[RARO1]

Originally Posted by blueash

Sorry, but you seem to not understand how it happened. Telling the doctor you won't pay this bill means nothing. The bill is not from the doctor it is from the lab. It's like telling your electric company you won't pay your phone bill. They are not involved.

Yes the doctor ordered the test. The OP clearly indicated it was ordered. No lab can do a test on its own. They only do what the doctor ordered.
As to authorization, when you gave the showed up at the lab for the tests the doctor ordered, whether with a paper order or for an electronic order, that is consent for them to draw blood. It is also routine at most encounters that you sign a form saying you will pay for any costs not paid by your insurance. That thus includes any copay, coinsurance, deductible, or non-covered tests.

The doctor ordered the test. The lab ran the test as ordered. The insurance companies declined to pay, correctly. The patient got billed.

Whether the lab did or did not specifically advise that the HIV test might not be covered is absolutely not an issue. The people working in the lab are not experts in codes and have no way of knowing whether the person having the test is having it routinely or because of a concern.

If this were my practice I would resolve it by apologizing to the couple for the misunderstanding and offer to pay the lab cost. Then I would change my office routine to be sure that if I were going to order HIV testing on people over 64 that I documented a reason they needed it or that I explained it was routine, not covered by insurance, and they patient was given an option to decline.

Then I would call the lab, explain what happened and ask that the bill be redirected to me and that I'd appreciate it if they would bill it at their insurance covered rate.

I am mystified at the cost billed. Quest does HIV screening for $89 thru their Quest Direct program

Both Quest and Labcorp offer HIV testing for $79 via this website:
STD Testing | Pricing & STD Test Packages - STDcheck.com and there is even a $15 off coupon so the lab is accepting $64 as payment in full for the test.

Perhaps a call to the lab to ask for billing at their advertised price might work even though the test was not ordered via the specific program.

I agree with you, it’s strange that they list is as $79 test but charged in laws $500 each...

I’m not sure if it’s related to this thread but my father in law got an email from premier yesterday out of the blue asking for copies of the lab bills from quest... it’s possible premier noticed this thread, and the uproar it’s causing. They do have a sponsor sticky on top of this forum advertising their services... will update if I hear anything.

[queasy27]

Originally Posted by RARO1

I believe it was AARP that told them the Ocala office was the only one that would accept them as new patients, apparently it was next to impossible to find a doctor who would take their plan in TV.

Oh, that's awful. As others have said, I strongly recommend that you encourage your in laws to investigate other insurance plans during the open enrollment period in October. AARP offers both supplement and advantage plans through United Healthcare but if they're not widely accepted here, it's kind of worse than nothing.

Medicare can be confusing. There are SHINE (Serving Health Insurance Needs of Elders) clinics here staffed by volunteers who can help explain all the options without bias.

The Villages has its own health care system that is highly regarded by many posters here and may be the easiest choice for one-stop shopping.

You're very kind to help your in laws with this. I once ended up paying $742 that I didn't owe just to get the tears and stress over with, so I truly sympathize.

[rdwalls]

Recommend you call Mid Florida Primary Care in Leesburg.

[Carlsondm]

I wish I knew which doctor requested the tests. The first doctor I interviewed to be my primary care doctor pulled some of what you describe but I questioned it and switched doctors. Yep Premier Medical. Definitely a charger pumper. He had been promoted to a lead worker .. likely because of the money he brought in. Not what I was looking for.

I always review and question the lab orders. Mistakes have been made for me.

Go to the supervisor of the person who ordered the tests. Who authorized the tests? Likely that doctor. Explain that unnecessary tests were done and that you request that the charges be removed. Perhaps they were intended for someone else and a mistake was made.

[vinnyfla]

Premiere is in the Villages also , and I left them for poor service, no one sets an HIV test unless you suspect something wrong?

[Spike380]

Originally Posted by RARO1

Im writing this on behalf of my mother and father in law, they moved down to TV recently, they decided to go get a new primary DR, they went to Premier medical associates in Ocala.

Premier recommended running routine blood test on both of them. A few weeks later they receive a letter from the lab saying they owe over $500 each for HIV tests, which neither Medicare or their AARP insurance will cover.

Mother in law has disputed the bill with both the lab and Premier but they claim a HIV test is “routine” and that they don’t need to disclose it during the appointment.

I find this ridiculous, why would a couple of 70 year olds with absolutely no history of exposure to HIV need a test?

Mother in law is at the end of her rope and is planing on paying the bill, but I suggested I ask on here to see if anyone has any suggestions.

GET OUT OF PREMIER. My husband was with them 10 yrs-10 yrs of middiagnosis; never getting approvals for tests; kept telling my husband he had pneumonia when he actually has a paralyzed diaphragm; only refers to their buddies; we were told they will not approve referrals to anyone out of network. Have to call tons of times before rx gets called in. It is a HORROR story. I know some people like them-but the majority do not. BEWARE

[dpmers]

Stay as far away as possible from Premier Medical, they belong to HMO,'s and control expenses. They refused my mother in law an MRI, turns out she had a fractured pelvis and ended up with a life saving colostomy. We tried to use, turns out no malpractice insurance.

[nn0wheremann]

Originally Posted by RARO1

Im writing this on behalf of my mother and father in law, they moved down to TV recently, they decided to go get a new primary DR, they went to Premier medical associates in Ocala.

Premier recommended running routine blood test on both of them. A few weeks later they receive a letter from the lab saying they owe over $500 each for HIV tests, which neither Medicare or their AARP insurance will cover.

Mother in law has disputed the bill with both the lab and Premier but they claim a HIV test is “routine” and that they don’t need to disclose it during the appointment.

I find this ridiculous, why would a couple of 70 year olds with absolutely no history of exposure to HIV need a test?

Mother in law is at the end of her rope and is planing on paying the bill, but I suggested I ask on here to see if anyone has any suggestions.

Premier Medical is best avoided. Somehow they attract providers with impeccable credentials, but then saddle them with support staff dredged from the bottom slime of the labor pool, staff with zero ethics, fewer skills, and no supervision or training. Their website never works, providers are not available by telephone or email, and they just recently paid a huge fine for Medicare fraud. On her way out the door my wife was asked by a clerk if she had a living will. The EOB showed a billing for a 30 minute in-depth discussion of advanced planning alternatives for a hospice patient. Do not pay the bill. Raise Cain with Medicare’s fraud squad.

[nn0wheremann]

Originally Posted by RARO1

I’m not sure, I know their AARP insurance isn’t accepted by a lot of providers in the villages, hens they have to go up to Ocala

When you call PMA they will direct you to their most underutilized office. They do not give a hoot for your preference or convenience

[pabotticelli]

Originally Posted by RARO1

Im writing this on behalf of my mother and father in law, they moved down to TV recently, they decided to go get a new primary DR, they went to Premier medical associates in Ocala.

Premier recommended running routine blood test on both of them. A few weeks later they receive a letter from the lab saying they owe over $500 each for HIV tests, which neither Medicare or their AARP insurance will cover.

Mother in law has disputed the bill with both the lab and Premier but they claim a HIV test is “routine” and that they don’t need to disclose it during the appointment.

I find this ridiculous, why would a couple of 70 year olds with absolutely no history of exposure to HIV need a test?

Mother in law is at the end of her rope and is planing on paying the bill, but I suggested I ask on here to see if anyone has any suggestions.

I would go back to the Doctor who wrote the script for blood work. They must have made a mistake in the type of test they ordered. If so they should be responsible for clearing up the issue or paying the bill.

[RARO1]

Originally Posted by queasy27

Oh, that's awful. As others have said, I strongly recommend that you encourage your in laws to investigate other insurance plans during the open enrollment period in October. AARP offers both supplement and advantage plans through United Healthcare but if they're not widely accepted here, it's kind of worse than nothing.

Medicare can be confusing. There are SHINE (Serving Health Insurance Needs of Elders) clinics here staffed by volunteers who can help explain all the options without bias.

The Villages has its own health care system that is highly regarded by many posters here and may be the easiest choice for one-stop shopping.

You're very kind to help your in laws with this. I once ended up paying $742 that I didn't owe just to get the tears and stress over with, so I truly sympathize.

I will pass on your suggestions, I know they like the plan they have now because even though they pay quite a lot a month, it doesn’t have any copays and almost no deductible, if they ever have any big health issues they like the fact that the won’t have to pay 10s of thousands out of pocket.

[Carla B]

Originally Posted by RARO1

I’m not sure, I know their AARP insurance isn’t accepted by a lot of providers in the villages, hens they have to go up to Ocala

If they have Original Medicare plus AARP supplemental, it's simply not true that a lot of providers in The Villages will not accept their insurance (aside from The Villages Health). in 12 years of living here or anywhere else, we haven't had that experience at all. Hopefully, they will ditch Premier Medical and find a normal practice. Rivers Family Medicine is one that is recommended.

[RARO1]

It’s been a while but seems like this debacle has been solved.

According to the Doc these were supposed to be Hepatitis tests not HIV test. There was apparently some kind of paperwork mistake at some point. Anyhow, the doctors office is apparently going to eat the cost. Still waiting for confirmation from quest...

Thanks for all the suggestions and ideas from all of you!

[Carla B]

Thank you for getting back to us. I'm happy it seems to be resolved and was a coding mistake by Premier. Now, if your parents will just find another practice besides Premier, I think they'll be happier. Thousands of people in The Villages have Medicare plus AARP supplemental, and numerous doctors accept that insurance.