Doctor's bill for tests not done

The question at heart of this long story that follows is "would you pay for tests a doctor didn't do? What if it turns out there is no way you can prove that the tests were not done and your (private) insurance company tells you there is nothing they can do either to prove otherwise (other than suggesting that I no longer go to this doctor)?"

During the early weeks of my pregnancy, when my regular gynec/obstetrician went on vacation, I went to the replacement doctor she had suggested. (I couldn't stand to wait till my regular doc came back, I am chicken little, whatever,...I just wanted to see the fetus on the ultrasound and make sure everything was fine).

So I went to this doc in Englischer Garten. His office made me fill out forms, took my insurance card, I waited a little and then I was called in. During the wait, my bloodpressure was not taken which I found to be unusual from my visits to my regular doc but I thought 'may be because I am not their regular patient'. I had my ultrasound done, the doctor declared the fetal heartbeat to be sound, the little fella was swimming around merrily, and I was mighty happy. All in all some 10 minues with the doc in his office. Before leaving I asked the receptionist if we were done and then walked out.

A month later, I got a bill for a 182 euros which listed charges for, in addition to the normal untersuchung, various other ultrasound tests (3 weiteren organen fruchtblase, 3 weiteren organen dottersack etc..), a blood test and a urine test. I called the billing company and told them none of these tests were done. They said the doctor was on vacation but they'd investigate and urged me to contact the doc's office when when he came back. I did so, the receptionists in the office told me they'd look in the files and call back. No such call came.

Last week I received a letter from the same doc saying they did the tests and indeed have results on file and I needed to pay up. I called my regular gynec's office and asked them if they could request the test results. We decided that if they send the test results, I would admit I was wrong and pay up. Well, the offending doctor's office refused to share the test results with my regular doctor saying it was against their policy to do so. My regular doc has been pretty sympathetic and said she supports my decision if I decide not to pay and that in her profession a heated debate and criticism has been going on over these kinds of practices.

The problem isn't with the money. My insurance company will simply pay up (I just confirmed this) and I will get my money back. It is just that this is WRONG. Somewhere in this scenario (if it is being repeated often enough around the country), the cost is coming ultimately out of our pockets. No???

Don't pay. Simple.

I had a disagreement with my OB-GYN (who I have since dumped) about a procedure I felt she hadn't done. In the end, I paid for everything but the procedure we were in conflict about.

Stick to your guns about it and fight the good fight!

Report him to the Ärztekammer, easy as pie. And don't pay.

AAGGHH!! These kinds of stories make my blood boil. Snow you have every right to be angry, and quite frankly I am glad you are taking the moral high ground. This doctor is a crook and yes his abuse of the system is what is helping to bankrupt Germany medical system

As someone in the health care field, I am appalled at the abuses I see. Especially if you have private insurance, you often get unneccesary tests and even procedures or get billed for things that were not done. I knew of a German OB who had a 90% C-section rate with U.S. private patients. When she was confronted with being reported, the % dropped back down to 30%.

If you are comfortable with it, I would go directly to the doctors office and ask for a copy of your results. I don't know what the German laws are here, but I can't imagine a patient not having access to their records. I would also let them know that you have informed the insurance company that these tests were not done. Believe me if they are red flagged they may think twice.

On principle I would not pay this, but I understand that it is hard for many people to be confrontative.

Congrats on the pregnancy, and let us know what happens.

they must be able to share the results with you though, and then you can take them to the other doc. ??

@ showem - Glad you dumped the ob-gyn.
@Gemini - I was slightly worried about impact on credit reports and such but am told if we go back to US in a couple years, it won't affect us. Very true about the unnecessary c-sections in the US.

@sarabyrd, I will google Ärztekammer and report. Sad part is, I am not sure the doctor is at fault as much as his staff is. I don't know if the guidelines include routine tests, but if they do, his staff clearly failed him. The follow-up letter does include his signature though : (

It's against their policy to share results? Wha'?! So they would force you to undergo the same tests again for your own doctor? If true it's unethical. Report that doc to the Ärztekammer.

The burden of proof is on the doc. Either he shows you the test results or he goes away. If you get a Mahnung, call the office, tell them that the tests were never performed, that you're perfectly happy to go to court if necessary and that your lawyer is rather expensive. You can recover all costs for a wrongful suit or even dealing with their fraudulent attempts to make you pay, but be damned sure no such tests were performed or it could get expensive for you.

woof.

@snow: I am referring to German docs who see Foreigners, not US docs (though that is high too).

Here's a link to the Bayerische Landesaertztekammer. Contains useful info including on patients rights. If there is one specific to Munich, I haven't found it yet.

a quick update on the ongoing saga...
Just called the said doc's office and asked for my test results to be sent to me. I was told that I would have to speak to the doctor himself who happens to be available to speak on the phone only on Monday afternoons

Next episode: Monday, November 14th.

Oh, they are just pulling your chain. Only available Monday afternoons, whatever. Phone them again and tell them you have absolutely no intention of paying the bill unless the test results are sent to you pronto.

Not an expert in this area of law, but its pretty simple.

Without your permission they are not allowed to share the test results with anyone. With your permission (which you have given) they are obliged to share the results.

Yes it is his fault! He writes in the chart what he did and did not due, then either the secretary or a outbase company writes the bill... they only write the bill for what was written in the chart.

Also! He has to give you a copy of the test results! They are yours! And not sharing with your regular doc is a crock! That is the ultimate of unprofessional! Please list the bad docs name so none of us will go to him.

yep do it in writing explaining the situation of your not believing the bill etc. request the results to be sent to your normal doctor. send copies of this letter to your doctor, the "bad" doctor, your insurance company, and the ärztekammer, and your lawyer. make sure that the letter states that copies are being sent to others. and sit back and enjoy the fire works.

Don't send it to your lawyer. That will cost you. Just send it to the others.
And state in the letter that the reason you are not paying the bill is because they are illegally witholding the test results from you. Then they can't just send Mahnungs to you. They have to either:

1) Explain why there are not obliged to send the results (impossible)
2) Send the results (impossible if they weren't done)
3) Admit they are criminals (impossible they won't)
4) God knows but this is what they'll do

Couldn't that be construed as an implicit admission (even if untrue) on her part that those tests WERE done? I would state the real reason - the fact that there were no tests...

At this point, after receiving a threatening letter, they may make up the test results. In that case, they are really, really unethical.

But, it doesn't surpise me. In my German class the other day, we were all discussing what you should bring to the hospital if you ever are admitted. The students from the Eastern European countries said 'money' - to which all of us from more Western countries said 'What? What for?' They replied 'to pay off the doctors so you can get your test results' Apparently, the doctors rely on these 'tips' from the patients and it is a must if you want information about your test results, diagnosis, etc.

I must say, I was floored by that little revelation.

But, Snow - don't pay and do follow the advice above.

At the very least, I hope you can convince your own doctor NOT to refer any more patients to this other doctor when s/he is away. Especially if this other doctor won't then share treatment records with your regular doctor.

I have a friend who used to live in Munich, whose private insurance company rewarded patients somehow for catching false charges and reporting them for follow-up to the insurance company.

Unfortunately, it's only the private patients who even get a chance to review their doctors' charges. As a public patient, I never see what my doctors are charging the insurance company for, so who knows what they may be getting away with? Yes, it's expensive for all of us in the end.

kitkat, I read a story a couple of weeks ago that was similar to that. It was about nurses in Indian hospitals who refuse to bring new mothers their babies without a bribe.

Ok, state you suspect the tests were never done, and they are either illegally witholding valid tests from you, or covering up the fact that they never performed the tests that they tried to charge you for.

They won't fake some test results, because they will obviously be fake. Your blood chemistry is unique to you, and they would make a bad situation worse by faking results.

I'd push this through rather than just warning a handful of people not to go to this doctor.

They probably thought that because you were an Ausländer you would just roll over.

I don't want to go on again about my recent hospital experience here, but as it happens they asked me for money up-front - and it was an emergency admission, no less. I should point out that I'm a private patient, covered by my foreign (=Western European and as reliable as you can get) insurance; I have an address here, bank account, credit cards, the whole lot, so I was unlikely to vanish into thin air. I had to pay €150 before anyone looked at me - I was in absolute agony but they made me go into the office, punch in my PIN code, etc. etc. There was more of the same (with more money involved) while I was still in hospital, but I'll spare you the details.

that sounds like what they're trying on. its been done to me a few times with other legal issues. funny enough the people concerned get sheepish when my lawyer sends a letter (must add my lawyer is a mate so he whips up letters for me pretty sharpish)

If he does produce the test results I'd ask him why he did tests he hadn't told you about. If he hasn't had your agreement to carry the tests out can he bill you for them?

Good point MMag, but she never mentioned blood having been drawn, and people tend to remember that hapenning. He'll have been hard put to have done blood and urine tests if she supplied no samples.

@MMag and Madaxe -
Nope, no blood, nothing was taken from me that day. Now I have heard the old wives' tale about pregnant women getting absent minded (which turns out may not be the case at all btw, based on an article in NYT recently) but I think I would remember a finger prick blood test for sure if there had been one as I tend to act all martyrish and sport a band-aid all day etc...(yes, even if it is a finger prick test) when I come home from one.

Admittedly I am getting a little paranoid about this whole deal but I do wonder if the said doc would go to the extent of putting in a fake report to prove a blood test. I am not sure that ascertaining that a blood report is indeed mine would be easy for a non-doctor like me because 1) in the first trimester the blood test would be done normally to check only HCG harmone levels, 2) it is my understanding that the labs here don't check for blood group (which would be one easy giveaway) unless specifically asked for by the doctor, which wouldn't be the case here.
I wouldn't even know where to begin with the urine test report.

Anyhow. Will just have to see what the showdown with the bad doc brings on Monday (if he doesn't dodge me that is).

Nah, they could have done a blood test for things other than HCG levels. But you would definitely remember it.

During my whole pregnancy, I had blood drawn at my doctor's more visits than not, for no particular reason that I was aware of. I'm sure the different labs have different-looking results, but they all look distinctive and have your name on them, and would be REALLY hard to fake.

Another reason the substitute doctor would need to share whatever results he got from whatever tests he actually did with you and your doctor is that information needs to go in your Mutterpass, since you're pregnant. Good argument for you to make on Monday!

@snow05

I had a blood sample taken a couple of years ago to test for anti-bodies to see check if I needed injections before going on holiday, and the doc had to send the sample away to a lab to be tested, he didn't do it himself. I would guess that this may be the same with you doc. I'm just guessing here, but i wouldn't be surprised if there is a requirement for these labs to store the sample for a given period of time, even if just to be able to prove that they haven't screwed up the analysis if something happens in the future.

Given that no samples were taken, if he produces some test results saying they are yours then they are obviously fake. Depending on how far you want to go with this (if it was me i'd take it as far as necessary, preferably to the extend of seeing this doc punished for this kind of thing, as things like this really get on my nerves, and i can be a stuborn b*****d when i'm in the mood) you may be able to demand that "your samples" are tested to prove they are indeed yours.

Good luck on Monday.

BTW, i don't think you ever mnetioned the name of the doc in question. I'd guess a few people would be interested, just to be able to avoid him.

More important: Blood or other samples drawn without your consent are considered bodily harm and can be prosecuted. This doc's goose is cooked no matter what he does or doesn't say on Monday.

Hi Guys,

Some pos. advice for those claiming to have problems with receiving emergency treatment.

Another route you can try - even though technically it's mixing up the rules of residency is to use the E11 form.

I'm working in the UK (four days) and pay taxes there but living here - so I have no german insurance except the E11 form. If you have to access emergency treatments then you just have to produce the form - if the Hospital didn't treat you they would be in serious trouble as they would be breaching EU Laws. *

This form doesn't work well for GP/Dentist as many wouldn't want to go thru the paper work to claim the money back from the UK - but you are able to ring before hand and ask if they will accept the form - the rules are that you get the same treatment in the other country as would be afforded at home (in the case of the NHS that would be shit treatment!!).

Regards

Stanford.

* There is an EU obudsman that deal with such issue - so you can write to them and they would investigate any such controvention of EU laws.
** They are also bringing out a EU wide Health Card soon and once you have that it will be even easier to get you emergency treatment thru/out the EU.

Hello all!

A long overdue update on this story which didn't move along on as timely a manner as I had hoped.

In November about a week later than I was told, I was finally able to speak with the doctor himself. I explained my position to him and asked for the test results. He asked me to fax the bill to him on his personal fax number (?) and promised he'd get back after investigating the matter. Two weeks went by. December and January came and went by. I have so far received no phone call, no explanatory letters, no test results and no mahnungs either.

Meanwhile 3 weeks ago mid-January I checked into Geisenhofer for the delivery. Everything went well (I have a lovely healthy baby). Midway through my recovery at the clinic my ob/gyn had to take 2 days off. She mentioned that someone else would be coming for the daily check-ups while she was gone and guess who shows up I am not sure he recognised me as I did't him either on the first day and on the 2nd day I thought he beat an even hastier retreat but it could have been my imagination.

Anyhow. Moral of the story: Stick to your guns if you are ever in a similar situation. Btw, I have not paid his office for the Ultrasound portion of the bill yet which he did do and which I should send a payment for.

I cannot/should not out him in a public forum but if you want to make sure your ob-gyn isn't the one with bad accounting issues, PM me the name and I will tell you whether he is the one or isn't.

Congratulations and best wishes to the whole family!

Congratulations to the healthy baby and happy-sounding Mom. Good work for not lettng this guy get away with it.