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Medical Forum / General / Laboratory / February 2005

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In US, Is Doctors Prescripton is mandatory for Routine Blood and Urine Tests

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Shashi - 22 Feb 2005 16:10 GMT
Hi,

I am diagnosied with Proteinurea (Protein Loss in Urine)
due to Iga Nephritis (due to Hypertension in Kidney)

It started with 1400 mg/day - in  24 hours urine (2 years back)

Now it came down to 500 mg/day on daily medication.

In few months I will be moving from India to California,US

Due to the pre-existing situation, my company insurance may not
cover the treatment for Iga Nephritis.

For every 4 months I need to undergo the below Blood and Urine Test:

1) Blood - Cretenine
2) Urine - Complete Urine Exam
3) Urine - 24 Hours Urine Protein

Whether I can directly walk-in to any Lab, Pay Cash and Give the
Blood/Urine Samples and get the reports without the intervention
of Doctors.(as there is no insurance is involved as I am paying cash)

If Doctors prescription is compulsory then will they accept the
prescription given by my current Indian Nephrologist.

How much it will cost (Approx.) when I pay cash for all the 3 tests

thanks,
Shashi
Robert - 22 Feb 2005 18:56 GMT
It will be hard without insurance. You need a prescription from a US doctor
for testing. The results need to be evaluated by a doctor and not just
yourself as you will need treatment eventually.
IgA nephropathy can lead to renal failure so it can be a problem without
insurance.
You are in a bind where you need insurance but companies will not want to
can you on.

> Hi,
>
[quoted text clipped - 27 lines]
> thanks,
> Shashi
blades - 22 Feb 2005 19:55 GMT
Shashi, I think there are coming into being, some private labs that will
do testing without a physician's prescription.  I can't be sure, but
believe I've seen ads from private labs.
--
Bruce
Robert - 22 Feb 2005 20:26 GMT
> Shashi, I think there are coming into being, some private labs that will
> do testing without a physician's prescription.  I can't be sure, but
> believe I've seen ads from private labs.
> --
> Bruce

There are federal and state laws mandating doctor ordered testing for all
complex lab work. There are a few low complexity tests such as pregnancy
tests, Hgb, cholesterol that can be bought over the counter and done without
orders.
I think it is misleading to suggest that you can obtain testing without a
doctors order. What is being offered, as far as I can determine from above
is that those labs who are doing such tests are in fact doing low complexity
testing or is being done with their own doctors (200 or so).
There is a monetary connection between the ordering doctor and the lab
performing such testing.
I want somebody to explain to me why a lab would charge less without a
doctor order than with a doctors order and let the feds get involved with
Medicare fraud or kick-backs to the doctors involved.
There are very strict rules for private labs in not giving incentives to
doctors for obtaining business.
We could not even give them printers for the lab results generated.
Shashi - 23 Feb 2005 08:23 GMT
Hi Robert/Bruce

Thanks for the replies.

Even though I will be in US, I want to monitor my health condition
closely with my
Indian Nephrologist, who is guiding me from the last 2 years.

With his prescribed medication the 24 hours protein loss came down from
1400 mg/day to 500 mg/day.

So, I am planning to take the Indian Medicines for the treatment but as
I am
physically located in US , I need to send him the results for the
"24 Hours Urine Protein Loss' once in 4 months, just to monitor the
counts
whether it is increasing/decreasing and accordingly he will alter the
medicine
(if required).

I can get my medicines from India by my friends who are coming back
after their vacation from India. The US customs will allow the
medicines if we can show them the Indian Doctors prescription for the
same.

As the US doctors prescription is mandatory then anyone can please
tell me how much I may have to pay by CASH for the below

1) Doctors Fees for giving me the prescription
2) Cost of : Blood - Cretenine
3) Cost of : Urine - Complete Urine Exam
4) Cost of : Urine - 24 Hours Urine Protein

I also need a copy of the reports to send to my Indian Doctors for
analysis.

I am only looking into an Approximate figure (may not be the actuals
amounts)

Including the doctors fees will it be more than $200 - $300 when I pay
by Cash ?
(Doctor is only required to give me the prescription to undergo the
above Lab
tests based on my indian doctors reference letter of my health
situation)

Thanks in advance.

regards,
Shashi
Robert - 25 Feb 2005 07:39 GMT
> Hi Robert/Bruce
>
[quoted text clipped - 25 lines]
>
> 1) Doctors Fees for giving me the prescription

I would go to a community clinic that allows you to pay based on ability and
talk to the doctor there. You might also go to a University afiliated intern
program where they charge less based on ability to pay.

> 2) Cost of : Blood - Cretenine

Blood creatinine runs about $30 more or less

> 3) Cost of : Urine - Complete Urine Exam

Runs about $ 20

> 4) Cost of : Urine - 24 Hours Urine Protein

runs about $ 22

> I also need a copy of the reports to send to my Indian Doctors for
> analysis.
Have the lab give you a copy.

> I am only looking into an Approximate figure (may not be the actuals
> amounts)
>
> Including the doctors fees will it be more than $200 - $300 when I pay
> by Cash ?

There is an additonal $15 cost for having the blood drawn and other
expenses. You might want to visit several doctor offices and ask how much
the charge for a visit.

> (Doctor is only required to give me the prescription to undergo the
> above Lab
> tests based on my indian doctors reference letter of my health
> situation)
Talk to the doctors and if they don't want to help then they should not
really charge you anything or only a limited office visit.
Make some calls and explain your situation and see what develops.

> Thanks in advance.
>
> regards,
> Shashi
Shashi - 25 Feb 2005 14:11 GMT
Thanks Robert for the valuable information.

regards,
Shashi

> > Hi Robert/Bruce
> >
[quoted text clipped - 68 lines]
> > regards,
> > Shashi
 
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