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Capital Pathology Management – unethical treatment of patients?

By 24 June 2014 15

I went to have some tests done at capital pathology today.

The staff member pointed out that the Dr had not written bulk bill on the form so it wasn’t bulk billed as my tests have always usually been.  (That is not their fault of course but led to the problem)

I asked then how much the tests would cost.  Perhaps it was stupid or unreasonable of me to expect to be able to told the price of some simple blood tests? Was told apparently management do not provide the staff a list of all the prices much less the medicare rebate, if any.

I then had to sign something saying I agreed that I would be privately billed, without knowing the amount.  As it was almost closing time, the alternative to not agreeing to this would have involved waiting another month to do the test (as per Dr’s instructions as to when it must be done) as well as rescheduling a specialist’s appointment and the wait time that would have involved.

Are health care providers immune from normal consumer protection laws?  This wouldn’t be acceptable practice for any other business much less for providers of essential services. And I fail to see the reason why a price list can’t be provided for straightforward blood tests. The prices don’t normally vary depending on the complexity of the patients condition as say, a surgery might.

Had I had access to the price of the test, I would have been much better able to decide whether to go ahead with the tests that day, or put them off and go back to Dr and see if it was a mistake he didn’t write bulk billed on the form.  I also could have made the decision whether it was worth putting off the test to ring other pathology providers and see if they were cheaper.  Or of course I might have chosen not to do the test at all.

Maybe I would have still gone ahead with the tests that day if I knew the price – but that isn’t the point.  Different people with different budgets would make different choices.

Note my complaint is not of the staff member I saw.  It appears that it is an issue with the capital pathology management not providing the information to their staff.

I invite Capital Pathology to respond.

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15 Responses to
Capital Pathology Management – unethical treatment of patients?
bd84 2:26 pm
24 Jun 14
#1

Wouldn’t a smarter approach be to contact capital pathology directly and speak to a senior staff member first rather than writing a rant that could be possibly explained by the individual possibly junior staff member not knowing the procedure to find out?

Inviting them to reply through a means they may know nothing about doesn’t make a lot of sense, unless you just want to create a spectical of what could amount to a lack of experience of one person.

dungfungus 5:18 pm
24 Jun 14
#2

You could have gone to ACT Pathology at Canberra Hospital and it would be free (to you that is). They should accept the referral that your GP had written to Capital Pathology.

aaa123 6:27 pm
24 Jun 14
#3

bd84 said :

Wouldn’t a smarter approach be to contact capital pathology directly and speak to a senior staff member first rather than writing a rant that could be possibly explained by the individual possibly junior staff member not knowing the procedure to find out?

The staff member told me that they had already raised this with management as an issue. It wasn’t a new staff member. It is a problem with Capital Pathology.

aaa123 6:28 pm
24 Jun 14
#4

dungfungus said :

You could have gone to ACT Pathology at Canberra Hospital and it would be free (to you that is). They should accept the referral that your GP had written to Capital Pathology.

I didn’t know that – thanks for that tip. I will investigate that for next time.

Masquara 8:16 pm
24 Jun 14
#5

I’ve had this problem, was burned to the tune of $300, and always remind the doctor to tick the box!

aaa123 8:30 pm
24 Jun 14
#6

Masquara said :

I’ve had this problem, was burned to the tune of $300, and always remind the doctor to tick the box!

From now on I will tick the box myself if I see the Dr hasn’t done it.

Mainly I am wondering as to the legality of me being asked to “agree” to being privately billed when they couldn’t tell me the cost. I had to “agree” or delay my tests and appointments by probably 6 weeks or more and didn’t even have time to ask my Dr if that was an issue or not.

Frankly I feel like refusing to pay the bill. I wish that I had decided not to do the test at the time and would have done so I think if I had time to consider it beforehand. But I was under pressure and made a hasty decision and now feel that I have been taken advantage of as a health consumer and have probably wasted a bunch of money. And to top it off us patients aren’t even allowed to know our test results even if we’ve just spent a fortune on them. The system sucks

Nightshade 9:21 pm
24 Jun 14
#7

aaa123 said :

And to top it off us patients aren’t even allowed to know our test results even if we’ve just spent a fortune on them. The system sucks

You can ask your doctor to have a copy of the results sent to you. There’s a box on the form where they can nominate copies to be sent to others. I always ask for a copy and my doctor writes “patient” in the box.

slyfox 9:33 pm
24 Jun 14
#8

As you say, the decision to bulk bill is usually made by the doctor. However, most pathology providers also bulk bill pensioners, those under 16 and the chronically ill regardless of what the doctor advised.

The pricing system for pathology is actually surprisingly complex and depends greatly upon the mix of different tests ordered, so it is not particularly easy for a pathology collector to calculate on the spur of the moment. If you called up the accounts department, they should be able to provide you with an estimate.

If you aren’t bulk billed, my understanding is that you are generally billed at the “full fee” rate (the full amount as stipulated in the Medicare Benefits Schedule). The full fee is also capped at a maximum of $50 out of pocket, with the exception of a few special tests such as ThinPrep on a pap smear.

An idea of a typical general blood test:
FBC (full blood count) – $16.95
EUC (kidney function tests) – $17.70
LFT (liver function tests) – $17.70

I believe you would then be able to go into Medicare and claim 75% of this back. I think your pathology test should therefore cost you around $12.50 out of pocket.

You are incorrect in saying that patients do not have the right to access to their pathology results – refer to the Health Records (Privacy and Access) Act. However, this information should be obtained through your GP. If you insisted though, the pathology company will arrange a time for you to come in with your ID and pick up your results.

Fact sheet from RCPA – http://www.rcpa.edu.au/getattachment/75fcb3dd-421c-4307-aed8-67fa41ff53aa/FctSht-7-FeesCalc.aspx

My background – formerly employed at a pathology company, and now working at a hospital

aaa123 9:43 pm
24 Jun 14
#9

Nightshade said :

You can ask your doctor to have a copy of the results sent to you. There’s a box on the form where they can nominate copies to be sent to others. I always ask for a copy and my doctor writes “patient” in the box.

Yes but when I ask for something like that my Dr seems to get really annoyed and I have been refused on some occasions.

Patients shouldn’t have to beg for their results, they should be automatically entitled to them. It is particularly wrong to make a patient pay for a test they will never know the result of. If it doesn’t cost me I can accept the secrecy even if I don’t understand it. Otherwise I feel it is theft out of the patients wallet.

Nightshade 10:21 pm
24 Jun 14
#10

aaa123 said :

Patients shouldn’t have to beg for their results, they should be automatically entitled to them. It is particularly wrong to make a patient pay for a test they will never know the result of. If it doesn’t cost me I can accept the secrecy even if I don’t understand it. Otherwise I feel it is theft out of the patients wallet.

I totally agree. Find a different doctor? I don’t think I’ve ever been refused.

LadyxBec 10:42 am
25 Jun 14
#11

aaa123 said :

Masquara said :

I’ve had this problem, was burned to the tune of $300, and always remind the doctor to tick the box!

From now on I will tick the box myself if I see the Dr hasn’t done it.

Mainly I am wondering as to the legality of me being asked to “agree” to being privately billed when they couldn’t tell me the cost. I had to “agree” or delay my tests and appointments by probably 6 weeks or more and didn’t even have time to ask my Dr if that was an issue or not.

Frankly I feel like refusing to pay the bill. I wish that I had decided not to do the test at the time and would have done so I think if I had time to consider it beforehand. But I was under pressure and made a hasty decision and now feel that I have been taken advantage of as a health consumer and have probably wasted a bunch of money. And to top it off us patients aren’t even allowed to know our test results even if we’ve just spent a fortune on them. The system sucks

From personal experience – if you don’t pay they set a debt collector on you without even a phone call.
(I went overseas shortly after the test was done, the letter must have been misplaced/lost while I was away and I did not recieve any further communications until a nasty letter from a debt collector threatening legal action arrived).

curmudgery 11:01 am
25 Jun 14
#12

Some doctors do get annoyed when patients ask for a copy of their results because patients then go and get a ‘second opinion’ from Dr.Google – whose qualifications are highly suspect to say the least.

But I always ask for, and receive, a copy of my test results so I can do just that. It’s patient education and that’s important – it enables me to ask the right questions. I don’t expect a busy GP to give me a crash course in pathology.

dungfungus 11:14 am
25 Jun 14
#13

LadyxBec said :

aaa123 said :

Masquara said :

I’ve had this problem, was burned to the tune of $300, and always remind the doctor to tick the box!

From now on I will tick the box myself if I see the Dr hasn’t done it.

Mainly I am wondering as to the legality of me being asked to “agree” to being privately billed when they couldn’t tell me the cost. I had to “agree” or delay my tests and appointments by probably 6 weeks or more and didn’t even have time to ask my Dr if that was an issue or not.

Frankly I feel like refusing to pay the bill. I wish that I had decided not to do the test at the time and would have done so I think if I had time to consider it beforehand. But I was under pressure and made a hasty decision and now feel that I have been taken advantage of as a health consumer and have probably wasted a bunch of money. And to top it off us patients aren’t even allowed to know our test results even if we’ve just spent a fortune on them. The system sucks

From personal experience – if you don’t pay they set a debt collector on you without even a phone call.
(I went overseas shortly after the test was done, the letter must have been misplaced/lost while I was away and I did not recieve any further communications until a nasty letter from a debt collector threatening legal action arrived).

This happens with ACT Ambulance services as well. They take at least a month to send the bill then a few weeks later they are issuing it to the debt collector. I found both letters after I returned from a trip and immediately paid the bill. Then real problems started when I tried to get my full refund from my private healthcare insurer. They refused to refund to me – they will only pay ACT Ambulance direct.
After this was sorted out (2 months later) I was ready for another ambulance.

aaa123 9:01 pm
25 Jun 14
#14

slyfox said :

The pricing system for pathology is actually surprisingly complex and depends greatly upon the mix of different tests ordered, so it is not particularly easy for a pathology collector to calculate on the spur of the moment. If you called up the accounts department, they should be able to provide you with an estimate.

Well, it may be that it is not easy to provide me with an exact price but asking me to sign a blank cheque vs not getting my healthcare or putting it off for many weeks is not fair and is taking advantage of patients. If the patient is too dumb to be able to be trusted to receive their test results then how are we expected to be smart enough to know when we have to call the “accounts department” prior to turning up to get a blood test which almost never requires phoning ahead to get an “estimate” of the price of a blood test, which is usually bulk billed?

Nobody would consider it acceptable to have to write a blank cheque to their mechanic in order to drop their car off for an oil change. Health care should have the same consumer protection as any other business. If the pathology lab finds something that needs further investigation and is going to cost a lot extra then they can call me and ask my permission to proceed. Oh… except that would require telling the patient something about their results. Which is not OK. Just expect them to wear a few hundred extra bucks without ever knowing why and send them to a debt collector if they don’t pay. Much better system!

aaa123 9:12 pm
25 Jun 14
#15

LadyxBec said :

From personal experience – if you don’t pay they set a debt collector on you without even a phone call.
(I went overseas shortly after the test was done, the letter must have been misplaced/lost while I was away and I did not recieve any further communications until a nasty letter from a debt collector threatening legal action arrived).

I have no doubt they will send it to the debt collector… However, from my knowledge of debt collectors (not mostly from personal experience) when they send you a demand they are usually happy to accept a % of the amount owing for a quick settlement. At least that way the health care provider only gets a small fraction of what is “owing” and gets sent a message.

Also wonder if consumer protection laws come into play here. What if the pathology company decided, for example, to send me a bill for $100,000 for what was normally a $100 test because I had “agreed” to be privately billed whatever. There is a point where the courts will decide the clause cannot be enforced no matter what the consumer signed, as far as I know.

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