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    Lab Tests - Not Medically Necessary

    Saw my neuro in Jan. She ordered lab work but told me no rush. I told her I see my GP in April - doctor said it was fine to wait until then.
    In early April I went to lab to have blood tests. Between the two doctors, several tests were duplicates. The lab drew 6 tubes of blood.
    The lab charged me as if each doctors test orders were separate orders. Seems to me they should have been combined. I am now being charged for some of the tests as medically unnecessary even though the same test was paid for the other doctor.

    Also interesting to me is the times the blood was tested. Both reports indicate the same time the blood was withdrawn but the results are hours (6 hours) apart. The results for the same tests are different which I imagine is due to the delay in processing the second samples of blood for testing.

    It seems to me that the lab should not be charging me for any test that was a duplicate. Any I correct?
    Also not helpful is I received an email yesterday from the lab with an invoice dated July 29th - almost 4 months after the tests were done leaving practically no time to appeal with my insurance company...

    #2
    Wow! Sounds like the lab really messed up! When I have lab work done, I have them send results to both doctors, if that is necessary and the results will be important for both parties. I have had no problems with that.

    I hope you can get this all figured out and get an appeal from the ins. co.
    Goodluck!
    1st sx '89 Dx '99 w/RRMS - SP since 2010
    Administrator Message Boards/Moderator

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      #3
      Originally posted by its2much View Post
      Saw my neuro in Jan. She ordered lab work but told me no rush. I told her I see my GP in April - doctor said it was fine to wait until then.
      In early April I went to lab to have blood tests. Between the two doctors, several tests were duplicates. The lab drew 6 tubes of blood.
      Hello its2much

      Is it possible that your GP wasn't aware of the bloodwork that was already ordered by your neuro?

      I don't think the cost burden should be on you, for duplicate bloodwork done that you had no control over.

      Take Care
      PPMS for 26 years (dx 1998)
      ~ Worrying will not take away tomorrow's troubles ~ But it will take away today's peace. ~

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        #4
        Wow, if I had filled 6 tubes I would have had a Vasovagal reaction immediately.
        Marti




        The only cure for insomnia is to get more sleep.

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          #5
          That sounds ridiculous! Part of the beauty of combining labs is less cost due to no repeats and only 1 invasive procedure. I'd fight that and also wonder what CMS would have to say about that lab's practice.
          He is your friend, your partner, your defender, your dog. You are his life, his love, his leader. He will be yours, faithful and true to the last beat of his heart. You owe it to him to be worthy of such devotion.
          Anonymous

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            #6
            Originally posted by its2much View Post
            The lab charged me as if each doctors test orders were separate orders. Seems to me they should have been combined. I am now being charged for some of the tests as medically unnecessary even though the same test was paid for the other doctor.
            If the money is worth your time, before paying the bill I’d call and/or write to the lab AND the insurance company and appeal this. Modify your original post for brevity and add specific details with date of doctor and lab visits and tests ordered, clearly emphasizing they were duplicate tests performed on the same day. Not only are you getting ripped off but your insurance company could be, too.

            I’m sorry we have to dot so many Ts when managing MS.
            All the best, ~G

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              #7
              I had that before. So now I make sure PCP gets a copy of all neuro bloodwork. He then only has to order a few tests. Labs don't want to be in the business of separating, then identifying the duplicates.

              Hope you have success fighting.
              Kathy
              DX 01/06, currently on Tysabri

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                #8
                Originally posted by pennstater View Post
                I had that before. So now I make sure PCP gets a copy of all neuro bloodwork. He then only has to order a few tests. Labs don't want to be in the business of separating, then identifying the duplicates..
                Path of least resistance but unacceptable, imo. So you have to go to the lab 2xs, get stuck twice, the PCP has to track down the neuro's blood work and vice versa...Seems like an increased risk of harm to patient, unnecessary equipment utilized, additional frivolous cost and inefficient process. This is the kind of thing we as consumers need to report and protest. Medicaid and Medicare are not entities that anyone wants to cross so if they addressed this inefficiency and risk to patients it would stop.

                That the lab can't take a moment and combine two lab slips to avoid duplicates is ridiculous. Don't even get me started on why they can't seem to send results to both providers...
                He is your friend, your partner, your defender, your dog. You are his life, his love, his leader. He will be yours, faithful and true to the last beat of his heart. You owe it to him to be worthy of such devotion.
                Anonymous

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                  #9
                  Originally posted by Jules A View Post
                  Path of least resistance but unacceptable, imo. So you have to go to the lab 2xs, get stuck twice, the PCP has to track down the neuro's blood work and vice versa...Seems like an increased risk of harm to patient, unnecessary equipment utilized, additional frivolous cost and inefficient process. This is the kind of thing we as consumers need to report and protest. Medicaid and Medicare are not entities that anyone wants to cross so if they addressed this inefficiency and risk to patients it would stop.

                  That the lab can't take a moment and combine two lab slips to avoid duplicates is ridiculous. Don't even get me started on why they can't seem to send results to both providers...
                  Only one lab visit. I just make sure neuro's orders have my PCP copied, so lab sends results to both. When I see my PCP, I take copies of any bloodwork since last OV, and any pending neuro orders I have for bloodwork or tests. I keep it in one folder with multiple pockets.

                  I actually talked to the lab manager. They said they don't want to introduce any potential for error and the liability that goes with it if something missed, so they only do as ordered.

                  Personally, I think they cut staff so short - lab tech also does the paperwork, that is reason.
                  Kathy
                  DX 01/06, currently on Tysabri

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                    #10
                    Add Insult to Injury

                    When the insurer paid the lab, there was a huge discount. Charges were paid at about 10% of the charge. For those duplicates ("not medically necessary"), I am being charged the full amount!
                    Also interesting is the charge for drawing the blood is only indicated as being done once. No duplicate blood drawn....

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