 |
 | Home | Contact Us | FAQ | Search & Site Map | Link to Us |
 | Sign In | Join | Other 45 Sites in Network |
Medical Forum / General / General / December 2005Cost of Blood Tests
Hi, I am trying to get a handle on the cost of a blood test in a large Metropolitan hospital as part of a physical. My physician has an office in a wing of the hospital. I had a standard physical where the doctor sent me down to the lab for blood and urine tests. In the past I had free health care with this hospital but now I am on a deductible and I get billed for tests. However, when the bill arrived, I was amazed at the over $650 amount. Now I am trying to grapple with the specifics of the tests he wanted and cross reference that to the bill. Also I am questioning the amounts. Maybe its normal and I need to be educated. For example this is the only part of my bill that has me wondering if an error was made: LIPID PANEL - $115 COMPREHENSIVE M.... - $450 SEDIMENTATION - $20 Please note that in addition to being my physician for annual physical and reference to specialists, should I need one, he specializes in hematology. Therefore, perhaps he ordered some exotic tests even though I do not have a blood disease and just had a comprehensive physical. > Hi, > [quoted text clipped - 4 lines] > I had a standard physical where the doctor sent me down to the lab for blood > and urine tests. No such thing as a standard physical as people are not standard. Physicals are patient orientated. I have never had a urinalysis as a part of my physical and they are not generally recommended. It might be something about you that he needed it for. In the past I had free health care with this hospital Nothing is free so I don't know what's up with that. You mean you paid no deductable in the past? but > now I am on a deductible and I get billed for tests. However, when the bill > arrived, I was amazed at the over $650 amount. It's a game played in healthcare. Insurance carriers don't pay that total amount. If they did they would ban that lab from ever doing business with them again. Some insurance carriers specifically tell you to go to certain labs and they won't pay for other places. The laboratory checked to make sure you were eligible to go there otherwise they would not have done the work. Doctors can not tell you where to go for lab work as that would be a conflict of interest unless the insurance has policies on that. You can take the lab order to any lab or shop around for cost if you so desire. Now I am trying to grapple > with the specifics of the tests he wanted and cross reference that to the > bill. Also I am questioning the amounts. Maybe its normal and I need to be [quoted text clipped - 11 lines] > Therefore, perhaps he ordered some exotic tests even though I do not have a > blood disease and just had a comprehensive physical. There is nothing exotic about these tests but pretty common. Unfortunately again sedimentation rates are not a normal part of an anual physical unless there is something about you specifically that is of concern. > >> > For example this is the only part of my bill that has me wondering if an > > error was made: > > [quoted text clipped - 11 lines] > again sedimentation rates are not a normal part of an anual physical unless > there is something about you specifically that is of concern. Robert, my doctor does urine and blood for every patient. I asked about the blood tests and was informed there is nothing exotic about them. I guess that I just fell into the deductible well and have to pay amounts that an insurance company would not, because they have special contracts for what is charged. I will check around for these charges. Thanks. "Gary" <GParent@rocketmail.com> wrote in message > Robert, my doctor does urine and blood for every patient. Most abnormal results are ignored if the patient is asymptomatic and not worked up. Those that are worked up are expensive and of questionable significance. "Lawrence et al found the prevalence of abnormal results to be as high as 15%, but only 29% of those results were addressed by treating physicians. Therefore, routine urinalysis is not recommended for asymptomatic patients." "Examination of urine for signs of occult disease has a long tradition in medical care. The development of modern "dipsticks" that can perform multiple tests in a matter of minutes has made urinalysis inexpensive and quick. Most of the abnormalities detected by screening adults with urinalysis are indicative of benign disorders, such as idiopathic proteinuria, or of conditions for which the value of treatment is unclear, such as occult bacteriuria. For this reason, most authorities recommend use of screening urinalysis only for certain conditions in specific high-risk populations." http://www.vnh.org/PreventionPractice/ch44.html I asked about the > blood tests and was informed there is nothing exotic about them. I never said they were exotic only not normally done in all cases. The more tests that are done the greater the likelyhood of having an abnormal result. You are then confronted with a medical-legal position of not working up the abnormality and ignoring it or working it up into the thousands of dollars only to come up with something insignificant. Why not do a total body scan MRI every year? If you find a tiny lung lesion are they going in and tearing up your lung only to find it's nothing? Or are they going to ignore it only to find out it was cancer? The added expense would be enormous. There are a few tests that have been studied and proven to be of questionable benefit in asymtomatic individuals. A few of these are presurgical tests. There are no clincal studies out there recommending a sedimentation rate for every routine physical. "Recent trials of the ESR have demonstrated no value in screening asymptomatic individuals". As a hematologist, if he states he does it with all his patients then he should know better. http://www.haps.nsw.gov.au/edrsrch/edinfo/esr.html I guess > that I just fell into the deductible well and have to pay amounts that an > insurance company would not, because they have special contracts for what is > charged. I will check around for these charges. Thanks. The deductibe applies after the allowable charge is determined by the insurance carrier. In other words the lab can bill the insurance for $500 and the insurance only make $400 of that billable and they pay $380 leaving the $20 for you. You always look at what you have to pay rather than what the lab wants for the tests. The best place to ask is your insurance carrier as to where the costs may be less and go there. Most insurance carriers will only pay X amount for a sed rate and make the lab, no matter where you go, eat the difference and the cost to you is always the same. > Hi, > [quoted text clipped - 16 lines] > COMPREHENSIVE M.... - $450 > SEDIMENTATION - $20 IF you order your own blood tests at some place like The Life Extension Foundation, you can get the lipid panel and CBC for $35. That's right, $35 only! http://lef.org/newshop/items/itemLC381822.html For other tests, other labs catering to "customers" may have better value. For example, a VAP test can be had from lab-safe.com for $99. http://www.lab-safe.com/lab-tests/test/125/ The cost of the Sed test may be a good deal. There are different kinds. Life Extension offers a version for $14. In any case, it has been my experience that if you order your own tests, you get by far a much much much better value. > Please note that in addition to being my physician for annual physical and > reference to specialists, should I need one, he specializes in hematology. > Therefore, perhaps he ordered some exotic tests even though I do not have > a blood disease and just had a comprehensive physical. Patients taking blood work orders to local labs are price gauged big time. Customers who are able to order their own tests get a much more competitive price. I have ordered all my own blood work for quite some time now and all the work was done at the very same lab that previous physicians have sent me.  SignaturePramesh Rutajit - p2976221tongue@newsguy.com - remove tongue to reply. Pramesh Rutajit Can you explain to me about this "patient ordering one's own lab tests" process? Do you just call that place and arrange to go in and give the sample? > Pramesh Rutajit > Can you explain to me about this "patient ordering one's own lab > tests" process? Do you just call that place and arrange to go in and > give the sample? There are about 20,000 clinical lab tests out there and only about 6 or so are FDA waived, don't need a doctors order such as pregnancy and cholesterol. You need a doctors order for the other tests and the bottom line is you are the one paying for the entire cost. Paying for a sedimentation rate when you don't need one is called good marketing and making good money for the laboratory. I wish everyone were to get one every day. That really reminds me of the early days when money was thrown at healthcare with plenty of work and pay was poor because everybody wanted to get into the field and a surplus of a work force. Now the money is tight with clinically relevant lab tests being monitored by insurance companies and Medicare. I would suggest you monitor your cholesterol daily or often. We need your money. Forget about the doctor and order your own tests. > > Pramesh Rutajit > > Can you explain to me about this "patient ordering one's own lab [quoted text clipped - 16 lines] > I would suggest you monitor your cholesterol daily or often. We need your > money. Forget about the doctor and order your own tests. Thanks for the info. One question: Does the insurance give a hard time if the tests (of routine checks) are ordered w/o doctor's order request? > > > Pramesh Rutajit > > > Can you explain to me about this "patient ordering one's own lab [quoted text clipped - 20 lines] > if the tests (of routine checks) are ordered w/o doctor's order > request? They don't pay for something not ordered by a doctor and laboratories don't perform tests without a doctors order. There are many reasons for that. The lab doesn't want to get sued if your labs are showing that you are about to drop dead and the lab did nothing and just let you die. We call the ordering doctor any critical results and let him sweat. If he doesn't want to take the call then I tell him that I will document the call that he refused to take the result. If the patient dies it's his a.s. That's enough for any doctor to take the call. > Pramesh Rutajit > Can you explain to me about this "patient ordering one's own lab > tests" process? Do you just call that place and arrange to go in and > give the sample? First, do a web search for "blood tests" to get an idea of your options. I've used three different places. I order the tests I want online, I get either a lab order in the mail or they fax the order to the lab I select. Usually I get the lab order in the mail. The order comes with a list of 5-10 local labs one can use based on your mailing address. The one I use is a couple of miles away. I take the lab paper work to the lab just as if I had gotten a doctor's order. The paperwork is indeed the order of a doctor from the company you order the lab work from. They draw the necessary blood and I get the results in the mail in about 10 days. When I've needed the results faster, I call and they fax me the results to my fax machine. There is sometimes a release form that you can sign and they will fax the results to your physician. I prefer to get my own results (before the physician) and bring them into my appointments. I get a chance to check out the results, do any research I need to do, and have questions prepared for the doctor. Usually I know exactly what course of action I want to take before I go to any doctor's appointment. I expect to be treated like a customer (not a patient) and I expect the doctor to work with me on the course of action I want to take. On the other hand, one must be very careful when interfacing with doctors because most of them have a God Complex. SignaturePramesh Rutajit - p2976221tongue@newsguy.com - remove tongue to reply. > > Pramesh Rutajit > > Can you explain to me about this "patient ordering one's own lab [quoted text clipped - 20 lines] > treated like a customer (not a patient) and I expect the doctor to work > with me on the course of action I want to take. Thanks for the info. I need to spend time and learn what tests - names of tests - are needed for thorough routine checkup. >On the other hand, one must be very careful when interfacing with doctors because most > of them have a God Complex. By "God complex" you meant they think they are "superior" to us? > -- > > Pramesh Rutajit - p2976221tongue@newsguy.com - remove tongue to reply. >> Pramesh Rutajit >> Can you explain to me about this "patient ordering one's own lab [quoted text clipped - 24 lines] > must be very careful when interfacing with doctors because most of them > have a God Complex. Many doctors will be reluctant, or outright refuse, to intiate any significant treatment based on test results from a lab whose credentials they aren't familiar with. While some doctors should indeed pay closer attention to the customer-aspect of their relationship with their patients, most are busy enough that they have to set limits on how much "customer service" they can afford to provide. Personally, I have no problem with get blood tests done at another lab as long as I can know, somehow, how good that lab is. But even so, I would repeat any lab tests that were significantly abnormal, something physicians tend to do with abnormal results from ANY lab. HMc >>> Pramesh Rutajit >>> Can you explain to me about this "patient ordering one's own lab [quoted text clipped - 32 lines] > significant treatment based on test results from a lab whose credentials > they aren't familiar with. There's that "God complex" again! In any case, these are the exact same labs every physician I've had in the last 10 years have sent me too. There is no difference in quality or test results, only price. No need to get price gouged because one doesn't have insurance. In my case, I've ended up using LabCorp in all cases. Example, my daughter who didn't have insurance was sent by her cardiologest for a basic cholesterol test. The simple estimated cholesterol test. I was the one paying her medical bills and LabCorp charged her $109 several years ago. I went to the same lab at the same time and got a full CBC that included a cholesterol test that cost $28 - a test that I ordered. She was directed to show me her lab work after that and that we would order what the doctor needed ourselves. No need to pay a 300 percent mark up for the same test at the same lab. > While some doctors should indeed pay closer attention to the > customer-aspect of their relationship with their patients, most are busy > enough that they have to set limits on how much "customer service" If my physician won't work with me on cost containment, he can go f.ck himself. Without insurance, I'm interested in medications that cost almost the same price in say for example, a 20 or a 40 mg dose. If my physician cannot see the utility in prescribing the 40 mg dose (when I need the 20 mg dose) and letting me cut the things in half and cut my expenses in half, that is one lazy-a.s doctor. If necessary, I'll cut the 10 mg in half and let the doctor be personally convenced that I need the 40 mg dosage. That way I can get exactly what I need and at a cheaper price. I shouldn't have to manipulate my doctor but when the "God complex" is the rule rather than the exception, it becomes necessary. I don't intend to inflate my medical cost several hundred percent because the doctor only wants to practice assembly line medicine and thinks that "patients" don't deserve to be treated like customers/consumers. O, and for even better cost containment, I order some of my medications from international sources - the drugs are produced at the same FDA labs. They are sources I"ve been working with for 10+ years and are effective and effecient. > they > can afford to provide. Personally, I have no problem with get blood tests > done at another > lab as long as I can know, somehow, how good that lab is. All the lab work is done at fully accredited, licensed medical reference labs. > But even so, I > would repeat any lab tests that were significantly abnormal, something > physicians tend to do with abnormal results from ANY lab. Not a problem. I can reorder the same test again and again avoid the 300 percent markup. > HMc SignaturePramesh Rutajit - p2976221tongue@newsguy.com - remove tongue to reply. >>>> Pramesh Rutajit >>>> Can you explain to me about this "patient ordering one's own lab [quoted text clipped - 95 lines] > Not a problem. I can reorder the same test again and again avoid the 300 > percent markup. heh heh...It has nothing to do with "God Complex"...it has to do with the point where you just get to be too big a pain in the a.s as a customer, the point where the doctor just tells you to go f.ck yourself. He's busier than he wants to be anyway. Don't get me wrong, - most doctors that I know or practice with would probably go along with your lab and med shopping - certainly no skin off their nose as long as your self-provided info is safe and doesn't overly complicate the process and cost them any time/money. But life is short - why deal with dickheads?. Try telling your plumber where he has to buy the parts to fix your toilet. Take any busy, overworked service provider - electrician, plumber, car repair tech - and approach them with the smug, superior attitude you display here. I'll bet you have because you wouldn't be able to help yourself, and I'll bet you've heard "f.ck YOU" quite a bit. HMc "Pramesh Rutajit" <p2976221tongue@newsguy.com> wrote in > is no difference in quality or test results, only price. No need to get > price gouged because one doesn't have insurance. In my case, I've ended up > using LabCorp in all cases. Not saying LabCorp is doing anything wrong. Let's just say private for profit labs are in the business of making money. The owner of NHL, which LabCorp took over, did prison time. "Operation LabScam was launched following the Federal Government's 1992 prosecution of National Health Laboratories, Inc. (NHL) for submitting false claims to the Government. During the course of the two-year investigation of NHL, it became apparent to government attorneys and investigators that other companies in the laboratory industry were engaged in the same or similar practices, which included billing Medicare for millions of unnecessary tests, while misleading the physicians who purportedly "ordered" the tests into thinking that the tests would be performed for free. HHS simultaneously issued Inspector General subpoenas to a number of national clinical laboratories whom the working group had reason to believe were engaged in the same kind of marketing and billing scheme to which NHL had just pled guilty. The companies targeted included some of the largest independent clinical laboratories in the country. SmithKline is the third major laboratory case brought under the LabScam Initiative. On October 10, 1996, Damon Clinical Laboratories, Inc. pled guilty in Boston federal court to conspiracy to defraud Medicare and pay $119 million in criminal fines and a civil settlement. Damon's then-parent corporation, Corning, Inc., also agreed to enter into a revised corporate integrity agreement. On November 21, 1996, Allied Clinical Laboratories, San Diego Regional Lab, pled guilty to submitting false claims to Medicare and Medi-Cal, and Roche Biomedical Laboratories agreed to enter into a pretrial diversion program. Their successor corporation, Laboratory Corporation of America, agreed to pay $187 million in criminal fines and a civil settlement for conduct by Allied Clinical Laboratories, Roche Biomedical Laboratories, and National Health Laboratories. The Laboratory Corporation of America also agreed to enter into a corporate integrity agreement. http://www.usdoj.gov/opa/pr/1997/February97/082ag.htm Example, my daughter who didn't have insurance > was sent by her cardiologest for a basic cholesterol test. The simple > estimated cholesterol test. I was the one paying her medical bills and > LabCorp charged her $109 several years ago. I went to the same lab at the > same time and got a full CBC that included a cholesterol test that cost $28 > - a test that I ordered. How do you order a CBC without a doctors order? There is a conflict of interest for a laboratory to have a doctor order lab tests for a particular laboratory that is on the payroll for that laboratory. It would be obvious that he would order tests not really needed in order to get kickbacks from the lab. > > But even so, I > > would repeat any lab tests that were significantly abnormal, something > > physicians tend to do with abnormal results from ANY lab. > > Not a problem. I can reorder the same test again and again avoid the 300 > percent markup. Why would you order it again and again when you don't even understand what you are looking at? If you take a prescription from your doctor and pay for the labs out of pocket then that's normal. For somebody to call up a lab and ask them to do a test for you and having their doctor write up an order for you is bizarre. A cholesterol test is waived and don't need Drs orders but a CBC is not waived. |
Reply to this Message |
 Sign In
 Join
 My Latest Posts My Monitored Threads My Blog My Photo Gallery My Profile My Homepage Start New Thread Enable EMail Alerts Rate this Thread
|
©2008 Advenet LLC Privacy Policy - Terms of Use
This website includes both content owned or controlled by Advenet as well as content owned or controlled by third parties.