Tried out a new pcp and had routine blood work done.
Of course the doc tests me for marijuana without my knowledge and enters it into my insurance record.
@CaffeineNeeded can you shed some light on this? I’m assuming this is for their protection somehow but seems shady that they wouldn’t even mention it.
Unless you were like unconscious and they were trying to figure out why, it seems hard to come up with a legit justification for this. Depending on how exactly it went down, ethically it seems highly dubious. Legally maybe they can gin up some justification. If you’re really want to delve into it, one thing to consider would be obtaining all the records from the visit(s) in question and reading them yourself. Presumably, somewhere in there the doc will have explained why that test was ordered.
Also, what exactly do you mean by entered into your insurance record?
If you’re using insurance to cover the visit, the insurance company can pretty easily get any medical records related to the visit for the purposes of payment.
I found out they tested me when I was looking at my claims on my online account.
Obviously, I’m not using this doctor again. I am worried about my ability to get my medical mj card which is pretty shitty since I legitimately have arthritis. Just haven’t been diagnosed.
I did say I wanted several referrals, one of which was for an arthritis specialist. I also mentioned an ER visit a couple years earlier for chest pain and that years earlier I was a heavy cigarette smoker and smoked weed.
I understand I shouldnt even have mentioned weed, but I want to be honest with whoever is going to be my regular doctor. She must have profiled me as a card seeker and either disapproves or wanted it on record for any issues with pain management in regards to their liability.
Either way, it still seems shady to me. Zero reason to not tell me.
I’ve got no idea what’s involved in getting a medical marijuana card. I always assumed they were relatively easy to get.
Anyway what you’re describing as “entering into your insurance record” is standard. Once the test is ordered, then it will be billed to the insurance company and whoever is doing the billing (e.g. lab, doc’s office) needs to tell the insurance company what they are being billed for.
So once the test is ordered, what you have described is the natural sequence of events. That still leaves us with the question of why the test is ordered. If that answer is anywhere, it should be in your medical records, which you have the right to request anytime you like.
It’s shitty to not tell you but 100% legal. You agreed to treatment and likely signed multiple papers saying so in the office. Medically lots of people do it even though it’s dumb.
There’s no such thing as ‘your insurance record’. That data is unlikely to be easily accessible unless it’s in some massive system that shares its data with every PCP site.
Medical marijuana for arthritis is dumb anyways and I wouldn’t suggest it.
Yeah, I can say with 100% certainty that its great for it.
With all the downsides there are to being a habitual smoker one of the absolute upsides is a daily layer of pain relief.
I’m assuming you’re saying that it’s not worth some of the downsides but you would have to know my mental history to know that.
Thanks for the insight. I did some internet detective work and knew it was legal; just wanted an idea of how common it might be. Definitely going to be sharing my experience on grading websites. Might also call and see if someone who works at the office can explain why this would be done.
Seriously appreciate the medical advice.
I’ll be making an insurance change in January. I get a monthly med that costs ~$14,000. I have a copay assistance program through the drug company that covers the copay, and if I manage to not need any medical coverage before I get my second or third treatment each year then that usually covers my $5k out of pocket max.
Talked with my dad today who has decades of experience in the industry and he warned me that I need to make sure my new plan accepts copay assistance because several companies don’t. Quote “the point of a high deductible plan is to cause as much financial pain as possible to discourage you from using your coverage. Allowing someone other than you to pay removes that pain, so they don’t allow it.”
Is that not the most nauseating string of words you’ve ever heard? Instant rage.
[quote=“Coasterbrad, post:1657, topic:90”]
Is that not the most nauseating string of words you’ve ever heard? [/quote]
“people love their private insurance”
Update on my friend with myasthenia. The $88k per pop bi-monthly infusions were working really well to ease her symptoms. But the insurance cut them off after 7 treatments, saying that her neurologist didn’t try two other treatments that failed before trying Solaris.
This of course is a complete lie, and it’s thoroughly documented that they did try two other treatments. But for now she’s cut off from the infusions with her symptoms creeping back in while their claim works through the appeal process. Fun stress and sickness at the same time!
Of course there will be zero consequences for the insurance company other than maybe having to authorize the treatment again and look for a new excuse to shut it off.
You can’t tell me there aren’t employees and their bosses and their bosses with massive incentives to shut this stuff off. I’m sure it’s done in some sleight-of-hand corporate BS way. But it’s there.
“people love their private insurance”
Got a bill in the mail for $13.84 for some routine lab work, insurance covers it but the lab says “EXCEEDS CONTRACTED ALLOWABLE AMOUNT” so this means the lab just decided to charge more than they agreed to charge in their contract with my insurance company (Blue Shield of California)? And they can just bill me for whatever they want?
I had this happen over a bill after my son was born in 2004 and just called my insurance company to confirm the EOB amount was all I was responsible for, then called the company back and told them to FO. Never heard another word about it.
Might be worth checking your credit report.
It’s clean
This is 100% intentional and routine. I can’t tell you how many times I’ve been billed for services that were fully covered and paid for. Just yesterday my dad told me that his CPAP provider sent him a $600 bill. He dug into his EOB and confirmed he didn’t owe it. Had to call his insurance company and the provider to get rhe bill removed. It’s sickening to think about how much money people needlessly pay just because they are billed for something they don’t owe.
It can certainly be an error, but there’s a chance this is a preferred provider or in-network situation. And you are responsible for the balance if you use a non preferred one. Not saying this is what happened in your case necessarily, but that’s how and why balance billing occurs. Situations can occur where an in network doc can send your lab work to an out of network lab, but it’s still your responsibility to make sure they don’t. It’s also possible your doc may not know, care enough to check, or may even be incented to send their business to the higher priced lab or to a lab owned by the same provider group, so defaults to them over whatever lab your plan has negotiated with.
called the insurance company and they said the $13.84 was the negotiated cost for the test (the cost on the bill was $180 lol) and since it’s below the co-pay, I’m responsible for the entire cost. Which sounds… plausible, but if that is actually the case why would the bill say “EXCEEDS CONTRACTED ALLOWABLE AMOUNT”? I am probably going to call Blue Shield back today and get a 2nd agent to look at it.
My most recent FSA reimbursement request isn’t going through, even after talking to someone on the phone. The request is for monthly orthodontia payments that I’ve been making (and getting reimbursed for) for over a year.
So annoying.
what the fuck (not @ you, more @ this fucked up system)
Make sure to bill them your hourly rate for having to spend time sorting this garbage out.