Gyno ran STD tests insurance won’t cover

[Anonymous]

Honestly, we all should ask our doctors every single time, "WHat's the charge?" and should call up our insurance companies on the spot - "how much of this do you cover?"

Yes, appointments will take a lot longer. But until we all start doing this, nothing will ever change.

Imagine if 8 women EACH DAY in your OBGYN office asked the doctor "How much will this cost?" and sat there on the phone waiting to check with the insurance company? The doctor's office would now have an incentive to post the fees and codes and even to report back what other women found out would be the cost.

[Anonymous]

Anonymous wrote:Honestly, we all should ask our doctors every single time, "WHat's the charge?" and should call up our insurance companies on the spot - "how much of this do you cover?"

Yes, appointments will take a lot longer. But until we all start doing this, nothing will ever change.

Imagine if 8 women EACH DAY in your OBGYN office asked the doctor "How much will this cost?" and sat there on the phone waiting to check with the insurance company? The doctor's office would now have an incentive to post the fees and codes and even to report back what other women found out would be the cost.

Every insurance has different specifics. There is absolutely no way for a medical office to know this. Policies can change from week to week. Many offices accept dozens of insurance policies.

Also- there is no office where doctors see 8 patients per day, unless it is concierge.

There are multiple threads per year with complaints about waiting for doctors. This suggestion will not result in the change you are looking for.

[Anonymous]

Anonymous wrote:

Anonymous wrote:How much is the bill?

A little over $100. Again, it’s not the money. It’s an unfair business practice. I’m guessing most insurance plans wouldn’t cover these tests either.

But they asked if you consented to the tests.
You should know what your insurance covers before consenting.

[Anonymous]

Anonymous wrote:Annual exam/PAP. Doctor asks if I want STD testing. I say sure, why not. I’ve had this done as an add-on to annual exams before and never been changed a dime, as insurance covers the tests as preventative. Stupidly, I did not ask which specific tests; and she did not itemize.

Imagine my surprise when I receive results for a panel testing everything including trich and HSV 1/2. Unsurprisingly, I am being billed by insurance for those specific tests because they are not considered “preventative” STD screening. The normal stuff (HIV, chlamydia, etc.) is of course covered.

Trich and HSV 1/2 have never been part of a standard STD panel in all of my years of going to the gyno. In fact, it is specifically recommended by the CDC NOT to run these tests without symptoms, so I am not surprised my insurance isn’t covering them.

Am I just screwed? I’ve called and talked to the practice billing department and office manager, who said that is the standard panel since I consented to STD testing, and they are not responsible for what insurance does or does not cover. She even said that no one else seems to have a problem with this (highly doubt it, as I have a very standard BCBS PPO). My insurance company says they will not cover these tests because they are not considered preventative care under the ACA.

I will not go to this practice any more over this, obviously, but do I have any other recourse here? It’s not the money, it’s the principle of the practice wasting my (and insurance) resources on medically unnecessary testing. It was a money grab, pure and simple.

Yeah pay the bill. You consented.

[Anonymous]

Why did you think you needed to be tested for STDs? Are you a loose woman?

[Anonymous]

Anonymous wrote:

Anonymous wrote:You failed to ask questions. You also signed a paper about consent, right to refuse treatment and obligation to pay. Next time ask more questions. It’s your fault not theirs.

Oh stop it. Our system is stupidly complicated and it’s absurd to expect OP to be able to navigate it better than the people who literally designed and benefit from the systemic dysfunction.

Agreed.

Although I will say to OP that if you are mad any anyone/anything it should be your insurance. I just got a $300 bill for labs for ovarian cancer testing. I forgot to ask for it to be sent to Labcorp (if it even could be) and I'm irritated but there's nothing I can do.

I will also say that I got so pi**ed about a lab charge once that I let it go to collections and they eventually offered to take 50% of the total bill. #sortofwinning

[Anonymous]

I’m a doctor and part of the issue is we don’t know how much you are billed. We just order things we find necessary and aren’t aware of the ultimate charge. I sometimes wonder if we did if we provide unequal care- like get more tests for rich ppl or something like that.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:You failed to ask questions. You also signed a paper about consent, right to refuse treatment and obligation to pay. Next time ask more questions. It’s your fault not theirs.

Oh stop it. Our system is stupidly complicated and it’s absurd to expect OP to be able to navigate it better than the people who literally designed and benefit from the systemic dysfunction.

Oh stop it. It’s really not that hard to say “I consent only to what is covered by my insurance company I’m not paying out of pocket for it.”

I have never seen anyone succeed in negotiating any of the terms on the boilerplate forms you fill out at doctors appointments. I’m an attorney and don’t even bother reading them. If you try to negotiate I expect they’ll tell you to pound sand.

I'm an attorney, and I read these forms and cross out the parts I don't agree to. In particular, I always look for the boilerplate that says some version of "you consent to whatever tests we run" and "you consent to whatever doctors we bring in the room".

Yes, I have had admin staff tell me "you can't change the form" and I just look them in the eye and say it's not voluntary consent if you tell me I have to consent. I made an appt with Dr X and that is the only person I am consenting to see. I will provide consent to testing when I see what tests are recommended.

Just last week a doctor's office admin person was asking me to sign a blank form permitting my doctor to share my info with anyone. The staff person pressured me several times to sign the form assuring me "we only use it to share info with your doctors" and "I replied "I'd be happy to fill out which doctors I will allow the Dr. to share with", which she kept refusing and trying to force me to sign the form without filling it out. I finally said point blank - I will not sign a blank form.

I also notice when I am presented with a page to sign that says you agree to page 2 (when page 2 was never provided). I sign and note, "page 2 not provided".

I have never once been refused care because I refused to give a blanket consent.

I have been asked to pay huge bills at labs I didn't consent to or with doctors I did not consent to, and being able to say, I did not consent has been a solid defense.

Is it annoying? Yes, but it's less annoying than paying a $2K lab bill sent to an out of network lab I didn't consent to when I presented my insurance and the labs could have been easily sent to Labcorp where I would have paid $30.

[Anonymous]

Anonymous wrote:https://www.cdc.gov/std/treatment-guidelines/trichomoniasis.htm

I think you misread the CDC guidelines. You should definitely have a test if you have symptoms. But there is a recommendation for screening in other circumstances. And the majority of people with trich do not have symptoms. Nowhere does it say “don’t test unless the pt is symptomatic.”

I also think HSV is part of a standard panel, but I’d have to check.

HSV is not part of the standard panel.

[Anonymous]

Anonymous wrote:ONLY IN THE US IS THE SYSTEM SO COMPLEX THAT PATIENTS ARE BILKED OUT OF MONEY BY THE HEALTHCARE INDUSTRY WHEN THEY DON’T ACT AS THEIR OWN LAWYERS.

No patient should be expected to navigate such a system.

Don’t you dare blame OP or others for not remembering to ask all the right questions every single time.

Sorry this happened, OP. Healthcare and guns are the two biggest industries crying out for regulation in this country. Every other first world country does significantly better in these two categories.

+1
I hope you didn’t have your legs open in the air when she asked ffs

[Anonymous]

Anonymous wrote:You failed to ask questions. You also signed a paper about consent, right to refuse treatment and obligation to pay. Next time ask more questions. It’s your fault not theirs.

This. Lesson learned and thankfully it isn’t too $.

[Anonymous]

Something similar happened to me recently. Dermatologist in network sent my sample to an out of network lab = I had to pay out of pocket. In the future I could ask derm to send to an in network lab, but I doubt the practice is going to send samples to the many different locations covered by all their patients. They're going to use the lab they use.

[Anonymous]

Anonymous wrote:Honestly, we all should ask our doctors every single time, "WHat's the charge?" and should call up our insurance companies on the spot - "how much of this do you cover?"

Yes, appointments will take a lot longer. But until we all start doing this, nothing will ever change.

Imagine if 8 women EACH DAY in your OBGYN office asked the doctor "How much will this cost?" and sat there on the phone waiting to check with the insurance company? The doctor's office would now have an incentive to post the fees and codes and even to report back what other women found out would be the cost.

Do you understand how medical billing works? Your doctors office bills your insurance company and they cover some portion of service based on the policy you have. Whatever isn’t covered gets sent back to you. But if a doctor sees 20 patients in a day they may have 20 different insurance policies with 20 different Types of coverage so the amount that gets billed to your insurance company is not particularly useful information to you unless you know what percent you’ll be responsible for, that looks like before and after meeting deductible et cetera.

[Anonymous]

The issue is you think your priority is health, but it’s actually cost.

When asked “do you want STD testing?” you should have said “only if there is no out of pocket charge.”

When the doctor in turn said “I can’t tell you what will and won’t be covered”, then you should have declined testing.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:You failed to ask questions. You also signed a paper about consent, right to refuse treatment and obligation to pay. Next time ask more questions. It’s your fault not theirs.

Oh stop it. Our system is stupidly complicated and it’s absurd to expect OP to be able to navigate it better than the people who literally designed and benefit from the systemic dysfunction.

Oh stop it. It’s really not that hard to say “I consent only to what is covered by my insurance company I’m not paying out of pocket for it.”

I have never seen anyone succeed in negotiating any of the terms on the boilerplate forms you fill out at doctors appointments. I’m an attorney and don’t even bother reading them. If you try to negotiate I expect they’ll tell you to pound sand.

I'm an attorney, and I read these forms and cross out the parts I don't agree to. In particular, I always look for the boilerplate that says some version of "you consent to whatever tests we run" and "you consent to whatever doctors we bring in the room".

Yes, I have had admin staff tell me "you can't change the form" and I just look them in the eye and say it's not voluntary consent if you tell me I have to consent. I made an appt with Dr X and that is the only person I am consenting to see. I will provide consent to testing when I see what tests are recommended.

Just last week a doctor's office admin person was asking me to sign a blank form permitting my doctor to share my info with anyone. The staff person pressured me several times to sign the form assuring me "we only use it to share info with your doctors" and "I replied "I'd be happy to fill out which doctors I will allow the Dr. to share with", which she kept refusing and trying to force me to sign the form without filling it out. I finally said point blank - I will not sign a blank form.

I also notice when I am presented with a page to sign that says you agree to page 2 (when page 2 was never provided). I sign and note, "page 2 not provided".

I have never once been refused care because I refused to give a blanket consent.

I have been asked to pay huge bills at labs I didn't consent to or with doctors I did not consent to, and being able to say, I did not consent has been a solid defense.

Is it annoying? Yes, but it's less annoying than paying a $2K lab bill sent to an out of network lab I didn't consent to when I presented my insurance and the labs could have been easily sent to Labcorp where I would have paid $30.

Great advice thank you.