Why would DH doctor care who ordered labs?

yeahdisney

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I get free screening labs for spouse and kids if a doctor in my group that I work for, and is in my insurance network orders labs. out of my office is another 50 dr to choose from too that is my company.

As a perk my doctor will order DH labs and have them sent to DH doctor and I would have no co-pay. If DH dr orders them it will cost $300.

Our office accepts other doctors ordered lab results from Mayo Clinic, the VA from Hines, any outside hospital, and of out state doctor from our snow birds that go to florida and AZ and employee labs that are free from a competitor. And any company that provides their employees with their labs there as their benefits. We do not ask those patients to have labs redrawn because it would cost them money for the exact same lab. We also accept Walgreens and doc drug labs.

DH dr. says he will not accept the labs and keep DH as a patient, if someone else orders. Why? it is a lipid and yearly PSA. So DH might change dr because his colonoscopy is also free if done by a provided doctor and our insurance will allow him to go there without seeing primary. But the primary wants him to come in and let him decide which doctor to use. If primary picks it will cost 10% which will be $1000 to use.


Our DS dislocated his knees 4 times last year, I have lots of out of network doctors and PT bills. So I would like not to pay for something we could have for free. That why I wish to be cheap and let my drs order this year and yes DH dr aware of that.
 
I agree. It's about the money.

I bought an insurance policy that doesn't require me to have a referral from my primary care doctor. I pay more for it, but in the long run it saves me money as I don't have to see my primary care doctor and pay for a visit only to be told I need to see the gynecologist, urologist, etc.

Recently I had an issue that I needed to see a urologist for. Since I moved I decided to go to a place nearer to my home. I called for an appointment and they wouldn't give me one because I hadn't seen my primary care doctor first and "they didn't want me to have to pay for a visit." I explained that (1) I didn't need a referral and (2) I'd have to pay for the visit anyway because I'm into my deductible. Then the excuse was that they couldn't make an appointment for me until they received all of my medical records! Why, I don't know because the issue I have I've never had before. Then it was they're booking out into May.... I think it was all to make me have a needless appointment with my primary care.

At that point I called the urologist's office I had been using before I moved. Had an appointment the next day.
 
Guess it would be money as well ( or professional pride), although not sure why your doctor would order labs for someone who is not his patient. Sounds like he should just change his primary.
 

There is the money factor but it could also be records. The secondary DR might miss something or prescribe something that doesn't work or interacts with current meds. I know for us, all the DRs we see can pull up our records. Someone out of network or has never seen you could be liable if something is missed or happens while under.
 
I forgot to say, it might be time for DH to change DR to one in your network
 
There is the money factor but it could also be records. The secondary DR might miss something or prescribe something that doesn't work or interacts with current meds. I know for us, all the DRs we see can pull up our records. Someone out of network or has never seen you could be liable if something is missed or happens while under.

Ditto to this. Or perhaps not order something that primary md would want.
Although it could be about money if he insisting you must go to x gastroenterologist. Or maybe it's because he knows x md is good.

Have you discussed with him the reason that you are looking at these other MDs? Many are understanding when they realize there is a cost factor.
 
Thanks for the replies. Maybe ego. The lab would be the same place of service. The lab is what has been drawn every year for the last 11 years. A lipid screening and a PSA screening. The office girl actually told him to go to quest lab she heard cheaper, seriously most people know if you go to an out of network lab the patient pays the entire bill.

Drum roll charge to insurance for two labs $1058 last year. Our deductible $300.

My labs this year lipid, cmp charge to insurance $755. My deductible 0. I just wanted his to be zero. Due to DS last year and this years medical bills, I wanted the break.
 
I wonder the opposite: why would a physician order lab work for a patient he/she has never seen?

While ordering lab work can feel very routine, it really requires the exercise of medical judgment. There really are downsides to ordering tests the patient does not need, as well as failing to order tests that make sense for that particular patient this year.

It sounds like the most cost effective thing would be for your DH to switch to a doctor in your group.

-- Suzanne
 
I wonder the opposite: why would a physician order lab work for a patient he/she has never seen?

While ordering lab work can feel very routine, it really requires the exercise of medical judgment. There really are downsides to ordering tests the patient does not need, as well as failing to order tests that make sense for that particular patient this year.

It sounds like the most cost effective thing would be for your DH to switch to a doctor in your group.

-- Suzanne
I agree, I can't imagine any primary care doctor agreeing with having his patient have lab work done which was ordered by another doctor he is not being treated by.
 
It's just cholesterol and PSA. Fairly routine. I would have DH change doctors. Nor would I ever let my primary dictate what specialist I see. Since my wife is a nurse anesthetist at the local hospital she knows what doctors to use or run away from. Many docs just recommend ones they know, for no other reason than that.
 
I just wonder why you keep on seeing medical professionals not in your network?
I know its a pain to switch sometimes but its such a waste of money
 
A couple of years ago, most MD's wouldn't care, including yours.

People don't realize what the ACA has done to reimbursements, especially to primary care MD's.

In the past your MD probably didn't care because one billing code covered your visit. Today those bundle codes have changed significantly, if not been eliminated entirely. In order for a MD to get paid now, they have to document everything they have done and bill for every single thing.

So your PC (primary care) MD cannot "read" your results if he didn't order the tests. If he didn't "order" the tests, he can't bill for them either.

I.e. Old policy, your PC billed for "annual physical and a basic cbc" let's say. He'd bill $150, insurance would disallow about $80 and pay $70 for your visit*. The current break down is bill for office visit (minus disallowed) $10, check vitals and weight $10, h&p $10, cbc $10, consultation $10, read test results $10....

OP you're asking your MD to work for free. You obviously don't realize it, but that's what's happening. You wouldn't go up to a Jiffy Lube with 5 qt's of oil and a filter and ask the mechanic to change your oil for free because "I brought my own oil" and I'll be paying for a tire rotation "so you wouldn't mind would you?" ?

I know many people hear the word "Doctor" and instantly think rich and overpaid but keep in mind the average PC/GP made about $150,000 last year. Considering all the schooling and debt to make that income level, it's hardly "overpaid" and certainly not rich especially considering the average PC/GP works about 60 hours a week. That's barely $48 an hour for a person graduating with about $200,000 in student loan debt and who has to pay their own health insurance. A union auto worker can make $38 an hour plus has benefits.
 
Liability. A doctor is charged with the health and wellbeing of his patient. If you are seeking treatment elsewhere (labs are treatment, no matter how "routine" you think they are) there is a higher probability that something will get overlooked. For example...you say you get a free PSA...your doc agrees to accept this and continues treating you, then your husband has an elevated PSA, but doesn't go back to the primary doc for awhile. The elevated PSA turns out to be prostate cancer. If it was caught 6 months sooner, your husband would have easy treatment....now that its been 6 months, he may or may not be able to be treated. Are you reading his labs? In this scenario are you the one who is reviewing and deciding weather or not it needs to be followed up with treatment?

Who's responsible? Who can be sued for malpractice as a result of omitted care/neglect? Your primary care doctor. The one who know when he orders labs, and knows to follow up.

As a practitioner, it is a liability to treat a patient who gets "random" treatment from another clinician without any consultation, referral, or relationship. Honestly most doctors would sever the patient doctor relationship for this.
 
This is stupid. Have your DH change doctors. Lord knows it all costs more than enough as it is, why keep going where it's going to cost more?

And sorry, not sorry that the doctor "only" makes about $150K a year. That's twice what DH and I make, combined, with advanced degrees and a combined 15 years post-bacclaureate education. Doctor knew what the medical education would cost- not my responsibility to worry about him "only" making $150K a year. Also, if he works in a group practice or hospital-affiliated practice, he is more than likely not paying for his own individual medical insurance. (It was sweet when my DH was a post-doc at UCSF- amazing medical coverage, practically free!)
 
This is stupid. Have your DH change doctors. Lord knows it all costs more than enough as it is, why keep going where it's going to cost more?

And sorry, not sorry that the doctor "only" makes about $150K a year. That's twice what DH and I make, combined, with advanced degrees and a combined 15 years post-bacclaureate education. Doctor knew what the medical education would cost- not my responsibility to worry about him "only" making $150K a year. Also, if he works in a group practice or hospital-affiliated practice, he is more than likely not paying for his own individual medical insurance. (It was sweet when my DH was a post-doc at UCSF- amazing medical coverage, practically free!)

That attitude is why we will have doctor shortages in the coming year if not already. Where I live many of the MDs my wife works with are retiring early. The ACA is one reason, the complication of electronic medical records (different system at each hospital), declining reimbursement rates, and all with the privilege of getting sued.
 
I do believe DH is changing :). He was the only adult family member hold out. I think he does not want my docs to see his junk for his yearly, they are the same age. Wha hahahaha.

Guess what? Friday a pt from came in with labs received from docs pharmacy we accepted those labs. And he said my wife works for someone else and this year as an insurance benefit I can have free screening labs there. Will you take them? I said absolutely :) That guy could see the another doc for free. We are not free for him.

We will accept the free screening labs. DH competitor doc will not. That is the point I was asking why won't he accept free screening lab results. And still yes they are ordered by my practice. And the other guy labs are not ordered by my practice, it has a doctor name on it.

I am all good now. Thanks for ur opinions.

Off to make DS do therapy, he saw doc in Chicago Thursday, holding off decision for surgery. He finished last round of PT Monday.
 















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