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PM docs and drug testing

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Posted 2/25/2011 6:45 PM (GMT 0)
My PM requires "random" urine tests, which I end up having to take about once a year. He sends the test out to a lab and then charges my insurance $500. My insurance then writes the cost down to about $250, and that's what I'll pay (unless I've meet my deductible).

But for some reason, this year, my insurance wrote it down to just $50!

So, I'm wondering if they've caught on that such tests are being used excessively and are taking away the financial incentive for them.

Do others here have to take such tests? How much is your insurance and you paying for them?
Posted 2/25/2011 7:10 PM (GMT 0)
My prior PM dr did random testing and used a lab out in California. This outfit charged a little over a $1,000 and my insurance whittled their bill down to a little over $200. I did not pay anything for the testing, I had two tests done in 4 years.

I don't think the insurance as caught onto anything, most likely the person doing the billing did not code it correctly.
Posted 2/25/2011 7:51 PM (GMT 0)
Well everyone that goes to my PM has to give a urine sample every refill day once a month! After you check in at the front desk they have a open file bin with brown paper lunch bags in it and they tell you to take one and go give your urine sample. The bags have the plastic cup in it with the temp gauge thing on the side. Anyway after filling the cup you bring it back out in you brown lunch bag and wait till they call your name, and then you go  back to an office and they take your cup, and put a label on it, ask you for you full name, date of birth, and have you look at the label to verify it is one in the same, then they ask you when you took your last scheduled pain meds and what they were, and your last pain meds for break through pain and what it was, and any other pain meds. You then sign your name and initial a couple of places, then they take you to your exame room and you wait to see the Doctor. This happens every month, and I have never had to pay any thing for this, all I have to pay is my three dollar co-pay for my Blacofen and again for the percocet and a twelve dollar co-pay for my oxycontin.   I have medicare and TriCare. But I have never had to pay anything for the drug test.

 

White Beard

Posted 2/25/2011 8:05 PM (GMT 0)
 

         I just had a random test done about 4 to 5 weeks ago. I also, did not have to pay anything for it.

    With the goverment and local agency's putting pressure on these clinics, it does not surprise me, and the Dr's are covering their selves with proper documentation. It keeps everyone above board. I would not want to loose my PCD and the good care he has provided me, because he failed to practice this.

      I don't consider it as an insult for him to test me. We both know, that a few bad apples has ruined it for those who need treatment. Shortly a new law will come into effect here in KS, if it hasn't already. It is a syestem called K-Tracks or something like that, as to where the Dr's will have to report to the state what Class II, III, and IV meds are being scripted to who and how much. The Pharmacy's will also be under this new law, and will have to report on a daily basis, of who got what and how much. It will all be monitored by the state of KS. Dr's, PM's and Pharmacy's will all be on the same system.

    My Dr, is against it, and does not believe that the state needs their noses in it. However if it will help us in the long run for those of us who need these med's, then I'm for it. As with all new progerams or laws, I'm sure there are Pro's and Con's on this issue.

   SE wink

Posted 2/25/2011 10:31 PM (GMT 0)
I do accept the testing as a protective measure for doctors. It presumably scares away some drug seekers and also offers the doctor a bit of legal protection.

However, these tests are not about my medical needs but rather the doctor's legal ones. It bothers me that there is a pretext that they are medical in purpose and that I or my insurance have to pay.
Posted 2/25/2011 11:32 PM (GMT 0)
My PM's office does random drug tests also. They charge my insurance company $800 for each test. My insurance company is Medicare and they end up paying less than $20 per test. I have never been charged a copay for any drug test.

Trudy
Posted 2/26/2011 6:37 AM (GMT 0)
I just had my second medication test. i hate the word drug when it comes to prescribed medications. My first was a few years ago with a PM dr. that I lost because I missed too many appointments with him. about 9 or 10 days ago I had my second one. I'm not getting into that because it's a long story and most of you already know. I'm on medicaid and I have no idea what they charge. medicaid pays the whole thing and i never get a bill, so i have no idea. I bet it would be a lot if I had to pay it.

love and hugs
Loretta
Posted 2/26/2011 7:46 AM (GMT 0)
I had posted about this along time ago, but in the miltary (I retired in 1991) they often did random drug testing, and everyone would get called up and tested every now and then, but as a senior NCO sometimes we would get tasked to be the monitor, when they did the testing, as  someone always had to see the urine leave the subjects body and go into the container, and the container had to be monitored then entire time. That made for an extremely long day watching people pee into bottles.  If you could not go, then you had to stay in that area and drink coffee or soda or water till you could produce the specimen. It was an additional duty that most of us would of rather not had to do! So this testing is a piece of cake to do for the PM Doctors!  yeah  

White Beard

Posted 2/27/2011 5:42 AM (GMT 0)
Whitebeard, that sound like what I have to do....but not once a month....only every 4 months
Posted 2/27/2011 10:35 AM (GMT 0)
LOL funny ya'll should bring up this topic! My PM has me doing urine tests every time I visit. I think last year alone I did all but two visits! Doesn't bother me of course, I know they are just covering their butts and making sure that my meds are controlling the problem well.

Hugs

Scarred
Posted 2/27/2011 11:33 AM (GMT 0)
This is all very interesting to me. I have been in serious PM treatment for approx. six years and have--never--been drug tested. In the beginning I was told that it may be a possibility but it's expensive and only suspicion of abuse will MDs do it (a RN told me this). Now I have a substantial CP and CI history with multiple hospitalizations (writing this from a hospital bed right now in fact) so I'm guessing nothing in my records stand out as "abuser/seeker" but for some reason I believe this is mostly money driven; I have a HMO where they make and save money by Not doing procedures. I have a very small co-pay for everything and they don't get anything else (employer contribution is fixed). PPOs and govnt insurance like MediCare costs are procedure driven. Example: HMO me and my PPO friend have the exact same surgery I pay my five dollar co-pay and she has to pay 20% of the total procedure bill. And private MDs who accept MediCare do and will bill the government for very unnecessary procedures; there was a big crackdown recently where Feds found MediCare MDs even making up patients and billing for procedures for a nonexistent person. Just a thought.
Posted 2/27/2011 5:03 PM (GMT 0)
 

   Well! Apparently I was in fact drug tested in the beginning! I had honestly thought they were checking to see if I had a UTI. I have had such a long history of kidney problems that it was very normal from specimens to be taken at my primary cares office. For a long stretch of time (almost 10yr) I had to take prophylactic antibiotics. Not that it did any good. So, it was perfectly normal to give urine samples to all my other doctors. I even had to give urine samples for my yearly physical and GYN. All normal for me. I didn't find it odd that the spine specialists wanted a sample too.    

     Then I found Healing Well. After coming here I noticed nearly everyone was drug tested on a regular basis. I found it very odd. I just couldn't grasp the reasoning. So I asked my nurse. She said it is done and in fact even I was drug tested when I first came to them. They do it for all sorts of reasons. Suspicious behavior, those with a past history of abuse, new patient or just randomly. It is a CYA. Once I gave it some real thought, it occurred to me that was the safest possible solution. I have not been tested since I first came to them 4 years ago. But if asked (Now that I know!) I will gladly give over a sample.

     On a side note, it is just one of many actions we have to take to prove we are "real patients". It is costly and time consuming. Uses up a lot of resources. Until we can come up with some sort of "tracking system" for the folks abusing the medical community... I guess we just have to pay the price and suffer the consequences of "bad guys". Wouldn't it be nice if we could mail our UA testing bill to a addict. Attach a little note "Please pay promptly! Your the cause after all!"

*hugg*
  dani

Posted 2/28/2011 12:05 AM (GMT 0)
I have only been tested once after I told the nurse that I had a few extra days of pills left. The nurse that does the refills is a un-caring witch. (drunk with power) I have to call 24hrs ahead for a refill and I forgot one time. She snapped at me and said "We require 24hrs notice, so now you will have to go a day without your meds". When I told her "no problem, I have a few extra" she got angry. (My script is 2-3 times a day "as needed") When I went to pick up the script there was a note on the envelope that said "not taking as directed, urine sample required". I have not been tested since. (over 6 months)
Posted 2/28/2011 6:30 AM (GMT 0)
The 2 UA's I did in 4 years with my prior PM dr was right when he was referring his pump patients out to a new dr since he was closing down his practice. They can test to see if you have the medication in your system and check the levels. I was never offended by it. I always wondered why I wasn't tested till right at the end, lol. I know it was done because you always heard the shrieking when someone flunked their test. I think it was WhiteBeard that told us a story about an elderly man screaming because he apparently failed his UA, he had no medication in his system so the dr cut him off and rightfully so. The old geezer was selling his scripts. WhiteBeard said this is the last person anyone would have suspected. Now with REM's involved Contracts are supposedly something all PM drs have patients sign. My current dr did not have Contracts for her patients. Two months ago she had all of her patients sign one because of REM's. She was not real happy about having her patients sign them, she said she thought it was nonsense but it is now required.
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