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Do Doctors have to disclose costs of lab tests prior to ordering?

We live in California and my wife went to a gynecologist for an examination after a traffic accident. The doctor ordered 6 lab tests totalling 1200.00. There was no prior disclosure or explanation and the doctor knew we were cash payers. Is this legal? How can you agree to pay for treatment when you don't know what the prices are?

5 Answers

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  • 1 decade ago
    Favorite Answer

    Get on the phone and call the lab's billing office. Negotiate a discount just like the insurance companies do. Explain that you are cash payers. Tell them you'd like to pay but $1,200 is out of reach. They should be willing to work with you.

    If you ask the doc they'll find out for you. My guess is that most don't know. There's nothing in the law that says you must be informed.

  • 1 decade ago

    I'm not sure that I follow you. Was it the Dr's office that did the lab tests? Or did you go to another facility. If you went to another facility than I don't know that the Doc would have known how much that provider charges for its services. You could have gone anywhere to have those labs done. If it was done in the Doc's office then he may not have known exactly how much each test was going to cost (they have a lot of info to keep track of already) but it seems that he could have tried to steer you toward the cheapest option or found out what each would have cost and evaluated their need based on cost. I would call the business office and see if they can work with you. Does CA have any kind of a program that can help you? When I lived there it seemed they had a program for everything.

  • Wendy
    Lv 4
    5 years ago

    Call your insurance company and ask for them to review the medical records for your visit. Every policy has a 'medical necessity' clause, which essentially states that they have a right to deny (or in this case, revoke) payment to a doctor for services that are not necessary. If this is the case, the doctor would have had to advise you ahead of the test that it might be non-covered or else you cannot be held financially liable for the balance on the bill. Insurance companies are always looking to watch their bottom line, and they will happily investigate an opportunity to demand money back from a doctor. If they don't take action, you can submit your complaint to your state's department of insurance. Most have online complaint forms.

  • Anonymous
    1 decade ago

    they do not have to tell you. But if you ASK they will.

    You will find in the small print that you signed to ok this.

    Talk to the business office and see if they will lower it to what they pay the insurance companies which is probably less than half. Good luck. Medical Fees are a nightmare.

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  • 1 decade ago

    Thats your problem. As a doctor i would assume you would want me to take every precaustion to help your wife and that money wasn't as important as your wifes saftey. Your lucky it wasn't more.

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