Costly Error

FlowerGarden

Active Member
I just wanted to post about something that happened to my difficult child at his psychiatrist's appointment in case someone else winds up in the same situation. difficult child's dr wanted to drug test him. Normally he gets a script and goes to the lab. The doctor wanted to do it at the appointment and had the woman in the office check difficult child's insurance about having it done. difficult child said ok because the person supposedly called the insurance and said it was covered. They did the test and now difficult child received a bill for it. He's out hundreds of dollars because the insurance won't pay it because it was out of network. The dr's office says they were told it would be covered. Insurance says no and that difficult child is responsible for the bill. If anyone has a difficult child that gets drug tested please have them know exactly where they have to be drug tested and not trust what is being conveyed over the phone at the doctor office!
 

DammitJanet

Well-Known Member
Thats a wonderful question.

Every so many months when I go to my pain clinic I get drug tested. They use the same little tests that you get at Walmart that do the whole panel...they might cost more than $30 but not much. My insurance is billed over $150 for the test down in the office and then supposedly they also send it out to another lab to retest it. I see the charge for that too on my EOB's. I have no way to know if they really do send them out or not. Personally I doubt it. Maybe they would if the test was questionable but I know that my insurance gets billed for both every time they do the drug test on me. I think its an insurance scam.
 

Kathy813

Well-Known Member
Staff member
My difficult child's drug tests are billed at over $1000 each time. They are very in-depth tests and cover multiple drugs. The IOP sends them to a place that is not covered by her insurance and she gets a bill each time.

difficult child owes over $70,000 in medical bills and they will never see a penny. If difficult child ever does get her life in order and stays clean and sober, we are going to tell her to declare bankruptcy.

We have gotten some calls from bill collectors asking for her and I just laugh and tell them good luck.

You will probably have to fight the insurance company. I am disgusted with Humana. They tell us things are covered and then deny them when they receive the bill.

This is going to continue to happen as long as our health care is in the hands of companies that make a profit by limiting what they pay out. I don't understand why anyone thinks this is a good idea.

Kathy
 

DammitJanet

Well-Known Member
Me either Kathy. One would think I have pretty good health coverage right now because I have both medicare and medicaid. I do have pretty good access to doctor's as long as there happens to be one near me. However prescription drugs can be a whole other ball of wax.

I dont know if you have noticed the new advertisements for Belviq which is a weight loss medication. My psychiatrist prescribed it for me because nothing else is helping and I really dont want to have surgery. Well, neither my medicare part d nor medicaid will cover Belviq. Its hundreds of dollars a month...like 3 or 4 hundred. If not more, the pharmacist just told me I could never afford it.

Makes no sense. They will pay tens of thousands of dollars to cut me open but not pay for medication for me to try to lose weight. Not to mention all the other medications they are paying for because I am overweight!
 

GuideMe

Active Member
I bought my daughter a drug test at walmart for $20.00 that covered five drugs. The $30.00 ones covered all drugs. When I got arrested that one time, my probation officer used the same exact test I bought for my daughter... the $20.00 one from walmart. I find it ludicrous that you all are paying up to the $1000.00 range for a drug test.
 

susiestar

Roll With It
PLEASE be careful about the labs that do the drug tests. Not just bc of the cost, but because they actually need to be VERY sophisticated to get the correct results. I had no idea of this until about 5 yrs ago. A combo of the flu and severe migraine meant that I couldn't keep my reg pain medications down and I had a severe seizure. I actually lost 2 1/2 days, days I will not ever remember. The doctor at the hospital handled everything badly, including refusing to contact my primary care doctor and my pain mgmt doctor. She also had the hospital lab do all the drug testing. They normally only do the instant read kind and send the others out to a specialized lab, but she didn't want that.

The tests that she ordered came back positive for methamphetamine. I have NEVER even seen meth, much less taken it. By the time I got out of the hospital, she had given orders that my records were NOT to be sent to my doctors under any circumstances. Of course she cannot do that because she does not have the right. I had records sent to my pain doctor and he was FURIOUS.

If a lab does not specialize in the drug tests, it is incredibly EASY to get false readings, usually false positives. From the way she specified my tests to be done, she could not have gotten valid readings apparently. On top of that, the lab made some super common errors and what they registered as meth was actually the result of taking phenergan for several days and of being on methadone (an opiate) and suddenly stopping it.

My pain doctor explained how it happened, assured me that he knew I did not take meth, and as he had tested me a week before the seizure, he was sure that they just did it ALLLLLL wrong.

The tests are highly specialized and must be done very carefully. Most labs just don't have the expertise. Normal protocol for reputable labs and doctors is to do the instant read tests like you see on the tv shows and then to send the samples to a lab that only does drug testing. It isn't even extremely expensive. Cash patients at his office pay only $50 if they are only on standard medications and have never had illegal drugs in their systems. If you are found to have used any illegal drugs the testing goes up to $1000 or more for each time until you have 18 mos of only rx medications at appropriate levels. But the doctor would NEVER rely on a lab that did not specialize in drug testing as it can be super hard to figure out what is really going on. False positives are vastly more common than many people think.
 

toughlovin

Well-Known Member
I think the labs can do more sophisticated tests than the ones you buy over the counter....and there are things they can test for the over the counter ones don't.

And the over the counter ones can also give false results.

TL


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FlowerGarden

Active Member
I was told that testing done by labs are more precise than the store kind, according to another doctor he had gone to previously. I have no clue if that is true. I don't know if the insurance company or the person in the office that called the insurance is at fault. The insurance covers itself by saying that anything you're told over the phone isn't set in stone. To me, that is so wrong. Why the cost is so high, I don't know, but the cost is ridiculous.
 

Nancy

Well-Known Member
That is good advice FG. I have become accustomed to checking online for everything to make sure it is in our network. We do not have a lab test ever until we actually go to our health provider website and make sure it is in network.

by the way I use to bring difficult child to a drug testing location that drug tests for many of the employers in the area and the test cost $30. They did have a larger panel test that was a bit more but $1,000 sounds like that lab is gouging them.
 

DammitJanet

Well-Known Member
While I do have medicare and medicaid, I get EOB's that show what they charge, what medicare pays and then it has a little letter next to it saying it is referring it over to medicaid for payment. For me, if they take medicare they have to accept what medicare pays. Medicaid just picks up all copays. Quite helpful when you only get 800 a month. However what I was getting at is that on my EOB it says that the test is charged at somewhere around $158 per test. Once for the little cup in the office and then the same amount for the one they send out. Now I dont believe it costs that much for the one in the office and I dont believe they send everyone of them out.

I did have an issue about a year and a half or so ago where this place tried to tell me that my labs where coming back saying that I didnt have the metabolites in my urine for my medication which meant I must not be taking them. There was no way that was correct. For one thing they tried to tell me it went back 9 months and I know pain clinics would have never let me go that long with a bad urine test. Number two, I take my medications religiously. When they told me that I immediately went to another outside lab and had my blood tested...same day...and everything came back perfect. They wouldnt accept those outside results.

Turns out someone in that office was dirty and was messing things up. It is a whole new operation now. I like them much better.
 
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