6

(well, my wife). Background - we lost a pregnancy early this year. Got pregnant again. Wife had some spotting during first trimester, became panicky, and rushed off to a hospital. The main thing they wanted to do was perform STD screening. We've been exclusive partners for over 7 years now and neither of us have ever had any STDs, so my wife outright refused. Doctor was flustered and asked what she did want done, and she said an ultrasound to check on the baby. They needed to do a urine test first (checking for HCG levels and what-not) and then after the HCG levels were deemed high enough, did an ultrasound (baby was fine). I wasn't there for the visit (I was out of town) but she called me while waiting for the ultrasound and gave me the full run down, reiterating to me her refusal to have STD testing done.

A couple months later and lo-and-behold I get a bill from the hospital, including over $500 for the STD screening she refused. There were some other items on the bill that without question did not happen, so it is possible that this is a billing mistake and not simply them outright ignoring my wive's clear desires. As a result they either billed me for a test that didn't happen, or performed a test that my wife refused. Either way I obviously have no intention of paying for this. The hospital itself has been very obstinate about my attempts to get any information out of them.

My goal here isn't some poorly-thought-out plan to sue the hospital for damages. Rather, they made a number of serious billing mistakes, to the tune of about $2000 that I absolutely should not have to pay (the total bill is about $3600). So far they have not been receptive to my attempts to fix this, and I'm trying to find any leverage I can to get them to take me seriously. I'm not above threatening to (or actually) taking them to small claims court over this. I would like to figure out what legislation or regulations might be applicable before I start throwing the word "lawyers" around. So, to recap:

My wife refused some specific procedures. The hospital may have performed them anyway and definitely charged us for them (>$500). Are there any specific laws/regulations that this would violate that I can use to get them to take my requests seriously?

Update

After some more heated phone calls with customer service reps (I got out my grumpy voice, which is not my norm), they eventually assigned a manager/dedicated customer rep to discuss my case with me (took a couple weeks to finally get a call from them). They said they would look into it in more detail, and also suggested I file written requests for all hospital notes from my visit (which I was already doing anyway).

After getting the results we determined that (not surprisingly) the procedures which we knew never happened really didn't happen. As a result of the manager's own digging they finally realized that some of the billed services never happened and finally removed them from the bill. However, I was told that the STD screening did happen, that the notes showed the results were discussed with my wife (they weren't), and that there was no mention of a refusal for STD testing in the notes, so those charges would stand.

I fully intended to argue more (there were many mistakes in their notes so the fact that there was no record of us refusing the STD screening was meaningless, in my opinion). However, I got distracted by the holiday season. Fortunately, at the beginning of the year (aka a couple months after our last exchange) we got a phone call from the hospital telling us they were taking the charge for the STD screening off the bill. I'm not sure what changed their minds. All-in-all they took about $1700 off the bill. It's still far more than is reasonable (there was an expensive item which I contested which they did not change), but it's a big difference and I'm out of items that can be easily argued so...

  • Is there any evidence (results, etc) that the disputed tests were (or were not) performed? Disputing a charge for a test which did not take place is a different matter to disputing a charge for a test which was refused, but took place anyway. – brhans Oct 1 '18 at 22:19
  • @brhans I'm going to have them send me all test results, signed consent forms, and any other documentation from this visit. I know that they are legally required to give me those (and I've had to quote the relevant law at health care providers to get them to share said documentation with me in the past). I'm expecting that to clarify whether the tests were actually administered. I'm hoping it was a billing mistake as that seems the most likely to get the result I'm looking for (i.e. not having to pay this). I'm just trying to figure out all options first – conman Oct 2 '18 at 1:42
3

There aren't any specific laws or regulations about medical charges. Instead, this is a matter of general contract law, where you have to agree. You have to consent to be treated, and a signature is taken to be evidence of consent. The law does not say that they have to ask permission for absolutely everything they do, the action just as to be

in accordance with an accepted standard of medical practice among members of the medical profession with similar training and experience in the same or similar medical community as that of the person treating, examining, or operating on the patient for whom the consent is obtained

This law insulates doctors from getting sued. In a situation where treatment is provided against a patient's instructions, you may have a cause of action for e.g. battery. In general, a doctor can't poke you, draw blood, make "offensive contact" etc. without consent, and consenting to one procedure does not "open the floodgates" of consent for any othre procedure.

Of course, if the procedure was not performed, you obviously are not liable for the cost (and they are not liable for a non-occurring battery). This may in fact constitute gross negligence. During trial, the primary issue is likely to be whether there is proof that the procedure was expressly rejected. The doctor would probably provide the consent form, and that form may or may not indicate that the test would be conducted. It would not be surprising if the patient never saw an actual form and instead just electro-signed, having been told that this is authorization to treat. Corroborating witnesses would be helpful.

From a practical perspective, especially if the billing department is being recalcitrant, this is probably a matter best handled by an attorney who would start with a formal letter summarizing the consequences of unauthorized medical treatment.

Your Answer

By clicking “Post Your Answer”, you agree to our terms of service, privacy policy and cookie policy

Not the answer you're looking for? Browse other questions tagged or ask your own question.