO no pelvic was done either. Weeks later someone else said they did a urine test... but it sort of seemed like they didn't know what they were talking about. So who knows!
Payment is being demanded by Sutter Health, which is a massive medical conglomerate... it says that the lab is where the invoice initiated from, though I've never visited their lab in my life. No one can give me a straight answer!!

Now I'm wondering if maybe I should call them again, after all, to see if it's even humanly possible to test from urine. It is so incredibly frustrating. I'm mailing the letter out tomorrow so we'll see... but of course any response I get can take months and months, and meanwhile I am being sent to collections. Disgusting!

Is Sutter Health somehow connected to your MW's office? You would get a bill from their lab, if the urine got sent to them. Did you talk to Sutter or your MW's office? Who told you that it was the urine that got tested? Ask the MW's office for your test results. Whether or not you authorized the test, you still have full right to your medical records. It is possible, that there's a mistake somewhere, that someone else's records got mixed up with yours?
I would definitely first get a list of what was tested and the results and then go online to verify the validity of such testing. For example, I just googled gonorrhea, and it said while urine testing can be done, it's not as accurate as blood testing.
If you get a call from collections, tell them you are disputing that the charge is accurate, because 1-you specifically told your health care provider NOT to test 2-no blood was drawn 3- you were never notified that any test was conducted nor notified of results
I mean, really what's next, they'll swipe a hair from your sweater and send that in to test?

[khaoskat]

Originally Posted by jsh7809

I am being sent to collections. Disgusting!

Oh, this is a very easy one to deal with once it goes to collections.

I can even type the draft letter for you right here and now..

Dear Sir/Madam:

Please be advised that I dispute the validity of the debt that you allege is due and owing to XYZ company that you are collecting on their behalf against myself.

Please provide written proof and documentation within 30 days of receipt of this letter, from the original creditor, along with anything I have signed showing I would be financially responsible for said debt. Furthermore, if said debt is based upon medical testing or diagnostics please provide copies of any and all lab reports showing that said testing was done, including anything that I signed authorizing said testing.

[lmk1]

Originally Posted by khaoskat

Oh, this is a very easy one to deal with once it goes to collections.

I can even type the draft letter for you right here and now..

Dear Sir/Madam:

Please be advised that I dispute the validity of the debt that you allege is due and owing to XYZ company that you are collecting on their behalf against myself.

Please provide written proof and documentation within 30 days of receipt of this letter, from the original creditor, along with anything I have signed showing I would be financially responsible for said debt. Furthermore, if said debt is based upon medical testing or diagnostics please provide copies of any and all lab reports showing that said testing was done, including anything that I signed authorizing said testing.

wow, you're good! I think I have a few issues that I need your help with, LOL!!!

[jsh7809]

seriously, khaoskat, thanks! that is awesome
and, yes, Sutter Health is the parent (or whatever) of the Sutter Medical Foundation which is the entity that my midwife's offices at Sutter Medical Offices NorthBay is through. If that makes sense. So the bill is from Sutter Med. Foundation, for services through my MW's office, for labs sent to the Sutter Health Lab (upstairs from my MW). Where I've never been.
It's seriously such a waste of time/ energy/ stress for me, it's probably not even worth the $200 to contest! But I am sticking to my guns. I probably need to change my outlook about it and not let it get to me, but as you can imagine, it's frustrating to say the least.
The circle (of hell) phone calls have been something like:
me: "this is billed in error, I didn't have any bloodwork done."
sutter: "it was a pelvic exam."
me: "no, it wasn't - I didn't have one of those either"
sutter: "we'll look into it."
(months later): sutter: "that was for the lab's pathology charges."
me: "what does that mean?"
sutter (just a billing person, obviously has been told what to say): "you didn't have to visit the lab, these charges were for the pathology"
me: "I have no idea what you mean at all"
sutter: "let me check with my supervisor... okay, she says that is for some urine tests"=

AAARGH!

gotta laugh or I'll cry.

[khaoskat]

You could always throw them the curve ball that you would like a copy of their forms to fill out to receive treatment for low/middle class families, at no cost out of pocket to yourself.

And thanks about the letter.

[Dena]

Just to add to what others have said:

Send any letters you send certified mail, return reciept requested. Then they can't say they didn't recieve them. This is especially true for collection agencies.

As for the collection agencies, we had to go this route once when we were billed a re-delivery fee for a department store to re-deliver furniture because they BROKE THE LEGS OFF of the first table they sent, and we refused to pay. The first collection agency, upon receiving our letter, promptly sold the debt to a second collection agency, and so on. It took several years and several letters sent to several agencies before the thing went away - but it did finally go away, and now the department store at issue is the only place where we have an issue with our credit. So, you may have to be in this for the long haul.

In addition to the BBB, I would also file a complaint with your state Attorney General's office and any state medical licensing agencies. Their investigations may be sufficient to get the provider to drop the bill to avoid licensing sanctions. And believe me, running tests without informed consent is a big malpractice no-no.

And absolutely do demand the lab results and make sure that they can be run off of a urine sample. If the tests they say they did have to be done with blood, and you had no blood taken, you are being swindled, and a trip to small claims court may be in order to get the bill dropped.

[HaikuMommy]

Please be careful with Kaiser. I had my prenatal care with Kaiser and gave birth at a Kaiser hospital. Sure, I appreciated knowing in advance how much everything would cost, because of course money was tight... but with Kaiser you never get to meet the person who will be delivering your baby until you are IN LABOR. The CNM who delivered my daughter seemed to just glance at my birth plan and that was it. Even though it was expressly forbidden in my birth plan, she ended up pulling on the cord immediately after my daughter was born, leading to the cord snapping (due to a velamentous insertion). Next came 40 of the most painful minutes of my life, with her digging around trying to manually remove the placenta. I could have bled to death! Meanwhile my baby was taken away because I was in too much screaming, writhing pain to hold her, of course. I'd never want to give birth with a complete stranger in charge again. If I HAD to use Kaiser again, I would DEFINITELY hire a doula to make sure my wishes were not disregarded. Hope I haven't scared you, but I want you to have a good experience and not the shock of your life. Best wishes for you and your little one!

[jsh7809]

Dena, thanks for your experience. We have a doula we really really like and trust so that will hopefully help! I know it is such a drag to not know who will be there to attend the birth, but having my husband and the doula will hopefully mean that we will be left to ourselves as much as possible until delivery.
Very interesting, a friend of mine that just delivered there had to have her placenta manually delivered (i.e., pulled out, like you had to suffer through!) as well. I don't know the details of why, I think her placenta just never detached - but though it is likely a coincidence, I will definitely mention that to the doula so that someone who knows what's going on can watch for that. I hate the idea of them pulling on the umbilical cord! And, yes, she said it was nightmare having to have them manually remove it.
But that is where we're going to deliver, so we're going to make the best of it, and hopefully having a great doula will help.

[elus0814]

I don't have any suggestions because when this happened to me my insurance covered the whole thing. I started prenatal care at a practice, the doctor knew I was moving a few weeks later to another state and said he was ok with me not having blood work done because it would likely have to be redone after I moved. I was moving in my in laws and they have cats so I asked to be tested for toxoplasmosis, just so I would know if I had ever been exposed to it in the past. He sent me down the hall to their in house lab (which I'm sure he, as the owner of the practice, made a nice profit on). I don't like to watch blood draws but I looked when it seemed to be taking a long time and I saw a line up of little test tubes! I told the lady I was just having one test and she started listing all the tests the doctor asked for. There were std tests, a blood type (which I already knew), some kind of screening, and a slew of drug tests! They were testing for every drug I'd ever heard of and some I hadn't. I was so mad, I asked her to throw away the tubes since I hadn't consented to the test and she refused. I went back to the doctor's office and he was really defensive. I few weeks later I got a letter in the mail that said he had dropped me as a patient. Like I would have ever gone back there! Plus, I was about to move so it didn't matter.