Company Optional Physical
yahzoo yahhzy
required) which was quite comprehensive. The physical was supervised
by a D.O. not an MD. During the stress test part of the physical he
became alarmed and directed to me to the Emergency room for further
testing. He cited the stress test EKG reading as having something
abnormal. In the emergency room they performed various tests and a ct
scan of the heart along with chest xrays and various blood test.
Additionally they kept me over night for observation and to perform a
ECHO gram on the heart. Thankfully all turned out ok and no surgey/
stents etc was required.
However my insurance company has taken exception to almost everything
citing that is was an inconclusive stress test and not medically
indicated. Furthermore the heart doctor indicated that it was
probable that the D.O. misread the EKG and he could not find anything
wrong. My primary care physician more or less agreed that he did not
see anything major in the EKG.
Of course my problem is battling through the insurance and hopefully
winning the appeal to get them to pay the bill. Even in that event it
still leaves me with about $1500 in out of pocket expenses. My
question is I would like to present those unpaid bills to my company
for payment citing more or less the incompentancy of the DO. Prior
physicals have been supervised by an MD. My thought is had a
compentent doctor been on hand none of this happend and when I was
directed to the ER it was no longer voluntary at that point.
Obviously it can be argued that the test performed was not necessary
but my guess they where covering their bases.
Your guidance is appreciated.
Thank you.
Yahzoo
grendal
> Of course my problem is battling through the insurance and hopefully
> winning the appeal to get them to pay the bill. �Even in that event it
> still leaves me with about $1500 in out of pocket expenses. �My
> question is I would like to present those unpaid bills to my company
> for payment citing more or less the incompentancy of the DO. �Prior
> physicals have been supervised by an MD. �My thought is had a
> compentent doctor been on hand none of this happend and when I was
> directed to the ER it was no longer voluntary at that point.
> Obviously it can be argued that the test performed was not necessary
> but my guess they where covering their bases.
>
> Your guidance is appreciated.
>
I don't know what you can expect from MLM, but to your point, yes you
are correct that it was the DO who ordered you to the ER and it was
based on his interpretation of the stress EKG that lead to your
additional tests. The insurance company should cover those charges.
Its not as if you walked in to your doctor's office and demanded the
tests with no prior medical history or complaints to suggest a need
for the tests.
Insurance companies are looking to cut costs so that they will force
you to fight for your medical bills to be covered.
Steve Bartman
<yahz...@gmail.com> wrote:
>Of course my problem is battling through the insurance and hopefully
>winning the appeal to get them to pay the bill. Even in that event it
>still leaves me with about $1500 in out of pocket expenses. My
>question is I would like to present those unpaid bills to my company
>for payment citing more or less the incompentancy of the DO. Prior
>physicals have been supervised by an MD. My thought is had a
>compentent doctor been on hand none of this happend and when I was
>directed to the ER it was no longer voluntary at that point.
The DO may or may not have been competent, made a mistake, etc. But
there is no real difference between an MD and a DO as far as
schooling, residency, and licensing are concerned. A licensed DO is
fully capable of performing a physical and as capable of supervising a
stress test as an MD. However, he might not be as capable as an MD who
is also a board-certified cardiologist. That, however, is not the
distinction you present.
Steve
Keith
<yahz...@gmail.com> wrote:
>Of course my problem is battling through the insurance and hopefully
>winning the appeal to get them to pay the bill. Even in that event it
>still leaves me with about $1500 in out of pocket expenses. My
>question is I would like to present those unpaid bills to my company
>for payment citing more or less the incompentancy of the DO.
Your best bet is to make the DO pay for the procedures. It was his
mistake that caused you to go to the hospital. If your insurance won't pay
then you may have a suit for malpractice. If the amount you are charged is
small then you should consider small claims court rather then an expensive
trial. The DO's insurance may just pay the claim if it is small and the DO
seems incompetent.
I think trying to collect from your employer could lead to ill feelings,
after all they did it to help you.
--
Best Regards, Keith
http://home.comcast.net/~kilowattradio/
Tired of Google Groups?
http://home.comcast.net/~kilowattradio/usenet.html
slide
> Recently I had a company paid physical (which is optional, not
> required) which was quite comprehensive. The physical was supervised
> by a D.O. not an MD.
[DO may have misread EKG which also may cost OP much money]
If the DO's reading of the EKG or his insistence on you going to the ER
was below the standard of competence for a physician, you have a case of
malpractice. You can't blame your employer because the test was
voluntary. You need to read your insurance policy carefully and note
carefully if you were prescribed to go to the ER or recommended.
If you chose to go to the ER based on a recommendation, you probably
also can't move against your insurance carrier. If it was prescribed,
then you may have a good claim but you need to read the policy.
Part of the problem may be if you really were in an emergent situation
or if you could have waited a day or so to get the rest of the tests at
a non ER location (for much less money).
What you need to do is dispassionately read your policy and remember
step by step what was said to you and what caused you to go to the ER.