Health Diagnostic Laboratory Sticks it to Patients
Recently there have been a number of real complaints regarding billing practices at Austin Family Medicine. Most of the concern seems to have been started when a large group of our patients received collection notices related to blood testing that was done months ago through an advanced lipid and cardiovascular risk testing company called Health Diagnostic Laboratory, Inc., HDL provided incredible, state-of-the-art testing that could identify more than 40% more high risk cardiovascular issues than could standard testing. Additionally, they provided this testing by accepting whatever the patient’s insurance would pay and thus with no out of pocket expense to the patient. The insurance paid, the patient did not. To my knowledge, no medical office including ours ever received any payment for this testing. All billing was done through Health Diagnostic Laboratory, not our clinic. In many cases the information obtained was life changing for our patients.
Health Diagnostic Laboratory did go through a bankruptcy proceeding and was bought by another testing company. A collection agency named Accelerated Receivables Management sent letters to thousands of former HDL patients including many of our patients. This was unauthorized byHealth Diagnostic Laboratory and their new owners, not allowed in the State of Texas, and a probable violation of current insurance regulations. Many patients contacted us and we have helped all of those patients understand their rights and assist them in resisting this blatantly wrong collection effort. A cease and desist order was issued against this company and they have now stopped their collection efforts. If you had testing done by Health Diagnostic Laboratory, you owe nothing additional for those valuable tests.
I realize that insurance billing and the costs involved in medical care can be confusing and often, unfortunately, expensive. We value our patients and seek to provide the latest, most up-to-date care possible. We focus on cardiovascular risk identification for all our patients because this is the leading cause of death by far in the US. We also emphasize hormone balance and nutritional optimization. Laboratory testing is required to properly evaluate these issues. Patients who choose to decline such testing may always do so. There are some tests, not all, that are absolutely essential to provide proper care and without such tests we cannot provide care to those individuals.
Much confusion about medical bills comes from patients receiving statements from their insurance company. These are Explanation of Benefits (EOB) and they can be confusing as to just what you really owe. We typically collect a co-pay or part of an unmet deductable from our patients and then send an electronic claim to the insurance company. After several weeks or in some cases months we finally receive payment from the insurance and in some cases must then bill the patient for any additional part they may have. We often re-file the claim on behalf of our patients when there are mistakes by the insurance company. We are required by our contract with the insurance company to collect all applicable co-pays and deductable amounts. We have two full time insurance specialists that diligently work on behalf of our practice and our patients to resolve insurance issues that may arise. I’m not sure if any of the recent unfavorable reviews on Yelp regarding these insurance issues tried to contact us, but each day we work with many of our patients to sort out the various billing concerns that they have. We encourage our patients to contact us with their concerns and let us help advocate on their behalf.
Recent coding changes in medical insurance have certainly added to the complexity of the issue, but the biggest change is in the area of co-pays and higher deductibles. Pretty much gone are the days of a flat co-pay for all care, this has been replaced in many cases with very high deductibles, insurance care-outs like mental health, restricted access to specialists, prior authorizations for medications, imaging, and surgical procedures. Our patients just want to get well and stay healthy. The physicians and staff at Austin Family Medicine Associates are here to help you in the endeavor and to help negotiate the often confusing issues of medical insurance. If we have somehow failed to meet those goals for you we are sorry and will try to do better. If you are still reading this rather lengthy note would you consider contacting us with your specific concerns and needs and let us try to help. To those patients who entrust their health to our care thank you and know that every staff person appreciates you and will give their best to provide you with exceptional care.
Austin Family Medicine Associates
David L. Sneed, DO
