Head Cold Costs Insurer a Shocking $25,865 - Wormington & Bollinger

Head Cold Costs Insurer a Shocking $25,865

by Wormington & Bollinger

Head Cold Costs Insurer a Shocking $25,865 - Wormington & BollingerEarlier this fall, 40-year-old Brooklyn resident Alexa Kasdan went to the doctor to get checked out for strep throat. About to leave on vacation, the last thing Kasdan wanted was to deal with a head cold during her trip. She visited her local primary care physician in Manhattan, where she had her throat swabbed, gave a vial of blood, and received antibiotics. Thankfully, Kasdan felt better soon after that and enjoyed her vacation without any repercussions. That was until she got home to a hefty bill waiting for her. The bill in question? $28,395.50 for out-of-network lab tests. Of this, her insurance company paid $25,865, and the remainder was waved.

As you can imagine, Kasdan was shocked at the amount for a simple throat swab. She initially thought it was a mistake, and the bill was $250. After some digging and many phone calls, Kasdan learned the bill was indeed correct. You are probably wondering how a throat culture test could cost over $25,000. To start, Kasdan’s doctor didn’t just send the throat swab to check for strep throat, but ordered a “sophisticated smorgasbord of DNA test looking for viruses and bacteria that might explain Kasdan’s cold symptoms.” According to Dr. Ranit Mishori, a professor of family medicine, this was utterly overboard and unnecessary based on the patient’s symptoms.

Growing Concern for Medical Malpractice

As we know, doctors consistently over-order tests and make decisions not based on a person’s well-being and needs, but their own interests. Take, for example, the story we wrote about last month involving more than 300 families across nearly 40 states. Doctors were inaccurately identifying newborn symptoms as those typical with child abuse when other factors were to blame. Similarly, some doctors are guilty of purposely misdiagnosing patients to get kickbacks from medical device companies, manufacturers, and hospitals. All of these stories tell us one thing – the pharmaceutical industry is often corrupt and does not have the best interests of patients in mind. Sadly, this trend has been happening for quite some time in the United States, which is why medical malpractice is the third-leading cause of death in our country. Today we are going to take a closer look at Kasdan’s case.

If you believe you are the victim of negligence, or if your doctor missed your diagnosis, ordered unnecessary tests, made a surgical error, or did not fulfill his or her duty of care in some other way, contact Wormington & Bollinger today. Our experienced Dallas medical malpractice lawyers are here to answer your questions and help you understand your rights.

Surprise Bills More Common Than You Think

Unfortunately, cases like Kasdan’s happen all the time. You visit the doctor because you are feeling under the weather, only to face unexpected and ridiculous bills. In Kasdan’s case, her insurance company cut a check to cover the majority of the costs, but the tests should never have been ordered in the first place. According to Dr. Mishori, the tests would be conceivable for someone battling pneumonia or a patient in the intensive care unit, but not for a mild sore throat. Plus, numerous affordable rapid tests could have been used in place of the more comprehensive tests ordered.

Kasdan’s lab results all came back negative, so the $25,865 really was for nothing. Not only did her doctor order unnecessary and expensive tests, but she sent them to an out-of-network lab for analysis. Out-of-network labs set their prices for lab tests, unlike in-work labs that agree on a price with insurance companies. But Kasdan knew nothing about any of this when she walked out of her doctor’s office. If her doctor had sent the lab test to the proper in-network provider, the bill would’ve been closer to $653, a much more reasonable cost.

Even though Kasdan wasn’t stuck with paying the bill herself, it may eventually lead to higher insurance rates for the entire group.

The takeaway from this particular story is that surprise bills happen and are often out of your control. When a doctor outsources tests or labs to an out-of-network provider without the consent of the patient, the price tag can be shocking. Unfortunately, it is challenging, if not impossible, for a patient to catch on this is happening. This is why we encourage you to ask questions and do everything you can to protect yourself. We learn to trust doctors and other healthcare providers, but today’s climate shows us how dangerous that can be.

Patients Taken Advantage of By Doctors

There are endless scams on the market today that prey on patients and take advantage of the vulnerability that often comes with medical issues. From genetic testing scams to prescription errors, elderly abuse, and doctors using money to get the results they want, you can never be too careful. Other examples of medical malpractice include:

  • Anesthesiology errors
  • Lack of informed consent
  • Pain management errors
  • Medical overdosing
  • Nursing errors
  • Birth errors
  • Surgical errors

Am I the Victim of Medical Malpractice? Questions to Ask 

If you suspect medical malpractice, ask yourself the following questions:

  • Did you suffer an injury while under the care of a doctor or other healthcare provider?
  • Did your insurance provider question certain tests, procedures, or diagnoses?
  • Do the tests your doctor ordered seem inconsistent with your symptoms?
  • Did your doctor delay treatment?
  • Did a prescribed medication cause your injury?
  • Was your injury preventable?
  • Did your condition worsen after seeing your doctor?
  • Did your doctor fail to follow up after ordering tests?

If you answered yes to any of the above, you might have a medical malpractice claim on your hands. Although many people think of surgical errors and missed symptoms as the top forms of medical negligence, we know it can show up in many different ways. Money is often at the center of malpractice claims. Whether the doctor ordered unnecessary tests, resulting in over-the-top bills like in Kasdan’s case or received payment for prescribing a particular drug or ordering a specific test. The bottom line? You must protect yourself and be fully aware when receiving medical care of any kind.

Medical malpractice is dangerous and is a growing problem in the United States. It comes in many different shapes and forms and is often hard to detect. Our experienced Dallas medical malpractice lawyers have handled countless cases just like yours and are prepared to help you today. We offer free consultations and are just a phone call away.

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