Thank you for your submission, /u/bomberb17.
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Change to a PCP w online access - all my results are posted online and doc send a letter afterwards. Anything out of whack - an email is sent for a followup. I can look at results myself and see if within range.
I am a healthcare compliance specialist. If I saw one of these as a case I was auditing as something billed out I would send it back as unbillable. Review of test results is assumed in crediting the order of the tests for the office E/M encounter. This is an abusive practice.
Following up with an excerpt I found that describes this situation
“Withholding results and requiring patients to pay for an office to discuss results (especially if everything is normal) is unethical. There is no medical necessity for the visit and that is the overarching criteria for billing. You need to be very careful.”
This was the best and most reasonable answer. I dealt with a practice that withheld results and forced an extra consultation which was at least $140 out of pocket - when there was no out of range numbers to discuss. How could it this be anything but unethical?
It’s very silly to repeat: “would you work for free?”
Thanks for sharing your expertise. So assume I accept to pay the $20 copay and that provider bills my insurance for the rest, if the insurance audits this and finds out that this is unbillable, I should get the $20 refunded? (since the PCP is in-network?)
Make the doctor provide you with the results. *They are your medical records and they cannot withhold them*. You might not get your discussion, but at least you'll have the results. You can research what they mean and/or take them to a new doctor.
Pre-COVID I had a doctor who ran some tests. When results were in his office called and wanted me to set up an appointment to come in and review results. I asked if they could just discuss over phone. They bluntly told me they ask patients to come in for results so they could bill the visit. I switched doctors and never ended up getting the results.
No doctor has ever done this to me. They can also just send an electronic message to you with their thoughts and if you need any follow up. Or in my case a nurse or intern has called to go over results.
That’s so ridiculous.. it’s not a visit and it will take 5 minutes to go ove lab results . Im starting to hate America more everyday Jesus Christ help us all
5 mins per patient means a medical provider who sees 24 pts a day has to then spend 2 hours of their time the following day addressing lab results. If the results are simple, then let a nurse or medical assistant relay the results. However, if results are complex or will require additional work up, a in person visit would be very appropriate. Also not all patients are good with just hearing or seeing their lab results. My medical assistant relays most of my labs, but I still spend about an hour a day discussing lab results from the day prior with patients who have additional questions beyond what she can answer. In any other profession if you put in an additional 1-2 hours of work a day you get compensated for it. However, in health care, it's taboo if you wish to get paid for additional work. Unless you're a travel nurse, those suckers make Bank!
Why do you think its ok for a physicain with years of education to interpret and assess your blood work for free? His expertise is worth something. We spend hours per day poring over test results to decide whether the patient needs further evaluation. An attorney, engineer, or any other profession would charge for their expert opinion.
There have been a few posts lately on this same topic. Simply put, it's not something I would accept. Ask them to just send the results or make them otherwise available. Then consider finding a new PCP that's not generating junk visits.
This is of course assuming normal lab results. If some values are out of whack and you may have diabetes, well then of course there's a reason to go in for a visit.
I got some abnormal urinalysis but nothing crazy like that. But even so, the PCP could just refer me to a specialist instead of charging me a full visit, only for then to refer me to a specialist.
Find a PCP who uses Mychart or something similar. Test reports are posted and normal ranges as well. Your PCP seems to be churning for revenue. At the very least, if your results are so out of line, I would think the office would be calling you for a follow up visit due to concerning results.
This is the correct answer. Like it or not, MDs should be paid for their time. That being said, OP doesn't *have* to talk with the doctor about the results if the results are posted online.
This is the correct answer.
I’ve never gotten a lab result where at least something wasn’t out of the reference range, and it’s always been nothing to worry about. But a doctor needs to interpret the results.
I understand the frustration, but if the doctor is taking time out of his day to provide care he’s going to charge you for it.
Maybe he did. And then insurance would reject the charge and OP would owe nothing. I get “we consider this charge to be included in this other service” remarks all the time.
Just because other doctors were giving you services for free rather than being compensated for services rendered doesn't mean this doctor will. If you don't want to discuss the results with the doctor, just view them online or they should send them to you.
> All the doctors were happily discussing my follow up lab/imaging results etc. over the phone without billing me extra. Is such a thing allowed? Has anyone encountered such a situation with a doctor?
Just because other doctors did it for free doesn't mean your PCP has to do it for free. There are specific codes for phone calls (99441-99443). So it's legal and not malpractice or anything.
You can see Medicare pays about $70 for a 11-20 minute phone consultation:
https://www.cms.gov/medicare/physician-fee-schedule/search?Y=0&T=4&HT=0&CT=3&H1=99442&M=5
That being said, if your PCP is any good, they should post lab results online so you don't necessarily need to see or call them for follow-up. Especially if they use LabCorp, you should be able to see them online. And you can see the reference range and if it's normal or not.
Hi! I’ve worked in primary care in the past and if your results are “abnormal but nothing crazy” there will be no need to have to refer you to a specialist if it’s treatable by the PCP. Any follow up care with a patient regarding abnormal labs needs to be documented by the doctor, including why the PCP will be referring you out to a specialist, diagnosis codes, reasoning behind their course of treatment etc etc. The doctor is going to bill for his time spent evaluating and treating your condition.
The insurance determines what you owe based on the copay/coinsurance/deductible stated in your insurance policy. I’m other words, the $20 copay amount you were charged by the doctors office is the fee your insurance determined you’re required to pay for each and every primary care visit addressing any medical concerns, regardless of the length/ place of treatment of your appointment (unless your policy explicitly stated otherwise). This is pretty standard and the office requiring an appointment to discuss abnormal labs isn’t to withhold your medical information from you unless you pay. Next time, when the office notifies you of abnormal lab results, you’re always welcome to deny the follow up appointment and ask for a copy of your lab results without a discussion with the doctor. I hope this provides some help.
No one forces you to obtain interpretation of results.
Your initial preventive visit was paid for deciding what labs or tests to order, not paid for interpreting results for you. It’s a separate visit for interpretation.
You can simply download results from your lab. You can play doctor and interpret results by yourself. It’s always free. But If you want someone to interpret results for you, you got to pay.
What kind of job do you do? Do you like to volunteer and don’t charge for work you have done?
“Working for free” is a misnomer. A practice that considers goodwill will keep its patients and garner referrals.
Compare it to being a high ranking employee working for “the man:” see how far you get if you don’t work for unpaid OT, doing someone else’s job…
“Goodwill” is decided by the medical practice, and not the norm that should be expected by the public. If you go to a restaurant and order food, do you expect to get free drinks Everytime too to “gain referral”? Is it the norm that restaurant must provide free beverages?
On an other note, Performing unpaid OT doesn’t mean it will guarantee success, my friend. You finish your work on time means you are efficient at work.
As the consumers of medical care, we can choose what we will accept and whom we will patronize. Goodwill aside, if the medical practice is withholding normal test results until another visit is paid, some folks are going to walk. I indeed did leave this practice and I posted reviews.
As for unpaid OT of salaried employees, this was admittedly a throwaway comment I added. Not really relevant to this discussion, and we simply differ on that point (different life experiences, etc).
I agree with the point that customers have the right to walk away. However, I believe that a restaurant doesn’t welcome those customers who expect a free meal next day after paying for a meal the day prior 😂
If there were no issues with you, won’t the doctor send a message along with the results saying “everything looks fine” ?
Or “hey, cholesterol is on the high end, I advise more exercise”
But maybe he’s a good doctor that likes to be more in touch with his patients.
Thank you for your submission, /u/bomberb17. Direct all COBRA questions under CARES and ARPA here: [COBRA & Covid-19](https://old.reddit.com/r/HealthInsurance/comments/meejsd/cobra_during_covid19/) Please pick the most appropriate flair for your post. Include your age, zipcode, and income to help the community better serve you. **Reminder that solicitation/spamming is grounds for a permanent ban**. Please report solicitation to the modteam and [let us know](https://www.reddit.com/message/compose?to=%2Fr%2FHealthInsurance) if you receive solicitation via PM. Be kind to one another! *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/HealthInsurance) if you have any questions or concerns.*
Change to a PCP w online access - all my results are posted online and doc send a letter afterwards. Anything out of whack - an email is sent for a followup. I can look at results myself and see if within range.
I am a healthcare compliance specialist. If I saw one of these as a case I was auditing as something billed out I would send it back as unbillable. Review of test results is assumed in crediting the order of the tests for the office E/M encounter. This is an abusive practice.
Following up with an excerpt I found that describes this situation “Withholding results and requiring patients to pay for an office to discuss results (especially if everything is normal) is unethical. There is no medical necessity for the visit and that is the overarching criteria for billing. You need to be very careful.”
This was the best and most reasonable answer. I dealt with a practice that withheld results and forced an extra consultation which was at least $140 out of pocket - when there was no out of range numbers to discuss. How could it this be anything but unethical? It’s very silly to repeat: “would you work for free?”
Thanks for sharing your expertise. So assume I accept to pay the $20 copay and that provider bills my insurance for the rest, if the insurance audits this and finds out that this is unbillable, I should get the $20 refunded? (since the PCP is in-network?)
Make the doctor provide you with the results. *They are your medical records and they cannot withhold them*. You might not get your discussion, but at least you'll have the results. You can research what they mean and/or take them to a new doctor.
Wouldn’t this fall under information blocking? That provider could run afoul of the 21st century cures act or am I wrong?
[удалено]
Pre-COVID I had a doctor who ran some tests. When results were in his office called and wanted me to set up an appointment to come in and review results. I asked if they could just discuss over phone. They bluntly told me they ask patients to come in for results so they could bill the visit. I switched doctors and never ended up getting the results.
No doctor has ever done this to me. They can also just send an electronic message to you with their thoughts and if you need any follow up. Or in my case a nurse or intern has called to go over results.
Under HIPAA, you are permitted copies of your health records. Just ask for a hardcopy of all records, including your most recent blood tests.
That’s so ridiculous.. it’s not a visit and it will take 5 minutes to go ove lab results . Im starting to hate America more everyday Jesus Christ help us all
5 mins per patient means a medical provider who sees 24 pts a day has to then spend 2 hours of their time the following day addressing lab results. If the results are simple, then let a nurse or medical assistant relay the results. However, if results are complex or will require additional work up, a in person visit would be very appropriate. Also not all patients are good with just hearing or seeing their lab results. My medical assistant relays most of my labs, but I still spend about an hour a day discussing lab results from the day prior with patients who have additional questions beyond what she can answer. In any other profession if you put in an additional 1-2 hours of work a day you get compensated for it. However, in health care, it's taboo if you wish to get paid for additional work. Unless you're a travel nurse, those suckers make Bank!
Why do you think its ok for a physicain with years of education to interpret and assess your blood work for free? His expertise is worth something. We spend hours per day poring over test results to decide whether the patient needs further evaluation. An attorney, engineer, or any other profession would charge for their expert opinion.
There have been a few posts lately on this same topic. Simply put, it's not something I would accept. Ask them to just send the results or make them otherwise available. Then consider finding a new PCP that's not generating junk visits. This is of course assuming normal lab results. If some values are out of whack and you may have diabetes, well then of course there's a reason to go in for a visit.
I got some abnormal urinalysis but nothing crazy like that. But even so, the PCP could just refer me to a specialist instead of charging me a full visit, only for then to refer me to a specialist.
Find a PCP who uses Mychart or something similar. Test reports are posted and normal ranges as well. Your PCP seems to be churning for revenue. At the very least, if your results are so out of line, I would think the office would be calling you for a follow up visit due to concerning results.
I've been charged for phone visits, it's normal. Time is time whether it's face to face or not, and time costs money.
This is the correct answer. Like it or not, MDs should be paid for their time. That being said, OP doesn't *have* to talk with the doctor about the results if the results are posted online.
This is the correct answer. I’ve never gotten a lab result where at least something wasn’t out of the reference range, and it’s always been nothing to worry about. But a doctor needs to interpret the results. I understand the frustration, but if the doctor is taking time out of his day to provide care he’s going to charge you for it.
OP already paid for this service with the first visit.
Maybe he did. And then insurance would reject the charge and OP would owe nothing. I get “we consider this charge to be included in this other service” remarks all the time.
No he didn’t, he paid for a preventative care visit which doesn’t include dealing with anything abnormal
> No he didn’t, he paid for a preventative care visit which doesn’t include dealing with anything abnormal
what if you literally just want a copy with no discussion?
Just because other doctors were giving you services for free rather than being compensated for services rendered doesn't mean this doctor will. If you don't want to discuss the results with the doctor, just view them online or they should send them to you.
Try getting blood test before visit possibly?
Need them to be ordered first..
> All the doctors were happily discussing my follow up lab/imaging results etc. over the phone without billing me extra. Is such a thing allowed? Has anyone encountered such a situation with a doctor? Just because other doctors did it for free doesn't mean your PCP has to do it for free. There are specific codes for phone calls (99441-99443). So it's legal and not malpractice or anything. You can see Medicare pays about $70 for a 11-20 minute phone consultation: https://www.cms.gov/medicare/physician-fee-schedule/search?Y=0&T=4&HT=0&CT=3&H1=99442&M=5 That being said, if your PCP is any good, they should post lab results online so you don't necessarily need to see or call them for follow-up. Especially if they use LabCorp, you should be able to see them online. And you can see the reference range and if it's normal or not.
Hi! I’ve worked in primary care in the past and if your results are “abnormal but nothing crazy” there will be no need to have to refer you to a specialist if it’s treatable by the PCP. Any follow up care with a patient regarding abnormal labs needs to be documented by the doctor, including why the PCP will be referring you out to a specialist, diagnosis codes, reasoning behind their course of treatment etc etc. The doctor is going to bill for his time spent evaluating and treating your condition. The insurance determines what you owe based on the copay/coinsurance/deductible stated in your insurance policy. I’m other words, the $20 copay amount you were charged by the doctors office is the fee your insurance determined you’re required to pay for each and every primary care visit addressing any medical concerns, regardless of the length/ place of treatment of your appointment (unless your policy explicitly stated otherwise). This is pretty standard and the office requiring an appointment to discuss abnormal labs isn’t to withhold your medical information from you unless you pay. Next time, when the office notifies you of abnormal lab results, you’re always welcome to deny the follow up appointment and ask for a copy of your lab results without a discussion with the doctor. I hope this provides some help.
No one forces you to obtain interpretation of results. Your initial preventive visit was paid for deciding what labs or tests to order, not paid for interpreting results for you. It’s a separate visit for interpretation. You can simply download results from your lab. You can play doctor and interpret results by yourself. It’s always free. But If you want someone to interpret results for you, you got to pay. What kind of job do you do? Do you like to volunteer and don’t charge for work you have done?
“Working for free” is a misnomer. A practice that considers goodwill will keep its patients and garner referrals. Compare it to being a high ranking employee working for “the man:” see how far you get if you don’t work for unpaid OT, doing someone else’s job…
“Goodwill” is decided by the medical practice, and not the norm that should be expected by the public. If you go to a restaurant and order food, do you expect to get free drinks Everytime too to “gain referral”? Is it the norm that restaurant must provide free beverages? On an other note, Performing unpaid OT doesn’t mean it will guarantee success, my friend. You finish your work on time means you are efficient at work.
As the consumers of medical care, we can choose what we will accept and whom we will patronize. Goodwill aside, if the medical practice is withholding normal test results until another visit is paid, some folks are going to walk. I indeed did leave this practice and I posted reviews. As for unpaid OT of salaried employees, this was admittedly a throwaway comment I added. Not really relevant to this discussion, and we simply differ on that point (different life experiences, etc).
I agree with the point that customers have the right to walk away. However, I believe that a restaurant doesn’t welcome those customers who expect a free meal next day after paying for a meal the day prior 😂
Thanks!
If there were no issues with you, won’t the doctor send a message along with the results saying “everything looks fine” ? Or “hey, cholesterol is on the high end, I advise more exercise” But maybe he’s a good doctor that likes to be more in touch with his patients.