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When going to get tests, make sure that your insurance covers them (in-network labs)!
How A Urine Test After Back Surgery Triggered A $17,850 Bill
Urine drug testing has exploded over the past decade amid alarm over rising opioid overdose deaths. Many doctors who prescribe the pills rely on the urine tests to help reduce drug abuse and keep patients with chronic pain safe. Yet the tests have become a cash cow for a burgeoning testing industry, and critics charge that unneeded and often expensive ones are sometimes ordered for profit rather than patient care. Doctors can decide whether to test patients who take opioids for short periods, such as after an operation. Moreno's surgeon would not discuss her urine test — why he ordered it and why the sample was tested for so many substances.
Three experts contacted by Kaiser Health News questioned the need for such extensive testing and were shocked to hear of the lab's prices. They said these tests rarely cost more than $200, and typically much less, depending on the complexity and the technology used. Some doctors' offices use a simple cup test, which can detect several classes of drugs on the spot and could be purchased for about $10. Bills can climb higher when labs run tests to detect the quantity of specific drugs and bill for each one, as the lab did here.
The experts said the lab's prices for individual tests were excessive, such as charging $1,700 to check for amphetamines or $425 to identify phencyclidine, an illegal hallucinogenic drug also known as PCP. They also criticized a charge of $850 for two tests to verify that her urine sample had not been adulterated or tampered with.
Moreno's insurer, Blue Cross and Blue Shield of Texas, refused to pay any of the bill, arguing that the lab was out of network and thus not covered. Had it chipped in, it would have covered the service at $100.92, according to an explanation of benefits the insurance company sent to Moreno.
Sunset Labs says its list prices were "in line" with its competitors in the area. It also said doctors treating pain agree extensive urine testing is "the best course of action" and that a lab "is not in the position" to question tests ordered by a doctor.
Resolution: Fearing damage to his daughter's credit rating, Moreno's father, Dr. Paul Davis, paid the lab $5,000 to settle the bill in April 2017. A retired doctor, he also has filed a formal complaint about the bill with the Texas attorney general's office, accusing the lab of "price gouging of staggering proportions." The lab's attorney said he was not aware of the complaint. A Texas attorney general's spokesperson confirmed to KHN that the office had received complaints about the lab but declined further comment.
The takeaway: When a physician asks for a urine or blood sample, always ask what it
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