[Kgcetm]

I would decline to pay the bill on the basis that you did not authorize the test and that it is not routine by any measure. I have had blood tests administered at TV hospital, Leesburg Hospital, Rush University Hospital, Mass General Hospital and numerous doctor’s offices in TV. Not once have I been tested for HIV. The test was unnecessary and likely a profit builder for the lab/doctor. Did the doctor specifically request the test?

No, I wouldn’t pay that portion of the bill and I would clearly explain that to the physician involved.

I also wouldn’t go to Ocala for simple medical services.

[retiredguy123]

Originally Posted by Sunflower33

I would definitely call an attorney they will give you the best result.

The lab bill is only $500. How much would you expect to pay the lawyer?

[OhioBuckeye]

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.

WOW, I think I would get some legal help because this just another thing these services in a retirement area are taking advantage of the older people. To me I think you just got goudged.

[jrieker68]

Originally Posted by mydavid

Maybe they should look for a different provider, I have the same provider for the last 12 years and have never paid for any lab test order by my Doctor.

I would definitely get a new doctor, but I would also consider changing my Medicare Supplemental company when the change period opens up; there are plenty of doctors in TV.

[blueash]

Originally Posted by Kgcetm

I would decline to pay the bill on the basis that you did not authorize the test and that it is not routine by any measure.... Did the doctor specifically request the test?

No, I wouldn’t pay that portion of the bill and I would clearly explain that to the physician involved.

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.

[maribob01]

Originally Posted by Stu from NYC

A Would find a new DR immediately if not sooner.
B I would think their is a state licensing board in Florida would complain to them.

Here is the phone number for the Florida Medical Licensing Board, Customer Contact
Center
(850) 488-0595
I would definitely call them before paying that bill. Sounds like maybe it's going in someone's pocket!

M

[retiredguy123]

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. The lab probably billed $500 for the test because they assumed that it would be covered by insurance. They always overcharge for lab tests. The last time I had routine blood work done by Quest, they charged $654. But, the insurance company only paid them $45 and Quest billed me for $8, so they apparently lost $601. But, they were not allowed to charge me the difference because their contract with the insurance company requires them to accept the insurance company's determination of the "reasonable" cost for the tests.

I would suggest that the OP refuse to pay the bill and attempt to negotiate with the lab to pay what an out-of-pocket patient would pay for the test. But, once you pay the bill, you will never get your money back.

[BeauJangles]

Why did not they feel it was necessary to leave the area?

Originally Posted by Bogie Shooter

This firm advertises on TV constantly, a call to them may clear things up for you.
Morgan & Morgan For the People

Morgan & Morgan Law Firm | Personal Injury Lawyers For The People

If they call this firm, or any other lawyer, I would be interested in knowing how it goes. My impression is that unless you are suing someone for a lot of money the fees are high and it may cost more than the $1000 or so they owe.

[PugMom]

Originally Posted by mdieffenbach

Your first mistake was picking Premier Medical as your primary. They are crooks. I got billed for a pain consultant which consisted of the physician asking if I ever have pain. Of course I do, I'm old. It was an extra $200 and I didn't even get any pain medication. I switched to Village Health. It's like night and day.

dittos, only they charged me for an anti-smoking conference(?). i called the office & they explained it was a charge for the dr. to talk to me re:smoking for 10 minutes. LOOL. i got them to remove the charge, & am now in the villages health system--everything i need is @ my fingertips & all costs explained. i've read some 'bad' things re: villages health, but they're #1 for us. we havent wanted for care, & whatever isn't covered is carefully explained by the financial staff.

[airdale2]

Check out Florida Primary in Summerfield across from walmart, Good people, good doc's.

[airdale2]

Originally Posted by gregcharlesnelson@gmail

where is a good primary doc?

Mid- Florida Primary Summerfield

[NavyVet]

Sounds to me like that is an exorbitant amount to charge for one blood test. With their already tarnished reputation, it seems like a bold scam on unsuspecting new patients. I wouldn't pay it and would definitely dig deeper for explanations. Make them refile with correct codes or something. That happens a lot. Also, report to Medicare. I use Alliance Labs for labwork and they always let you know if an ordered test might not be covered by Medicare. I recommend you give Rivers Family Practice (near hospital) a try for primary care. We have always gotten good care and treatment there. Good luck!

[HappyRetired]

Some of Premier's offices have been fined for Medicare fraud. This sounds like a case. Dispute this with Medicare as a fraud case. Why did they go to Ocala when there are 2 offices close to The Villages? I don't know which office is the problem, but it sounds like part of the problem. Don't pay. Wasn't disclosed. Does the EOB say you might be charged? and, if so, how much? Won't be the billed rate. I'd also report this to the state's licencing board for doctors.

[rswegles]

What lab did they go to. Normally if your insurance will not pay for a specific test The lab staff make the patient sign a release form!!!