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PostPosted: Wed Sep 26, 2012 2:06 pm 
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This topic has been visited once or twice on this forum, but not recently that I can tell.... going to try to make this as quick as possible, just looking for any advice...

My sub doc has me go in once a month, do a UA, and he writes the script. The only time I've ever tested "dirty" for anything was two months in a row for a "trace" amount of benzos. I've been going there for quite a while (2 years?) so almost every UA he has done shows that I am taking my sub and nothing else. This week in the mail, I got about 10 different statements (in separate envelopes) from PT Laboratories out of Naples Florida. I guess this is where all my urine has been going. It is now almost October... the dates of service on these statements go back all the way to January (which is probably either when they started using this particular lab or when I switched my insurance carrier to Cigna). For each DOS, I am being charged between $200 and $1100, and that is after my insurance picks up 60%! I am determined not to pay these bills but am concerned about it going to collections or affecting whether or not they will continue to accept my labwork.

1. This seems like an insane amount of money. $1000 for a drug test each month for somebody that has a history of testing clean?

2. I did a little checking on the codes that they are using. From what I understand, code 80101 is a qualitative test giving you a simple yes/no answer for a bunch of different classes of drugs (cost is about $40). This code is listed on the top of every statement. If they are getting a "no" answer for every type of drug, why do they then go on to test for benzos, amphetamines, cocaine, vicodin, hydromorphone, methadone, and morphine??? I could deal with paying 60% of $40 each month.

3. Why in the world did they wait 9 months and then send me all these statements at once? If they had sent me the a statement back in January, I could have addressed this back then before it snowballed out of control.

I guess my plan is to just bring this up with my provider. My biggest fear is that I "rock the boat" and somehow lose my doctor. Doctor's are very scarce in my area and I have a feeling that they would be happy to "fire" me in exchange for another Medicaid patient. Oh BTW, none of these charges were explained to me up front... all I do is initial some paperwork and pee in a cup. In all honesty, I've never actually taken the time to read exactly what I'm initialing, but i doubt very much that it says that I will be responsible for $1000 in testing every month.

Help!


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PostPosted: Wed Sep 26, 2012 2:31 pm 
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Hi metakine,

If I were you, I'd speak to my insurance company before I did anything else. Do you have copies of your paperwork that you signed when you started seeing the doctor? Or do you recall signing anything pertaining to that lab (stating that you would pay the balance of anything insurance doesn't pay)?

Also, from what you describe, it sounds almost like they may not even be charging you the same amount for the same tests each time. I would go through all those statements on your own and get a good idea of what they're charging you for what tests, then call the insurance company and get them on board as well. THEN I would discuss it with the doctor and then the lab. But that's just me and what I would do.

I hope you can get it worked out easily and quickly. Those figures you're telling us about are absolutely ridiculous for a simple drug test. Good luck and let us know what happens.

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PostPosted: Wed Sep 26, 2012 9:50 pm 
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Thanks for the response Hatmaker,

I haven't called Cigna yet, but I plan on doing it tomorrow. Obviously a tough call to make at work, so I'll have to take a little time off in the morning. I did go on their website and reviewed the claims and the insurance is picking up 60% of the costs, and I have gotten EOBs from them saying that I owe money on the claims. So, when I talk to them, I think its going to be more of an issue of whether or not I was made aware of the costs up front. I really don't know if that matters or not... part of me thinks that it is the patient's responsibility to ask about these things, but I've been taking sub and doing UAs for a long time and I've never gotten bills like this from a lab. That being the case, i don't think that it was unreasonable for me to assume that paying my normal $25 copay per month at the doctors office would be all inclusive.

I don't believe that there was any paperwork that I signed when I initially began seeing this doctor. I have to initial and date something for the lab work every time I go, but I don't get a copy of anything. I just assumed that it was just to give permission for them to test my urine. Next time I go in, I'll have to take a closer look to see if I am accepting financial responsibility by initialing.

My biggest complaint is the absurdity of the cost. The more research I do, I am finding two main things. One, many doctors offices only do UAs 3 or 4 times a year for "low-risk" patients. I know that I'm not doing any other drugs, so I don't mind being tested, but I do mind paying for it 12 times a year when they all come back clean. Second, it seems that there is a qualitative test for many different drug classes that can be done for about $40. If everything comes back negative, there should be no reason to do the much more expensive GC/MS tests that quantify amounts.

I'll give Cigna a call in the morning and report back. One would think that they would want to save money as well. My primary concern is for my own wallet, but its ludicrous for the insurance company to be shelling out over $500 a month as well.


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PostPosted: Sat Oct 13, 2012 7:01 pm 
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Any updates on this for us?


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 Post subject: compliance
PostPosted: Thu Nov 08, 2012 10:53 pm 
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The reasons for doing such expensive testing seems to be 2 main things :

1) money

2) compliance

Doctors seem now days very concerned about diversion of drugs and protecting their licenses for prescribing them.
So for more money, they do more expensive test(s).

For compliance they sometimes do gc/ms to determine the quantity of the drug in ones urine at the time of testing. They are covering their asses so to speak by having documentaion in the form of expensive analysis to show that their patients are taking their medications as they are prescribed.

Some analysis for drug testing is as much as $3000.00/test.


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PostPosted: Tue Jan 12, 2016 3:27 pm 
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This is a common theme in modern Suboxone clinics it seems. In fact, you'll be hard pressed to find ANY clinic that doesn't do it this way now-a-days.

Sure, they could use $10 (by bulk) OTC drug screening kits which would definitely be effective enough. Heck, they are pretty darn accurate and sensitive. The only thing not shown is specific levels, for which you end up paying a huge premium for Toxicology reports. And if the concern was dedicating 'trace amounts' of stuff, they could administer these cheaper INSTANT OTC tests 4x as often and still save 80% on costs.

The thing is this: Most state insurers are apparently paying the labs. Like TennCare. They pay. My private insurance? They don't pay.

I recently switched Suboxone clinics because the clinic was doing an insane amount of drug tests, despite clean results, and I worried about potential liability, even though I *never* received one bill.... UNTIL 45 days after I quit their program (and I'd been there 8 months or so). Suddenly I get a bunch of bills, and I fear many more are coming.

Like yours, the cost varies wildly. It can be $163 or $973. It''s insane.

This seems to be the primary mechanism by which the Suboxone clinics are financed these days. That said, the doctors themselves have some laws preventing them from financially benefiting (or something), but the same person may own the lab and clinic, and - well - I don't yet know all the facts, just that there is a loophole somewhere letting them profit by over-billing on UNNECESSARY and EXCESSIVELY EXPENSIVE Toxicology Reports instead of the aforementioned $10 instant OTC tests.

Of course, they don't mention this to anyone up front, though it probably says something about paying for your own drug tests in the stuff you signed at the clinic -- but who in their right mind would expect a single drug test to cost $600+? And if they do this weekly, as they did with me (though finally I went to bi-weekly), well it adds up quick!

We need a proper investigation and accounting into this.... I also am not paying these bills, though it may destroy my credit. There is fraud, whether it's explicitly illegal or not, somewhere in this system.

p.s. I was told these things by my new doctor, who is great:

1. These labs MUST bill everyone the same, even if your insurer can't pay. The variance in costs between tests is another matter. I don't know if they randomly decide the cost weekly or what.
2. Labs often have agreements with Suboxone clinics to not sue any of their clients. That's find and dandy, but what about credit reporting, and other effects of liability?
3. They seem to treat you different after you voluntarily leave. In my case, I just switched doctors, THEN started receiving bills. But while I can only appeal an Insurance claim's rejection for 180 days, apparently there is no effective limit on how long labs can wait to bill you.
4. I mention the 180 day limit on appealing my insurance's decisions because they initially were rejecting them all because they said I didn't confirm that I had no other coverage, when I KNOW I did through their web form. So I did it again, via customer support, the same assertion I make every year - that I have no other health insurance. Anyway, they stalled a bit, and even the *little* bit they will pay to these labs probably won't get applied to most of the claims. That said, doesn't matter much, since the insurance company, rightfully, thinks these tests shouldn't cost so darn much and recommends use of their in-network labs!

TL;DR. Argh, not going to edit this. Someone, please, help me understand how this whole system works so that I, and others, can operate within it. It seems a shame only the poor can get treatment, which the middle class, again, gets decimated.


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