As I posted, my one little word that I’m hoping will have a BIG impact on my heart-soul this year is ‘begin’.
I wanted to share an encounter I had today with a radiology group that speaks to the importance that we all begin to stand up for ourselves and stop blindly paying for services that we were not discussed with us much less informed would be taking place.
Because of the high dose chest radiation that I received in 1978 to treat Ewing’s Sarcoma, I am at high risk for developing treatment-related breast cancer. Thus, I am screened with annual mammograms AND annual MRI spaced 6 months apart.
I received an invoice for $163 because the radiologist decided without my knowledge or consent to use computer-aided diagnostic technology which is presently investigational, and therefore, NOT covered by insurance companies.
After speaking with my health insurance company and learning that this service was all too often added without patient knowledge, I told the representative that I did not want to expend their time and resource rather I would take this up with the radiology group.
So, I called the radiology group’s billing department.
I explained to the billing representative the situation, and my belief that it was wrong for them to bill me for a service for which consent was not obtained.
I was advised that “unfortunately the service had already been rendered; therefore, it was my responsibility according to my insurance company and the radiology group”; I promptly responded that I believed there was a corresponding responsibility on the part of the provider to obtain consent and told the representative that I would need to speak with someone else because this was a patient’s rights issue.
Again, I was not informed nor did I consent to this investigational technology.
I was placed on hold.
When the representative returned, she informed me that “they would be taking care of the charge for me.”
Understand that because this technology is investigational and insurance companies do not cover it, radiologists can perform it, then charge YOU whatever they want; THIS is wrong, but it happens every day!
So, I strongly encourage you to begin to review your Explanation of Benefits statements and your invoices [and] stand up for YOU knowing that THEY will not.
Lastly, because I’m an insider of the healthcare system, I have the advantage of already being in the habit of challenging charges uncovered by my insurance company. I know the buzzwords that make things happen:
- not informed
- did not consent
- patient’s rights
- provider responsibility
I hope this helps you navigate the system more effectively.
As always, YOU are your own best advocate, so stand up and use your voice!