I had a similar situation to this years ago, got hurt while working-bruised a knee slipping out of the company van, got an X-ray to confirm no damage, and workers' comp denied it. Went on my credit report for about a year, contested it with the credit bureaus, it was removed. Not saying it's the right thing to do, but I felt ripped off because it should've been covered & wasn't.
Consequences for not paying a medical bill
- Thread starter Benito
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Probably the only wrong answer here is to just ignore the bills.
You should have contested the insurance companies decision right off the bat.
After that, negotiate the amount with the doctors office.
You said it yourself - the amount is relatively small. Is it worth putting a ding on your credit record for the next 6 years over a small amount?
You should have contested the insurance companies decision right off the bat.
After that, negotiate the amount with the doctors office.
You said it yourself - the amount is relatively small. Is it worth putting a ding on your credit record for the next 6 years over a small amount?
The right thing to do is to stop going to the doctor for annual physicals.
I had something similar happen to me but not to this extreme.
My 3 year old daughter had her yearly exam with her pediatric PCP. well, the PCP says "I want to do a hearing test just to make sure her hearing is normal". My wife says ok thinking it's part of the normal checkup for kids. My daughter had ear tubes for ear infections, but taken out. My daughter passes the hearing screening. My daughter is on my health insurance high deductible health plan. yearly preventive physicals/vaccinations are all free on my health plan.
30 days later, I get a EOB from the healthplan denying this hearing test said it was not medically necessary. I would have to foot the whole bill. a 3 year old with no hearing deficits didn't need a screening and at that age a hearing screening is not needed at that age per my insurance. I was mad. the bill was around 100 bucks or so. two weeks later, I get another EOB that my health insurance covered part of it, the pediatric PCP got paid, the PCP appealed it.
I guess this was just a money maker for my pediatric MD. She does free yearly checkups for my health plan. My daughter rarely gets sick. so she doesn't make much off of us.
After this incident with my healthplan, I got a letter from them saying any sick visits with this pediatric, I would have to pay $50 per visit out of pocket plus my health insurance. The joy of having a $3000 dollar deductible
My 3 year old daughter had her yearly exam with her pediatric PCP. well, the PCP says "I want to do a hearing test just to make sure her hearing is normal". My wife says ok thinking it's part of the normal checkup for kids. My daughter had ear tubes for ear infections, but taken out. My daughter passes the hearing screening. My daughter is on my health insurance high deductible health plan. yearly preventive physicals/vaccinations are all free on my health plan.
30 days later, I get a EOB from the healthplan denying this hearing test said it was not medically necessary. I would have to foot the whole bill. a 3 year old with no hearing deficits didn't need a screening and at that age a hearing screening is not needed at that age per my insurance. I was mad. the bill was around 100 bucks or so. two weeks later, I get another EOB that my health insurance covered part of it, the pediatric PCP got paid, the PCP appealed it.
I guess this was just a money maker for my pediatric MD. She does free yearly checkups for my health plan. My daughter rarely gets sick. so she doesn't make much off of us.
After this incident with my healthplan, I got a letter from them saying any sick visits with this pediatric, I would have to pay $50 per visit out of pocket plus my health insurance. The joy of having a $3000 dollar deductible
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Originally Posted By: 04SE
This thread is legendary!
It isn't MY fault, I am not responsible, nobody told me...
Working harder at avoiding the debt and trying to figure out how to scam the system instead of gee, I don't know? Paying it? LOL!
Healthcare is a for profit industry. Practitioners and facilities are always looking for the smallest excuse to make money. They don't care who pays for it. Since they usually get paid by the insurance company, they are used to not informing the patient.
No other industry gets away with sticking you with unexpected charges. Healthcare costs in this country are twice that of the developed world with no patient benefit. Apologists like you perpetuate that situation.
I don't accept attempts to trick me in any financial transactions. I don't accept receiving charges without being informed beforehand. I'm not changing my approach for the medical profession. You on the other hand can bend over all you like. LOL.
This thread is legendary!
It isn't MY fault, I am not responsible, nobody told me...
Working harder at avoiding the debt and trying to figure out how to scam the system instead of gee, I don't know? Paying it? LOL!
Healthcare is a for profit industry. Practitioners and facilities are always looking for the smallest excuse to make money. They don't care who pays for it. Since they usually get paid by the insurance company, they are used to not informing the patient.
No other industry gets away with sticking you with unexpected charges. Healthcare costs in this country are twice that of the developed world with no patient benefit. Apologists like you perpetuate that situation.
I don't accept attempts to trick me in any financial transactions. I don't accept receiving charges without being informed beforehand. I'm not changing my approach for the medical profession. You on the other hand can bend over all you like. LOL.
Originally Posted By: 04SE
This thread is legendary!
It isn't MY fault, I am not responsible, nobody told me...
Working harder at avoiding the debt and trying to figure out how to scam the system instead of gee, I don't know? Paying it? LOL!
Try navigating this:
Quote:
In Mr. Drier’s case, the primary surgeon, Dr. Nathaniel L. Tindel, had said he would accept a negotiated fee determined through Mr. Drier’s insurance company, which ended up being about $6,200. (Mr. Drier had to pay $3,000 of that to meet his deductible.) But the assistant, Dr. Harrison T. Mu, was out of network and sent the $117,000 bill. Insurance experts say surgeons and assistants sometimes share proceeds from operations, but Dr. Tindel’s office says he and Dr. Mu do not.
From http://www.nytimes.com/2014/09/21/us/drive-by-doctoring-surprise-medical-bills.html?_r=0
This thread is legendary!
It isn't MY fault, I am not responsible, nobody told me...
Working harder at avoiding the debt and trying to figure out how to scam the system instead of gee, I don't know? Paying it? LOL!
Try navigating this:
Quote:
In Mr. Drier’s case, the primary surgeon, Dr. Nathaniel L. Tindel, had said he would accept a negotiated fee determined through Mr. Drier’s insurance company, which ended up being about $6,200. (Mr. Drier had to pay $3,000 of that to meet his deductible.) But the assistant, Dr. Harrison T. Mu, was out of network and sent the $117,000 bill. Insurance experts say surgeons and assistants sometimes share proceeds from operations, but Dr. Tindel’s office says he and Dr. Mu do not.
From http://www.nytimes.com/2014/09/21/us/drive-by-doctoring-surprise-medical-bills.html?_r=0
By your own words it is a "small amount" yet you are turning this into a full blown drama. I don't get it? This is no insurance or doctor scam it is a legit thing from what I see.
The doctor recommended some tests in good faith and unless you requested a pre visit estimate, like a mechanic would give you on a vehicle before performing work, then you agreed to the tests being done and thus ultimately to pay for them. I will wager in some of the paperwork you signed you agreed to cover any costs not covered by insurance as well.
The insurance company didn't want to pay for one of the tests based on frequency administered. Not a completely outlandish policy for "check up "type tests. So the issue is with your insurance company and not the doctor whom you owe the bill to.
You agreed to the test and had it done so man up, do the right thing, and pay the doctor's bill. If you want to contest it with your insurance company for not paying by all means do so and work at getting a refund, change companies, or whatever. To not pay the doctor though is wrong and you have no moral, ethical, or legal grounds on that.
I just do not get where you are coming from here?
The doctor recommended some tests in good faith and unless you requested a pre visit estimate, like a mechanic would give you on a vehicle before performing work, then you agreed to the tests being done and thus ultimately to pay for them. I will wager in some of the paperwork you signed you agreed to cover any costs not covered by insurance as well.
The insurance company didn't want to pay for one of the tests based on frequency administered. Not a completely outlandish policy for "check up "type tests. So the issue is with your insurance company and not the doctor whom you owe the bill to.
You agreed to the test and had it done so man up, do the right thing, and pay the doctor's bill. If you want to contest it with your insurance company for not paying by all means do so and work at getting a refund, change companies, or whatever. To not pay the doctor though is wrong and you have no moral, ethical, or legal grounds on that.
I just do not get where you are coming from here?
I think the OP thinks the doctor broke his trust with the patient, the idea that doc is on his side vs the insurance company. Under the theoretical premise of an HMO, for example, if your primary care physician approves something, it's going to get paid for. But not all insurance setups are like that. And docs are, sadly, looking for profit center add-ons.
Originally Posted By: NHHEMI
By your own words it is a "small amount" yet you are turning this into a full blown drama. I don't get it? This is no insurance or doctor scam it is a legit thing from what I see.
The doctor recommended some tests in good faith and unless you requested a pre visit estimate, like a mechanic would give you on a vehicle before performing work, then you agreed to the tests being done and thus ultimately to pay for them. I will wager in some of the paperwork you signed you agreed to cover any costs not covered by insurance as well.
The insurance company didn't want to pay for one of the tests based on frequency administered. Not a completely outlandish policy for "check up "type tests. So the issue is with your insurance company and not the doctor whom you owe the bill to.
You agreed to the test and had it done so man up, do the right thing, and pay the doctor's bill. If you want to contest it with your insurance company for not paying by all means do so and work at getting a refund, change companies, or whatever. To not pay the doctor though is wrong and you have no moral, ethical, or legal grounds on that.
I just do not get where you are coming from here?
You and I are clearly outcasts on this topic.
By your own words it is a "small amount" yet you are turning this into a full blown drama. I don't get it? This is no insurance or doctor scam it is a legit thing from what I see.
The doctor recommended some tests in good faith and unless you requested a pre visit estimate, like a mechanic would give you on a vehicle before performing work, then you agreed to the tests being done and thus ultimately to pay for them. I will wager in some of the paperwork you signed you agreed to cover any costs not covered by insurance as well.
The insurance company didn't want to pay for one of the tests based on frequency administered. Not a completely outlandish policy for "check up "type tests. So the issue is with your insurance company and not the doctor whom you owe the bill to.
You agreed to the test and had it done so man up, do the right thing, and pay the doctor's bill. If you want to contest it with your insurance company for not paying by all means do so and work at getting a refund, change companies, or whatever. To not pay the doctor though is wrong and you have no moral, ethical, or legal grounds on that.
I just do not get where you are coming from here?
You and I are clearly outcasts on this topic.
Originally Posted By: 04SE
Originally Posted By: NHHEMI
By your own words it is a "small amount" yet you are turning this into a full blown drama. I don't get it? This is no insurance or doctor scam it is a legit thing from what I see.
The doctor recommended some tests in good faith and unless you requested a pre visit estimate, like a mechanic would give you on a vehicle before performing work, then you agreed to the tests being done and thus ultimately to pay for them. I will wager in some of the paperwork you signed you agreed to cover any costs not covered by insurance as well.
The insurance company didn't want to pay for one of the tests based on frequency administered. Not a completely outlandish policy for "check up "type tests. So the issue is with your insurance company and not the doctor whom you owe the bill to.
You agreed to the test and had it done so man up, do the right thing, and pay the doctor's bill. If you want to contest it with your insurance company for not paying by all means do so and work at getting a refund, change companies, or whatever. To not pay the doctor though is wrong and you have no moral, ethical, or legal grounds on that.
I just do not get where you are coming from here?
You and I are clearly outcasts on this topic.
I was just reading this thread, and I'm lol.
this thread is almost as funny as the one in which a guy asks if it's o.k. to use the same funnel for different fluids.
you can't buy entertainment like this.
carry on, people.
Originally Posted By: NHHEMI
By your own words it is a "small amount" yet you are turning this into a full blown drama. I don't get it? This is no insurance or doctor scam it is a legit thing from what I see.
The doctor recommended some tests in good faith and unless you requested a pre visit estimate, like a mechanic would give you on a vehicle before performing work, then you agreed to the tests being done and thus ultimately to pay for them. I will wager in some of the paperwork you signed you agreed to cover any costs not covered by insurance as well.
The insurance company didn't want to pay for one of the tests based on frequency administered. Not a completely outlandish policy for "check up "type tests. So the issue is with your insurance company and not the doctor whom you owe the bill to.
You agreed to the test and had it done so man up, do the right thing, and pay the doctor's bill. If you want to contest it with your insurance company for not paying by all means do so and work at getting a refund, change companies, or whatever. To not pay the doctor though is wrong and you have no moral, ethical, or legal grounds on that.
I just do not get where you are coming from here?
You and I are clearly outcasts on this topic.
I was just reading this thread, and I'm lol.
this thread is almost as funny as the one in which a guy asks if it's o.k. to use the same funnel for different fluids.
you can't buy entertainment like this.
carry on, people.
With my family of 6 all covered under my high deductible, PPO plan, I run into this all the time. Your Doctor's office has no idea what's covered and what's not by your plan. It's a shame it's come to this, but your only guarantee that 100% will be paid is by reviewing your coverage documentation ahead of time, call them or just refuse any procedure that seems out of the ordinary when at the office. It's a major pain. I've paid countless +/- $100 charges for things not covered. I've pursued ones that were more, only to be shown where in the plan it's not covered.
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Originally Posted By: JTK
With my family of 6 all covered under my high deductible, PPO plan, I run into this all the time. Your Doctor's office has no idea what's covered and what's not by your plan. It's a shame it's come to this, but your only guarantee that 100% will be paid is by reviewing your coverage documentation ahead of time, call them or just refuse any procedure that seems out of the ordinary when at the office. It's a major pain. I've paid countless +/- $100 charges for things not covered. I've pursued ones that were more, only to be shown where in the plan it's not covered.
You cover part of the issue I am faced with.
However, a part that is additionally relevant is that there are nationwide standards on when certain tests should be performed. The doctor should know that and carry out tests accordingly.
In this instance we were led to believe that the test was customary and the charge would be covered.
I started this thread to gain an understanding of what is the worst thing that could happen since I do not think I am liable for this but I cannot of course control how the doctor's office decides to use the system to pursue the amount.
Some of you are making points with nothing to do with the question I asked, throwing in assumptions and then questioning my ethics. You should know that that says far more about you than my decision to challenge somebody else's mistake that I refuse to pay for.
With my family of 6 all covered under my high deductible, PPO plan, I run into this all the time. Your Doctor's office has no idea what's covered and what's not by your plan. It's a shame it's come to this, but your only guarantee that 100% will be paid is by reviewing your coverage documentation ahead of time, call them or just refuse any procedure that seems out of the ordinary when at the office. It's a major pain. I've paid countless +/- $100 charges for things not covered. I've pursued ones that were more, only to be shown where in the plan it's not covered.
You cover part of the issue I am faced with.
However, a part that is additionally relevant is that there are nationwide standards on when certain tests should be performed. The doctor should know that and carry out tests accordingly.
In this instance we were led to believe that the test was customary and the charge would be covered.
I started this thread to gain an understanding of what is the worst thing that could happen since I do not think I am liable for this but I cannot of course control how the doctor's office decides to use the system to pursue the amount.
Some of you are making points with nothing to do with the question I asked, throwing in assumptions and then questioning my ethics. You should know that that says far more about you than my decision to challenge somebody else's mistake that I refuse to pay for.
Send it up to the White House. ObamaCare gonna pay 'dat fo sho.
Offer 25% over the phone and pay w cc.
Originally Posted By: Benito
The doctor should know that and carry out tests accordingly.
Big assumption here.
IF your only evidence is the doctor should know this, hate to break it to you, but that's not how it works in the US.
Studies and reports about 25% of medical charges nationwide is found to be unneeded and unnecessary treatment. There is about $750B in what is considered completely unnecessary treatment in the US-meaning tests or procedures run where the most up-to-date current studies say are useless. (BTW) This is the same as the entire education budget on just wasted and useless work. So you are NOT an unique case, and this is something you as a consumer need to be more aware of.
Doctor's DON'T know things are unnessary, they error on the side of caution and tests that come up negative don't register on their radar, they just run them.
Unfortunately, they are NOT resposible for knowing this is unnessary, YOU as the patient and the insurance are responsible for signing off on any procedures and the bills. Did you sign any paperwork before the visit? I am sure it's buried in there that if your insurance doesn't pay, you have to pay. If you don't agree to that, you instead have to be careful to ask them to pre-authorize everything with insurance, otherwise they'll run wild with charges.
It's the same as you just drop your car off at a true Stealership for service and say just fix everything. They're going to replace and change every single thing whether it helps or not.
If after the work is done, you later say, "hey I only wanted what was in the scheduled service manual, my work only covers scheduled services, I'm not paying for this other work". Too bad. The horse is already out and the work is already done, and they're going to point out that you already signed off on the work order before they began.
The problem is not illegal or a scam, and you and the insurance are left on the hook as being responsible.
Part of the reason for the trouble is the conservative political cry who said, don't get in between me and my doctor; and don't put in big government and beuracrats and death panels are deciding my health.
And so the doctors just run wild with test cause someone else is going to pay for it, and they don't have oversight with respect to COSTS, only oversight on patient outcomes.
It's so common and severe, that medicare threw into ACA that doctors can form medical practice groups to work directly with them, and also the 2nd part that if practice group is able to reduce costs, they gets to KEEP a % of the savings to encourage them to change behavior not run unnecessary tests, procedures, and instead get the patients healthy.
They did not and could not say what the doctors were doing was wrong or bad because technically it was not illegal or wrong! The doctors know best but just aren't thinking about costs. They're just thinking about your health.
So what they did was completely legal, not a scam, and they had to encourage better behavior through financial mechanisms rather than legal ones.
If you want articles on this, there came from a New Yorker, but each are like 20pages long, so doubt folks are truly interested in learning about the issues with healthcare.
Google "McAllen health care" if you want details.
The doctor should know that and carry out tests accordingly.
Big assumption here.
IF your only evidence is the doctor should know this, hate to break it to you, but that's not how it works in the US.
Studies and reports about 25% of medical charges nationwide is found to be unneeded and unnecessary treatment. There is about $750B in what is considered completely unnecessary treatment in the US-meaning tests or procedures run where the most up-to-date current studies say are useless. (BTW) This is the same as the entire education budget on just wasted and useless work. So you are NOT an unique case, and this is something you as a consumer need to be more aware of.
Doctor's DON'T know things are unnessary, they error on the side of caution and tests that come up negative don't register on their radar, they just run them.
Unfortunately, they are NOT resposible for knowing this is unnessary, YOU as the patient and the insurance are responsible for signing off on any procedures and the bills. Did you sign any paperwork before the visit? I am sure it's buried in there that if your insurance doesn't pay, you have to pay. If you don't agree to that, you instead have to be careful to ask them to pre-authorize everything with insurance, otherwise they'll run wild with charges.
It's the same as you just drop your car off at a true Stealership for service and say just fix everything. They're going to replace and change every single thing whether it helps or not.
If after the work is done, you later say, "hey I only wanted what was in the scheduled service manual, my work only covers scheduled services, I'm not paying for this other work". Too bad. The horse is already out and the work is already done, and they're going to point out that you already signed off on the work order before they began.
The problem is not illegal or a scam, and you and the insurance are left on the hook as being responsible.
Part of the reason for the trouble is the conservative political cry who said, don't get in between me and my doctor; and don't put in big government and beuracrats and death panels are deciding my health.
And so the doctors just run wild with test cause someone else is going to pay for it, and they don't have oversight with respect to COSTS, only oversight on patient outcomes.
It's so common and severe, that medicare threw into ACA that doctors can form medical practice groups to work directly with them, and also the 2nd part that if practice group is able to reduce costs, they gets to KEEP a % of the savings to encourage them to change behavior not run unnecessary tests, procedures, and instead get the patients healthy.
They did not and could not say what the doctors were doing was wrong or bad because technically it was not illegal or wrong! The doctors know best but just aren't thinking about costs. They're just thinking about your health.
So what they did was completely legal, not a scam, and they had to encourage better behavior through financial mechanisms rather than legal ones.
If you want articles on this, there came from a New Yorker, but each are like 20pages long, so doubt folks are truly interested in learning about the issues with healthcare.
Google "McAllen health care" if you want details.
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Originally Posted By: raytseng
Originally Posted By: Benito
The doctor should know that and carry out tests accordingly.
Big assumption here.
IF your only evidence is the doctor should know this, hate to break it to you, but that's not how it works in the US.
Studies and reports about 25% of medical charges nationwide is found to be unneeded and unnecessary treatment. There is about $750B in what is considered completely unnecessary treatment in the US-meaning tests or procedures run where the most up-to-date current studies say are useless. (BTW) This is the same as the entire education budget on just wasted and useless work. So you are NOT an unique case, and this is something you as a consumer need to be more aware of.
Doctor's DON'T know things are unnessary, they error on the side of caution and tests that come up negative don't register on their radar, they just run them.
Unfortunately, they are NOT resposible for knowing this is unnessary, YOU as the patient and the insurance are responsible for signing off on any procedures and the bills. Did you sign any paperwork before the visit? I am sure it's buried in there that if your insurance doesn't pay, you have to pay. If you don't agree to that, you instead have to be careful to ask them to pre-authorize everything with insurance, otherwise they'll run wild with charges.
It's the same as you just drop your car off at a true Stealership for service and say just fix everything. They're going to replace and change every single thing whether it helps or not.
If after the work is done, you later say, "hey I only wanted what was in the scheduled service manual, my work only covers scheduled services, I'm not paying for this other work". Too bad. The horse is already out and the work is already done, and they're going to point out that you already signed off on the work order before they began.
The problem is not illegal or a scam, and you and the insurance are left on the hook as being responsible.
Part of the reason for the trouble is the conservative political cry who said, don't get in between me and my doctor; and don't put in big government and beuracrats and death panels are deciding my health.
And so the doctors just run wild with test cause someone else is going to pay for it, and they don't have oversight with respect to COSTS, only oversight on patient outcomes.
It's so common and severe, that medicare threw into ACA that doctors can form medical practice groups to work directly with them, and also the 2nd part that if practice group is able to reduce costs, they gets to KEEP a % of the savings to encourage them to change behavior not run unnecessary tests, procedures, and instead get the patients healthy.
They did not and could not say what the doctors were doing was wrong or bad because technically it was not illegal or wrong! The doctors know best but just aren't thinking about costs. They're just thinking about your health.
So what they did was completely legal, not a scam, and they had to encourage better behavior through financial mechanisms rather than legal ones.
If you want articles on this, there came from a New Yorker, but each are like 20pages long, so doubt folks are truly interested in learning about the issues with healthcare.
Google "McAllen health care" if you want details.
Every other doctor that I or any member of my family has been to knows precisely which tests are to be performed at what frequency and at what age during an annual check up.
Consequently, no charge has ever been denied by any insurance company.
In this instance, the insurance company denied the charge because it was not "usual and customary".
There was absolutely no consultation nor any word from the doctor that this test was a separate item in the visit. They just went ahead and did it during the overall checkup.
Originally Posted By: Benito
The doctor should know that and carry out tests accordingly.
Big assumption here.
IF your only evidence is the doctor should know this, hate to break it to you, but that's not how it works in the US.
Studies and reports about 25% of medical charges nationwide is found to be unneeded and unnecessary treatment. There is about $750B in what is considered completely unnecessary treatment in the US-meaning tests or procedures run where the most up-to-date current studies say are useless. (BTW) This is the same as the entire education budget on just wasted and useless work. So you are NOT an unique case, and this is something you as a consumer need to be more aware of.
Doctor's DON'T know things are unnessary, they error on the side of caution and tests that come up negative don't register on their radar, they just run them.
Unfortunately, they are NOT resposible for knowing this is unnessary, YOU as the patient and the insurance are responsible for signing off on any procedures and the bills. Did you sign any paperwork before the visit? I am sure it's buried in there that if your insurance doesn't pay, you have to pay. If you don't agree to that, you instead have to be careful to ask them to pre-authorize everything with insurance, otherwise they'll run wild with charges.
It's the same as you just drop your car off at a true Stealership for service and say just fix everything. They're going to replace and change every single thing whether it helps or not.
If after the work is done, you later say, "hey I only wanted what was in the scheduled service manual, my work only covers scheduled services, I'm not paying for this other work". Too bad. The horse is already out and the work is already done, and they're going to point out that you already signed off on the work order before they began.
The problem is not illegal or a scam, and you and the insurance are left on the hook as being responsible.
Part of the reason for the trouble is the conservative political cry who said, don't get in between me and my doctor; and don't put in big government and beuracrats and death panels are deciding my health.
And so the doctors just run wild with test cause someone else is going to pay for it, and they don't have oversight with respect to COSTS, only oversight on patient outcomes.
It's so common and severe, that medicare threw into ACA that doctors can form medical practice groups to work directly with them, and also the 2nd part that if practice group is able to reduce costs, they gets to KEEP a % of the savings to encourage them to change behavior not run unnecessary tests, procedures, and instead get the patients healthy.
They did not and could not say what the doctors were doing was wrong or bad because technically it was not illegal or wrong! The doctors know best but just aren't thinking about costs. They're just thinking about your health.
So what they did was completely legal, not a scam, and they had to encourage better behavior through financial mechanisms rather than legal ones.
If you want articles on this, there came from a New Yorker, but each are like 20pages long, so doubt folks are truly interested in learning about the issues with healthcare.
Google "McAllen health care" if you want details.
Every other doctor that I or any member of my family has been to knows precisely which tests are to be performed at what frequency and at what age during an annual check up.
Consequently, no charge has ever been denied by any insurance company.
In this instance, the insurance company denied the charge because it was not "usual and customary".
There was absolutely no consultation nor any word from the doctor that this test was a separate item in the visit. They just went ahead and did it during the overall checkup.
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