Is this Test Optional?

I hate Doctors. I hate insurance. Everything is so confusing. I was going to try to have a positive blog entry, and I promise, one day, there will be...it's just so easy to use this to vent.

Insurance for individuals SUCKS. Here's a little background...Luke and I waited until we had insurance coverage to try for children (because I had quit my job, and needed to get on Luke's insurance). We should've been a little more proactive on making sure it covered maternity, but we're young and stupid and assumed (partially because his dad went through this before and we were on the same plan as them so we figured it included maternity). We get pregnant. I go to the Doctor for my first visit. It was a new doctor that a couple of people in my family had been to for wellness visits and they seemed to like her. I was told my insurance did not cover maternity at ALL. *panic*

We've done quite a bit of research, and about the only company that even offers maternity coverage to individuals is Golden Rule. Obviously, for their safety, they have a "vested" plan - my first year, I get $2500 in coverage, the rest is out of pocket. The longer you are in the plan, the more they cover - I think after 5 years they cover $10,000. So, in the long run, it will be worth it. And, it's better than NO coverage.

With the Doctors office/lab work, I become a private pay patient. The doctors office and lab (located in the dr's office) tell me that they will give me a 20% discount off of the "normal" prices for their services. I begin making large payments to the dr. Every one there is VERY aware that I am a private pay patient (including the doctor, obviously). During pregnancy, they have to perform a pap smear, and since i was technically due for one any way, I asked the Dr's office if they could file it as a regular wellness exam, which is completely covered by my insurance. I get a bill from the lab saying it wasn't completely covered, which is what prompted my phone call to the Dr's office.

Apparently, during pregnancy, they have to test for STD's during your pap smear. HAD I KNOWN THIS, it wouldn't have bothered me. Instead, i got a bill in the mail from the lab company letting me know that this had been tested. I was shocked that my dr wouldn't have said, "fyi, we also have to test for this during the pap smear". after insurance coverage, this test only ended up being like $44.60 - so it's not a crap load. But then...

I explained to the lady that I might have made a mistake by saying I wasn't going to file my lab work on insurance because the "negotiated rates" are SIGNIFICANTLY cheaper. For example, one test was $172, repriced to $20.60. ARE YOU KIDDING ME?! That's a heck of a lot more than a 20% discount!!!!!

This lead me to ask her about my most recent lab work because I was explaining to her that I was very disappointed in my Doctor for not making it perfectly clear what tests they were performing when they were performing them. I said, I read on the Internet of all places, that the Quad Screening test, that was performed on me on my last visit (that i paid for completely out of pocket for - close to $400), was an OPTIONAL test? She said, yes, it was. Then, continued to say that I signed a form when i first went in (at 5 wks) and met with Debbie, the office nurse, consenting to this test. I was PISSED. I let her know...I am a first time mother. I have NO CLUE what tests are "optional" and dang sure wasn't clear on all of the testing that would be performed on me - especially when things are thrown at you your first day. (and mind you, my first visit was when I was an emotional wreck, finding out I did not have insurance coverage). I told the lady that next time I am in the office I will be retrieving that form from my file and SHREDDING IT b/c I want to be asked about EVERY SINGLE test they are giving me. I said, I dang sure never got a copy of this "signed form" consenting to this test with out my knowledge. It is VERY possible that I signed a form that day - but the way things were worded to me, the tests would be explained as we went along (especially the optional tests). The lady said had i NOT signed the form, it would've been a red flag for them and they would've asked me if I actually wanted the test or not. I was again PISSED. I told her that whatever the results of the tests were I would not be terminating the pregnancy, nor would I go on and have more invasive procedures (such as an amniocentesis) performed because the outcome would not effect my decision and HAD this been more clearly explained to me, I would not have "wasted" money on an unneeded test. The ONLY thing that I remember them telling me was an optional test was screening me for Cystic Fibrosis and that I could make that decision at a later date - which i chose NOT to do.

I expected my Doctor to be very thorough and explain the testing to me. ESPECIALLY since #1, I am a first time mother who has NO CLUE about all of the lab work given, and #2, I am a private pay patient, practically paying for everything out of pocket. I don't know which tests are "standard" and which tests are "optional" - and the "optional test" might be a standard test to someone who has insurance--but I WANT THE OPTION.

I do not fault the "office nurse" whom I apparently sign forms for at all. She was doing her job. She was a very nice lady who actually sold me on this practice because of how helpful she was. I remember her telling me that if my new insurance would not cover prenatal vitamins to let them know and that they most likely would be able to give me samples through out my pregnancy so I wouldn't be out that money also.

When I explained to the dr that I was out of prenatal vitamins and that my insurance didn't cover them, she told me to go to GNC to get over the counter vitamins - she didn't even offer samples. I completely fault the doctor, who obviously has some kind of shady practices, having first time mothers consent to testing when they have no clue what they are consenting to. Again, i know this is partially my own ignorance, and I should've asked more questions about what i was signing. I really thought I was signing a form allowing them to look at my lady parts and to use them as my OBGYN and that tests would be explained along the way and that I had the option to be able to deny any optional testing. But, the doctors should be a lot more clear - especially since this is HER practice, so I'm sure it's rules she's put in place.

I'm sure I'll stick it out with this doctor during the pregnancy, only because I don't want to undergo the hassle of switching doctors..but in the future...I need names of good OBGYNs around the Dallas/Rockwall area if ya'll have them!

After my conversation with the lady on the phone, she told me she was going to talk to Dr. Brothers and the office nurse and explain my frustrations. She called me back and told me she did, but she's not saving me any money. She did tell me that they will put together a form for the Quad Screening to send home with expectant mom's on their first visit so they know what they are consenting to (and she confirmed that nothing was sent home with me that day either - b/c at first she said I had a copy of the signed paperwork) and they are also going to have a form set up for private pay patients informing them of the different lab testings, etc all broken down so they can see what they will be paying and know how to budget (which I asked them if they had the first time I went in - and they didn't and I was shocked). I really think this will help patients in the future.

Ok, the positive part to all of this...she told me my Quad Screening came back normal - which i think I technically read could have 'false positives' (another reason I really wouldn't have wanted the test)...but at least there wasn't something odd in it to worry me more. And, my liver numbers are back to normal now.

Ugh. Please pray for me and this doctor situation. I'm very frustrated with it all, and it's very stressful to think of how much we'll be paying for in the near future. I know it will all be worth it when the baby gets here, but I also want a doctor that is "on my side" and is helping me to make the best decisions and that I feel is being completely up front and honest with me. And now, it's probably going to be completely awkward when I go in for my next appointment in 2 weeks since the doctor obviously knows I'm not happy. And, I really don't want her to throw anything back in my face and say "you can ask questions"...and I KNOW i can, but I just want my doctor to WANT to explain things to me. Do ya'lls doctors explain testing, or am I asking too much (I might be, I want an honest answer...).