Is a patient required to pay for non-emergency services they did not request from a medical provider?

For example, a radiology clinic takes an x-ray and then sends it to a 3rd party radiologist for interpretation without the patient having requested any analysis of the x-ray nor having participated in the selection of the third party who would perform the analysis.

I view this as the medical equivalent of cleaning someone's windshield at a red light without them asking for it and then demanding money for the windshield washing service.

If that's not so, why is the medical industry treated differently than other services such as painters; if I asked someone to paint my house, and then they also decided to paint my shed without me asking, no one would expect that I be obligated to pay the painter for painting my shed.

I understand that in emergency medical situations, it may be implied that the patient cannot consent or decline services, so it is by default considered to be agreed to. This question is about non-emergency services only.

  • 2
    Why are you having the x-ray, if not to have it interpreted? I agree that the use of external/third-party doctors etc. is terrible in the US medical field, but it's widespread.
    – mkennedy
    May 8, 2020 at 22:03

2 Answers 2


Presumably you consented to have an x-ray.

It is a reasonable assumption that it was not your intention to simply be given the films without interpretation by a radiologist. If that was your intention then the obligation would be on you to make that clear since it is so far from ordinary practice that no reasonable person could know that.

To use your analogy it would be like you asking to have your window washed but not wanting to have the soapy water rinsed off afterwards (assuming these were separately billable services).

Further, rights and obligations under contracts are transferable by default. So it is perfectly legitimate for the lab to outsource the radiography without having to ask you.


You have the option to refuse to sign the financial responsibility paper, which is what obligates you to pay. They, of course, can then refuse to treat you. This is a matter of contract negotiation – perhaps you can negotiate a specific limit in advance. The problem is getting the doctor to agree to interrupt the treatment every minute or so to find out if a certain treatment is covered or not, or a service involves an in-network versus out-of-network provider. From the (typical) doctor's perspective, it's impractical to find out in advance whether the patient will get socked with an extraordinary bill, if they depend on insurance. It's really not even practical to ask for an advance list of charges, because they don't know in advance if you'll need some blood test. That's why they require you to sign a generic "I'll pay whatever the insurance doesn't cover" form. There may be doctors that specialize in "financially predictable" treatment.

You must log in to answer this question.

Not the answer you're looking for? Browse other questions tagged .