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  1. #1

    Angry Do I Have to Pay for Non-Indicative Medical Testing from Well-Woman Exam

    My question involves a consumer law issue in the State of: Texas
    I went to the doctor for a well-woman exam. Previously my blood pressure was at pre-hypertension levels and I had, through life-style changes, brought it down to not just normal but good. The nurse took it twice just to be sure because she was surprised.
    I have now received bills for a battery of test that were "investigational" and were all targeted to finding something genetic that could point to a potential problem with my heart or circulatory system.
    I do not have a family or person history of heart or circulatory problems on either side of my family. In fact one of the tests was applicable only to 2-3% of Caucasians of non-O blood type with a history of oral contraceptives. I have blood type O and have never taken oral contraceptives. This is a doctor that I have been going to for decades but since it was just a run-of-the-mill exam I told the receptionist that I could see the doctor or his nurse practitioner and ended up with his nurse practitioner.
    I have listed the tests below if anyone is interested. My insurance company refuses to pay for these tests after reviewing my medical history and I don't blame them, but I do not feel that I should pay for them either.
    TESTS:Lipoprotein, Liporprotein-associated Phospholipase A2, F2 Gene Analysis, 20210G>Variant, F5 Gene Analysis, Leiden Variant, Galectin-3, Lipoprotein Blood Quan Numbers and Subclasses

  2. #2
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    Default Re: Do I Have to Pay for Non-Indicative Medical Testing from Well-Woman Exam

    If you consented to the test and signed a contract agreeing to pay for them if there was a problem with your insurance, then you contracted to pay for them. Are there more details you could share?

  3. #3
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    Default Re: Do I Have to Pay for Non-Indicative Medical Testing from Well-Woman Exam

    Quote Quoting Mr. Knowitall
    View Post
    If you consented to the test and signed a contract agreeing to pay for them if there was a problem with your insurance, then you contracted to pay for them. Are there more details you could share?
    All of those tests could be done from drawing one vial of blood. If the nurse practitioner did not inform the patient in advance what the blood draw was for, it could result in a lot of expensive tests that the patient was unprepared for.

    I am one of those people who don't have health insurance. My job doesn't offer it, and what it would cost me annually, at my age, is more than quadruple what I have ever spent on medical expenses in any given year, in my entire life, including the year I had my daughter. Nor could I afford it.

    So, I pay as I go. Every single time a doctor proposes something and I ask how much it will cost, not a one of them can tell me that. They always refer me to their business manager who takes at least a week to get back to me with a price, and generally even then, they end up billing me twice what they quoted, and I have to fight it out with them...On top of that, unless you know, from experience that the price they are quoting only includes the doctor's fee, and not whatever the lab charges, you are sol.

    I can nearly guarantee that what the nurse practitioner told the patient was that we need to do some blood tests. The patient, trusting their doctor said ok. I can guarantee that the nurse practitioner did NOT tell the patient that they wanted to do some very expensive blood tests that their insurance might refuse to cover.

  4. #4
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    Default Re: Do I Have to Pay for Non-Indicative Medical Testing from Well-Woman Exam

    But an "okay" in response to "we need to do some blood tests" is all it takes to create an obligation to pay for the testing, particularly when the patient has signed a contract that they will pay any medical costs for care provided that is not covered by insurance.

    The situation is worse than you suggest, actually, as when the blood is tested at an outside lab doctors offices often have no idea what tests will cost.

  5. #5

    Default Re: Do I Have to Pay for Non-Indicative Medical Testing from Well-Woman Exam

    I have been going to this doctor for decades. A well-woman exam requires blood to be drawn and tested for cholesterol, triglycerides, etc. There are specific things always tested and they are all covered by insurance. Since I went in for a well-woman exam I didn't expect to be tested for things I couldn't even have. For the last 20 years, a well-woman exam has always covered the same things and since I have no symptoms of anything wrong with me I didn't expect a fishing expedition out of the blue.

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