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Dr ordered blood test commonly not covered by insurance. Should I dispute?

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I had my annual physical exam, which usual costs me almost nothing because it is considered preventive care.This time my doctor ordered a Vitamin D blood test without telling me. My insurance doesn't cover this, so they say I am responsible for full amount $175.

Looking through similar Fatwallet threads the standard conclusion is that my doctor is not responsible for knowing what my insurance covers, so I should pay it and move on which I am willing to do if no case. However, based on my cursory research it seems well known that Medicare doesn't not cover this test and many, if not most, insurance companies do not cover. If my doctor is normally ordering this tests for a standard physical it seems to me he should be aware there is high likelihood the test isn't covered and he should have informed me.

Should I ask my doctor to waive this fee or charge me only what insurance would pay if they had covered it? Or should I just pay and move on?

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I don't go to the doctor.

It's easier and less painful to just die than deal with the medical industry.

wilesmt (Feb. 17, 2017 @ 11:52p) |

I just had this happen to me. I'm hypothyroid and told my doctor my symptoms and she ordered some tests (I have never be... (more)

graceisenough44 (Apr. 29, 2017 @ 1:45a) |

Although Medicare doesn't pay for Vit D test for routine screening, it does pay for test for patients with below diagnos... (more)

tuphat (Apr. 29, 2017 @ 8:49a) |

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Generally, you doctor would of sent the blood work out to some lab (LabCorp, Quest, etc) and not just run it in house. So, there isn't much chance of you getting any type of reimbursement from your doctor.

I'd start with asking your doctor why they ordered the test, was there something they thought you needed or did something come up in your annual physical.

One thing that HDHP's are forcing people to be is more proactive about their health care. Whenever my doctor wants to take blood, I always ask, what tests are you planning to run, why do you think I need them, what are you looking for. If it's ever a case of "Well, I like to order this test every couple of years just in case something comes up", I tell them no. If I have symptoms of something then we'll order the correct test for the symptoms, but I am not interested in going on a fishing expedition. Doctor's in the US run too many tests, IMO.

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AverageGuy09 said:   
One thing that HDHP's are forcing people to be is more proactive about their health care. Whenever my doctor wants to take blood, I always ask, what tests are you planning to run, why do you think I need them, what are you looking for. If it's ever a case of "Well, I like to order this test every couple of years just in case something comes up", I tell them no. If I have symptoms of something then we'll order the correct test for the symptoms, but I am not interested in going on a fishing expedition. Doctor's in the US run too many tests, IMO.

Going in for an annual check up is being proactive.

Having to figure out if a test the doctor orders is necessary, that's doing the doctors job

Now maybe if the question were, is all this covered by my insurance , then perhaps we should be proactive and ask.

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As bogus this is, it's up to the consumer to verify the procedures being ordered by medical professionals, and you have to watch them like a hawk.

I had a similar situation, except I specifically told the doctor I only wanted the specific blood tests which the insurance company had told me were preventive. I thought that was enough, didn't ask to review the order before they sent my blood off to the lab. Lo and behold, she'd ordered a bunch of tests in addition to the ones I'd approved. I refused to pay the bill stating that I'd authorized only a few of the tests, and referred the lab back to the doctor who'd ordered unauthorized tests. They sent a few more bills and eventually dropped it.

I'd pay it and take it as a lesson to not let any medical provider order anything without your personal review.

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My doctor also ordered this test, and my insurance did not cover it. Quest informed me that it would not be covered BEFORE they drew the blood and had me pay up front (but Quest only charged $80). I could have refused the service at that time, so if anyone to blame, I would say it is the lab who did not inform you of their charges. It was very quick and easy for Quest to run my insurance through their computer and tell me the copay up front. I would just pay and move on.

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Just FYI -- a large subset of the populations is vitamin D deficient. The prescription vitamin D to fix it is pretty cheap -- and many people find that it makes a noticeable difference. We don't get out in the sun enough, and that's about the only way to naturally get vitamin D. Doctors are ordering the tests because it's a problem and it affects quality of life.

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doveroftke said:   As bogus this is, it's up to the consumer to verify the procedures being ordered by medical professionals, and you have to watch them like a hawk.

I had a similar situation, except I specifically told the doctor I only wanted the specific blood tests which the insurance company had told me were preventive. I thought that was enough, didn't ask to review the order before they sent my blood off to the lab. Lo and behold, she'd ordered a bunch of tests in addition to the ones I'd approved. I refused to pay the bill stating that I'd authorized only a few of the tests, and referred the lab back to the doctor who'd ordered unauthorized tests. They sent a few more bills and eventually dropped it.

I'd pay it and take it as a lesson to not let any medical provider order anything without your personal review.

It is a doctor's responsibility to do her best job to heal patients. To imagine that doctors would know the matrix of insurance carrier/plan/procedure/provider and which is covered in your individual case seems unrealistic. That said, it seems incumbent on both the doctors and insurance companies to provide some easy and reliable mechanism for patients to find out this information.

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I think the vitamin D tests are relatively recent, the last 10 years or so, and now that doctors can test they find something they need to treat, what a surprise. But I think we should be cautious. Here's a Harvard Med School article from 2014.

Vitamin D testing not recommended for most people

As the OP noted, most insurance and Medicare don't cover this test, and that's because it's of uncertain worth.

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AverageGuy09 said:   Generally, you doctor would of sent the blood work out to some lab (LabCorp, Quest, etc) and not just run it in house. So, there isn't much chance of you getting any type of reimbursement from your doctor.

I'd start with asking your doctor why they ordered the test, was there something they thought you needed or did something come up in your annual physical.

One thing that HDHP's are forcing people to be is more proactive about their health care. Whenever my doctor wants to take blood, I always ask, what tests are you planning to run, why do you think I need them, what are you looking for. If it's ever a case of "Well, I like to order this test every couple of years just in case something comes up", I tell them no. If I have symptoms of something then we'll order the correct test for the symptoms, but I am not interested in going on a fishing expedition. Doctor's in the US run too many tests, IMO.


So essentially, you're asking people to start predicting the future and become more knowledgeable about the subject in which you are paying to see an expert on.

Remind me again, why am I the one seeking the expert medical care on what is necessary when I can just do it all myself on YouTube videos and have self diagnosis on what's necessary and covered?


Do you not see a clear conflict of interest here?

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revheck said:   This time my doctor ordered a Vitamin D blood test without telling me. My insurance doesn't cover this, so they say I am responsible for full amount $175.

Do you take a daily multi-vitamin pill? If not, it would be cheaper to take one for a year than the cost of that test which probably wouldn't be needed then anyway.

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For senior patients, Vit D labs have become quite routine. However, most providers tend to know what is covered by Medicare and what isn't. It's not true that most insurances do not cover this lab, it's actually the opposite as long as it's billed correctly.
I would call the office and ask them to work it out. Perhaps they can rebill the lab with Medicare in such a way as to justify it.

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atikovi said:   
revheck said:   This time my doctor ordered a Vitamin D blood test without telling me. My insurance doesn't cover this, so they say I am responsible for full amount $175.
Do you take a daily multi-vitamin pill? If not, it would be cheaper to take one for a year than the cost of that test which probably wouldn't be needed then anyway.

How do you know that?
Are you a doctor and know OP's medical history?

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Vitamin D is very important. I just presented some research on the topic this weekend. What you need to do is to thank your doctor for ordering it since you do need to know your level and pay it. Complain to your insurance company for being inept not the doctor.

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Post deleted.

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eddierd said:   Vitamin D is very important. I just presented some research on the topic this weekend. What you need to do is to thank your doctor for ordering it since you do need to know your level and pay it. Complain to your insurance company for being inept not the doctor.
Since you are a medical researcher, how do you reconcile the meta-studies that shows no better outcome for people subjected to the test?

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videogamesaremylife said:   
marcopolomle said:   
atikovi said:   
revheck said:   This time my doctor ordered a Vitamin D blood test without telling me. My insurance doesn't cover this, so they say I am responsible for full amount $175.
Do you take a daily multi-vitamin pill? If not, it would be cheaper to take one for a year than the cost of that test which probably wouldn't be needed then anyway.

How do you know that?
Are you a doctor and know OP's medical history?



Is the passive-aggressive non-sense really needed here? I believe you suspect the poster is neither a doctor nor personally aware of Ops medical history.

The person's point was based on simple math. Even some of the most expensive multi-vitamin and/or Vitamin D supplements would be cheaper than $175 a year. Would this guarantee no need for a test? Possibly not, but I'd say you better have a very specific reason for ordering the test if i'm taking more than sufficient supplements.

I'll add on and say that $175 could go a long way toward eating healthier (Fruits and vegetables.) While may not solve the vitamin D problem, it could decrease the need for more of these "Let's take a look around and see if we can find any other problems" type tests.

Op, do you suffer from any sort of depression or anxiety? (Especially in wintertime?) Curious since that could be a big symptom that could cause the Doctor to want to run the test.

So youare asking OP's medical history on a public forum and giving medical advice to OP ?
So many wannabe "Doctors" here.
Keep in mind OP did not ask for anyone's medical opinion here but insurance advice.

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MD here- subspecialized though so I don't do routine H&P. I think routine ordering of Vitamin D levels isn't standard. If the MD is running around ordering vitamin D on everyone, then he is likely causing your problem to many others- and you are correct he should be aware in general about stuff he does routinely. My father is a pediatrician and he is WELL aware of different healthcare plans and the cost implications. Not every doctor is that aware of the cost of what they do however(I know I'm not since my billing is done by the hospital).

Where was the test sent? If this is an 'in house' test (which it likely wasn't) and the doctor office is billing you then there is a large chance that the doctor has a financial connection with the lab and that might drive his ordering.

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ZenNUTS said:   
eddierd said:   Vitamin D is very important. I just presented some research on the topic this weekend. What you need to do is to thank your doctor for ordering it since you do need to know your level and pay it. Complain to your insurance company for being inept not the doctor.
Since you are a medical researcher, how do you reconcile the meta-studies that shows no better outcome for people subjected to the test?

Depends on themeta-study,genetic makeup of the individual, what you are looking for, as well as others effects of calcium on the body.

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marcopolomle said:   
atikovi said:   
revheck said:   This time my doctor ordered a Vitamin D blood test without telling me. My insurance doesn't cover this, so they say I am responsible for full amount $175.
Do you take a daily multi-vitamin pill? If not, it would be cheaper to take one for a year than the cost of that test which probably wouldn't be needed then anyway.

How do you know that?
Are you a doctor and know OP's medical history?

Says right on the jar of Centrum, Vitamin D 1,000 IU 250% of minimum recommended daily amount. If OP takes a multivitamin he would be getting enough and wouldn't need the test unless he takes other medications that interfere with v.D absorption and he didn't mention that.

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I think the real question here is "how do you get fair pricing close to the insurance negotiated rate for excluded tests?" If it had been covered, it probably would have been less than $80. None of this speaks to the deductible though. Covered just means they consider it necessary, therefore the price gets reduced down to the cheap rate.

I'd prefer my Dr.s advice on what's medically necessary over my insurer, but I don't want to end up writing the testing lab a blank check since they'll bill excluded items at rack rack.

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OP,

When you say that Ins won't cover it, do you mean they denied it, or they approved it, but aren't paying because you haven't met your deductible.

If they aren't paying because you haven't met your deductible, then it's pretty much what it is and next time make sure you understand everything your doctor is requesting.

If they are denying it outright, find out from the insurance why they are denying it. It's likely that the charges would be approved if rebilled with an appropriate diagnostic code.

That said, with High Deductible plans becoming the norm, Doctors ordering procedures/tests without medical necessity is an issue that will keep getting more visible.

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See if they have another Diagnosis code they could use that would include the test or at least lesson the cost.

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If you have a health issue related to low Vitamin D they should cover it. For example, I take Prevacid. This drug reduces stomach acid such that not enough Vitamin D is absorbed. Therefore I am Vitamin D deficient and must take a supplement. You cannot take a supplement without a blood test to establish whether the supplement is working. My insurance has always payed for the blood test because my chart shows that I am a long term user of Prevacid plus I now have a history of low Vitamin D. The charges from the lab are extraordinarily inflated. For example, when I get the EOB the charge might be $120 but shows that my insurance payed $12. So for $1,000 worth of lab work the insurance paid roughly $100.

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Also of importance is where OP lives. If he lives in an area like the Pacific Northwest then he endures an extended rainy season which may deprive him of the the proper amount of Vitamin D.

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revheck said:   I had my annual physical exam, which usual costs me almost nothing because it is considered preventive care.This time my doctor ordered a Vitamin D blood test without telling me. My insurance doesn't cover this, so they say I am responsible for full amount $175.

Are you sure you will need to pay the full $175? With my insurance (and I thought this was standard), you should only be required to pay the negotiated price, which will be much less than the $175.

Also you should fight it and say that your doctor thought it was medically necessary. See if the doctor's office will help if necessary.

As for those who said it's your responsibility to make sure it's covered in advance, I don't buy that. My doctor's office warned me before getting a shingles vaccine that it was expensive and I would have to pay if my insurance did not cover it, and even made me sign a letter to that effect. If they are ordering a test which there is a history of not being covered, they should have warned you beforehand since clearly you had a reasonable expectation that your entire physical would be covered.

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billrubin said:   
revheck said:   I had my annual physical exam, which usual costs me almost nothing because it is considered preventive care.This time my doctor ordered a Vitamin D blood test without telling me. My insurance doesn't cover this, so they say I am responsible for full amount $175.
Are you sure you will need to pay the full $175? With my insurance (and I thought this was standard), you should only be required to pay the negotiated price, which will be much less than the $175.


If it's not covered and/or the lab was not in network, the negotiated price doesn't apply.

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billrubin said:   
revheck said:   I had my annual physical exam, which usual costs me almost nothing because it is considered preventive care.This time my doctor ordered a Vitamin D blood test without telling me. My insurance doesn't cover this, so they say I am responsible for full amount $175.
Are you sure you will need to pay the full $175? With my insurance (and I thought this was standard), you should only be required to pay the negotiated price, which will be much less than the $175.

Also you should fight it and say that your doctor thought it was medically necessary. See if the doctor's office will help if necessary.

As for those who said it's your responsibility to make sure it's covered in advance, I don't buy that. My doctor's office warned me before getting a shingles vaccine that it was expensive and I would have to pay if my insurance did not cover it, and even made me sign a letter to that effect. If they are ordering a test which there is a history of not being covered, they should have warned you beforehand since clearly you had a reasonable expectation that your entire physical would be covered.

When insurance doesnt cover something, you dont get the negotiated rate. It is entirely between you and the doctor's office to sort it out. IOW, $175 is what OP owes, unless he can negotiate it down with the provider directly.

We had the same problem two years ago. It was somewhat widespread in the medical office we frequent. Apparently, the insurance companies (at least some of the major ones used in that facility) decided not to cover Vitamin D testing starting that year. After a few months of this change, there were prominent notices in the office about Vitamin D testing not being covered by insurance and that the patient will be responsible for the fee ($59 I think). Of course, the patient could decline Vitamin D testing. I believe they also made you sign a form explicitly agreeing to that test and paying for it.

But for an initial few months during the transition, it was not clear to many and resulted in unhappy patients.

Given that this is February, I am guessing this was a change that went into effect with the plan year starting January in OP's case as well.

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Many insurance companies do cover the Vitamin D test.

My standard insurance plan (a middle-range "marketplace" insurance policy) covers my Vitamin D blood tests.

Medicare covers my elderly relatives' yearly Vitamin D tests during their annual exams, no question.
(Not sure what timeframeyour researchon Medicare's coverage of Vitamin D testingisbased on,but my most recent data points, on3 different Medicare recipientsliving in 2 different states, are from the last 6 months.)

There has been at least one past Fatwallet thread about getting the Vit D test covered after it was initially refused, and the insurance company backed down and paid up. You might read that thread for tips on how to follow up with your insurance company and what to tell the lab test company in the meantime (they usually will not bill you for 3 months as a courtesy, while you petition the insurance company).

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atikovi said:   
marcopolomle said:   
atikovi said:   
revheck said:   This time my doctor ordered a Vitamin D blood test without telling me. My insurance doesn't cover this, so they say I am responsible for full amount $175.
Do you take a daily multi-vitamin pill? If not, it would be cheaper to take one for a year than the cost of that test which probably wouldn't be needed then anyway.

How do you know that?
Are you a doctor and know OP's medical history?

Says right on the jar of Centrum, Vitamin D 1,000 IU 250% of minimum recommended daily amount. If OP takes a multivitamin he would be getting enough and wouldn't need the test unless he takes other medications that interfere with v.D absorption and he didn't mention that.

This assumptionis based on a false,limitedunderstanding of how supplementalnutrients work, how different people's bodiesprocess them, and how the requirements of different people's bodies can vary widely.

Some people can take 3,000 iu of Vitamin D a day and it's not enough for them. Some people can take 1,000 iu a day and it puts their levels way too high. I have a relative who takes 50,000 iu a week, as recommendedby her MD. This isn't a one-size-fits-all, if-you-take-a-daily-cheapo-multi-like-Centrum-you-should-have-perfect-levels-of-everything situation.

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Vitamin D is a hormone, not a vitamin as such, and it's been found to be deficient in a lot of people, and getting it up to a decent level in the body is a good, healthy thing to do.

I have heard ofmany GPs testing for it,especially in the northern states and in Europe,and it is not out of the ordinary at all for GPs to test people for it.

Sometimes insurance companies don't automatically pay for it, but usually you can argue the point with them, especially if the GP thought it was medically valid to test for it in the first place.
(Again, see a FW thread from a couple of years ago that detailed this situation and how the person won the claim in the end. I don't know if the situations were exactly like yours, but it might give you tips nonetheless.)

If the OP's result on the blood test showed a low level of Vitamin D, all the more reason for the doctor to have been right in suspecting that it would be good to test the OP for it, and to treat it.

---
By the way, about 5 years ago, before routine testing of Vitamin D was done by GPs, I ordered my own test from Labcorp (it's easy to do online) and I think the Vit. D. test was less than $50 by doing it that way, so if you are deficient, if your insurance company won't budge, if your doctor won't re-code the order, and you are taking supplemental Vitamin D to try to get your level in the normal range, then you can pay for the test yourself once in a while to make sure you are hitting the blood level range that you are aiming for.

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atikovi said:   
marcopolomle said:   
atikovi said:   
revheck said:   This time my doctor ordered a Vitamin D blood test without telling me. My insurance doesn't cover this, so they say I am responsible for full amount $175.
Do you take a daily multi-vitamin pill? If not, it would be cheaper to take one for a year than the cost of that test which probably wouldn't be needed then anyway.

How do you know that?
Are you a doctor and know OP's medical history?

Says right on the jar of Centrum, Vitamin D 1,000 IU 250% of minimum recommended daily amount. If OP takes a multivitamin he would be getting enough and wouldn't need the test unless he takes other medications that interfere with v.D absorption and he didn't mention that.


marcopolomle,

What is the fix for vitamin D deficiency? Would taking 1000 IU daily not be a solution for some?



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Years ago during an annual physical (in which my doctor ordered a comprehensive blood test), it came back that my Vitamin D level was low (I'm pretty sure the entire blood test was acceptedby my insurance as I only had to pay the insurance negotiated rate which was considerably less than thelab's billed rate).

Per that test,my doctor prescribed me a 1 month supply of high dose of Vitamin D (50,000 IU's), where I needed to take 1pill perweek. In other words, that prescription was for 4pills total, and I guess my prescription co-pay at the time was$10 (it apparently would have been more expensive w/o my insurance). So each pillcost me $2.50, which I thought was highway robbery for such a small quantity ofVitamin D.A follow-upblood test (maybe 90 days later)showed that my Vitamin D levels were normal, so apparently taking Vitamin D supplements is something I needed to do.

In this next part, I may sound like a shill for Puritan's Pride(I'm not), but so be it. They sell Vitamin D in different doses, the highest being 10,000 IU's. A bottle of100 pills10,000 IU's costsless than what my 4 pills of prescription 50,00 IU's cost.

At the moment 1 bottle of 10,000 IU's (qty 100) is $7.99 (and 5 bottles is $27.15, so $5.43/bottle):
http://www.puritan.com/puritans-pride-brand-0102/vitamin-d3-10000-iu-035872

Even if I needed to take 50,000 IU's per week long term, 1 bottle of 10,000 IU's at qty 100 is equivalent to 20 doses of 50,000 IU's, which is basically 5 months worth of Vitamin D @ 50,000 IU's per week. As a bonus I can spread out the Vitamin D intake as 10,000 IU's per day, 5 days a week, if desired.

I decided to take 10,000 IU's every other day, so I alternate between taking 40,000 IU's in one week (Sun, Tue, Thu, Sat), then 30,000 IU's the following week (Mon, Wed, Fri). My Vitamin D level has never been problematic since (verified by follow-up blood tests over the years).

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After reading this thread I regret going into medicine even more. not sure what's worse: google doctors or insurance companies.

OP, your blood work isn't covered because the good little doctor (hope you actually saw an MD and not some mid level wannabe) didn't document properly. If the documentation explains symptomatically why the test was ordered, it will be covered. Of course, it maybe take a few rounds of fighting and appeals with the insurance company--but don't worry the doctor I'm sure has dedicated staff to deal full time with insurance BS.

What I would give to just be able to diagnose and treat.....

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atikovi said:   
revheck said:   This time my doctor ordered a Vitamin D blood test without telling me. My insurance doesn't cover this, so they say I am responsible for full amount $175.
Do you take a daily multi-vitamin pill? If not, it would be cheaper to take one for a year than the cost of that test which probably wouldn't be needed then anyway.

OP asked for help with a test already done and billed. He didn't ask for medical advice, which, unless you're a doctor, you're not qualified to give.

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bikerboy22 said:   After reading this thread I regret going into medicine even more. not sure what's worse: google doctors or insurance companies.

OP, your blood work isn't covered because the good little doctor (hope you actually saw an MD and not some mid level wannabe) didn't document properly. If the documentation explains symptomatically why the test was ordered, it will be covered. Of course, it maybe take a few rounds of fighting and appeals with the insurance company--but don't worry the doctor I'm sure has dedicated staff to deal full time with insurance BS.

What I would give to just be able to diagnose and treat.....

Depending on the staff you are lucky if they can read.. I have seen too many times to count where they can not read an id card. 8 becomes S 00 becomes oo

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jerosen said:   
marcopolomle, What is the fix for vitamin D deficiency? Would taking 1000 IU daily not be a solution for some?

IMHO fix depends on the cause since there can be many different causes of Vit D deficiency.
First your doctor have to rule out any serious cause(s) of the deficiency. Once that is done then you can take OTC Vit D (1000 IU) along with Calcium (1200 mg). Only taking one or another won't help that much since Vit D help absorb (which need stomach acid) as well as process Calcium in the body (along with other hormones). An analogy would be a Mason(Vit D) putting Bricks (Calcium) on a building (bone).
Starting any kind of Vit D requires Vit D levels not only to diagnose Vit D deficiency but also as a baseline to monitor response to therapy. You won't know where you are unless you know where you started to begin with !

Now there is a big difference between OTC Vitamin D and prescription Vitamin D.
OTC Vitamin D is an inactive Vit D which needs to converted to activeVitamin D in Liver and Kidney or Kidney only (depending on the formulation e.g.D2/D3).
Prescription Vitamin D is already active but can be dangerous to take since it is very powerful and can cause serious damage to body (hence only available by prescription).

Usual dose of OTC Vitamin D 1000 - 2000 or even 5000 IU depending on level of deficiency.
Usual dose ofPrescription Vitamin D is 50,000 IU per week.

Hope this help.
More info hereand here


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OP here: I understand that I am ultimately responsible for knowing my own insurance, not my doctor, My question has more to do with whether my doctor has any responsibility to inform me if he plans to order a test where he should know that insurance denial is common for otherwise healthy people.

For example, do I need to anticipate and make sure that my doctor doesn't use my blood sample to order a pregnancy test? Or, if I don't think to ask, would I still be responsible to pay the full cost when my insurance EOB arrives stating that this test is not normally necessary for healthy males.

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Your doctor do not have any responsibility towards informing you about what your insurance covers or not since it is not his/her job.
Most do it as a courtesy since they try to avoid ill will of their patients.
However, it is not possible for them to know about each and every insurance plans and their changes i.e. if one thing was covered today it might not be covered tomorrow since insurance companies might have figured out a way to not pay for something they are supposed to.

What they are required to do is to discuss every test or medication with you while ordering it to make sure you understand why that test was ordered.
They are also (in an ideal world) supposed to answer each and every question of yours.

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Vitamin D test just standard for me now, not that I even noticed. My specialist looked back though and saw my level was lower than he liked and I didn't even know the test had been done. He asked me to start taking two 2500 IU daily and get tested again in a couple months. I'm glad they had that history to look back at for comparison. Our insurance is zero copay on all labs though

Skipping 41 Messages...
rated:
Although Medicare doesn't pay for Vit D test for routine screening, it does pay for test for patients with below diagnoses.

chronic kidney disease stage III or greater;
osteoporosis;
osteomalacia;
osteopenia;
hypocalcemia;
hypercalcemia;
hypercalciura;
hypoparathyroidism;
hyperparathyroidism;
malabsorption states;
cirrhosis;
hypervitaminosis D;
obstructive jaundice;
osteosclerosis/petrosis;
rickets;
low exposure to sunlight; and
vitamin D deficiency to monitor the efficacy of replacement therapy.

https://www.cms.gov/medicare-coverage-database/shared/handlers/highwire.ashx?url=https://www.cms.gov/medicare-coverage-database/details/lcd-details.aspx@@@LCDId$$$33996***ContrId$$$238***ver$$$11***ContrVer$$$2***CntrctrSelected$$$238*2***Cntrctr$$$238***name$$$+(15202,+MAC+-+Part+B)***s$$$42***DocType$$$Active***bc$$$AggAAAQAAAAAAA$$$$$$***&session=tpe1u1554jtncludclccjley&kq=781986281

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