Has this kind of outrageous medical charge ever happened to anyone?

Question

My recently OB found out that my white blood count was abnormally high. The OB and my primary physician found nothing wrong with me, so they sent me to the hemotologist. Before going to the hemotologist, I made sure that they were in network for my insurance.

The hemotologist did some blood work and determined that I was basically healthy, and the high white blood count was probably related to allergies, pregnancy, or some minor digestive problems I was having. She said I showed no signs of leukemia, but she was going to do a leukemia test, just to rule it out. She said if she had to guess, she'd be like 90% sure that I did not have leukemia.

So off goes the labwork...

A month later, I got a statement from my insurance company saying that a claim had been submitted for $3500 for some lab work, under a doctor I had never heard of. After some investigation on my part, I found out that the hemotologist had sent my blood to a lab, which was NOT covered by my insurance co

The doctor was very flippant about her suggestion to send off this labwork. She made it sound like it was no big deal. She never mentioned that the test cost a HUGE amount of money. She never asked me if I'd like to do the test--she just said "I'd like to do a leukemia test, just to rule it out." She also never mentioned that this lab was out of network. (I have a very popular insurance company!)

legally, is there anything I can do about this?

Answer 1

There probably is if your insurance company won't pay it. You can get 2 CAT scans for that amount of money!

I bet she has a deal with the lab and gets a kick-back from them! Be nice if you could prove it.

My PCP is in a huge area belonging to a hospital. The hospital lab does almost all of the physicians work and are always covered! Well, I better not say always!

Be interesting to see what she ordered, and get a breakdown of the cost from the provider! I bet some tests had nothing to do with luek..

If they thought you might have luek they should have referred you to an oncologist and the procedure they usually use has been bone marrow biopsies, which I assume you did not have.

There are other tests on the horizon, however that is the one normally used!

A blood test might detect abnormal cells, but it does not require anything close to what you paid.

I think you just got had by the medical profession!

Answer 2

There are many specialty labs that cannot be done at local lab facilities - while it would be nice for a physician to inform the patient when a lab needs to be sent out they cannot possibly be expected to know the exact insurance coverage of every insurance company that each patient has.

If this lab was unable to be done at a local lab that was in network then I suggest you discuss with your insurance company the fact that the lab was required for a complete diagnosis and there was no in network lab available.

As for the doctor acting inappropriately - I really don't see it. She said I would like to run a test for leukemia - not I demand you have this done or forcibly drew your blood - you had the option to consent to the test or refuse. You chose to have it done. As for the poster who said they should have sent you to an oncologist - heme/onc are concurrent specialties and your doctor was perfectly within her scope of practice. A bone marrow biopsy would have been further down the line from a simple blood test.

She did the test, you're fine, you're mad. Had she not suggested the test, you actually had been one of the few people who actually DID have leukemia with your symptoms you'd be mad.......doctors can't win.

Answer 3

I know this kind of thing has happened to other folks and it really makes me angry. I would probably start by writing a letter to the physician explaining as you have here. Depending on her response, I'd consider filing a complaint with the local and state board, if for no other reason than to make her aware there could be future repercussions if she doesn't take the financial impact of her care on her patients. Finally, you would probably need an attorney to know if there is any legal recourse to recovering the $3500. Given the amount, it might be worth whatever the consulting fee might be (there isn't always one) to find out what you can really do. I fear not much, but I don't know that. Good luck.

Answer 4

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