Discussions By Condition: Medical Errors

Diagnosed with hypothyroidism to get meds

Posted In: Medical Errors 1 Replies
  • Posted By: moonshines24
  • February 25, 2008
  • 09:53 PM

I dont know if this is where I should be posting for help, but I have to start somewhere.

I received a collections letter in the mail, from my doctors office. I called the doctors office to see why I owed this money from sept 07 and they said the insurance company paid in sept 07 then took the money back in january of 08.

I called the insurance company, they said they finally received my medical records from my doctor in november, and showed I had a "pre-existing" something, I dont know if it is a disease or illness, but I had something "pre-existing" I said "SINCE WHEN?!?!?!?!?"

I called my doctors office back, and they told me to give me this appetite suppressent(sp) He HAD to diagnose me with something.

In 05, I started going to this doctor off and on for weight loss. At that time, he told me he was sending me to get my GLUCOSE, CHOLESTROL, AND THYROID tested. My next visit, doc said I was fine.

So, this is what I told the doctor last week, he said my results came back fine, so why diagnose me with this? He asked me to go to hospital to get my test results. I went to hospital, they said my thyroid was never tested, but everything else was fine.

I took the results to the doctors office, and said how could you diagnose me with something you never even tested me for. He went on to argue that I told him I was tested, and "I" said I was fine. Only reason I said that, is because he told me I was being tested for it. Who on earth can read the doctors prescriptions, and if he says that is what is being tested, why would I think otherwise?

Anyway, I asked him again, how can you diagnose me with this, without tests? (Hospital said you need blood work to diagnose with this hypothyroidism) He looked at me and smiled, and said, "LOOK AT YOU, YOU ARE PRETTY HUGE"

I just about hit the floor. What kind of doctor says to their patient they are HUGE? My eyes bulged, I wanted to give him a HUGE piece of my mind. I could see you are over weight, needs to lose some weight, but HUGE? Infront of two other men to top it off. I am in no way HUGE. He again told me to give me this medication PLEGINE, he had to diagnose me with something. Can he honestly diagnose me with this, just to give me a envelope of pills, that he hands out to hand fulls of people everyday that enter his office?

I told him I wanted it off my medical history, I am not worried about the $200, but this is on my medical history, and shouldnt be.

My question is, can he do this, and get away with it? If in the future I do have problems with this hypothyroid, I will have issues again, with an existing condition, and problems with insurance, and...............GEEZ, this just shouldnt be here.

HELP!!!!!

This guy is such a back door doctor to begin with. There was an incident where a young girl's UTI was discussed in the waiting room of about 50 people that was only made to hold 10. Saying the "smelly and cloudy urine" My heart sunk for her.

I see him handing out these PLEGINE pills like candy to people, so I am sure I am not the only one he has done this to, and this needs to stop.

If he really thought I had this condition, why not test me for it and treat it? From what I am reading, if you have it, and it is not taken care of, the outcome could be bad. So wouldnt you think, if he thought I had it, he would have me tested, and treated? Or is it just me?

Thank you

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1 Replies:

  • It’s not clear if you went to this ‘same’ doctor in ’05 that you are having problems with now! But you’re right. If the test wasn’t done, it shouldn’t be in your record that you have a thyroid condition. It sounds like it was in your medical records from 2005 and that’s why the insurance company is saying it is a pre-existing condition. Or they could be denying the claim because seeing a dr. for a weight problem in 2005 is what they consider pre-existing. But, If your 2005 records are wrong, you’ll need to write to the insurance company. They usually have instructions on how and where to appeal their decision. It doesn’t have to be fancy. Just explain that they are refusing to cover a dr. visit because of a pre-existing condition. Then tell them what service he did perform and about the blood test that wasn’t done. You should get copies of your medical records first. And anything you can find that backs up your claim that the thyroid test wasn’t ordered by the doctor. If you keep paperwork you get from the insurance company (like ‘explanation of benefits’, where they let you know who is billing them and for what), you might have something that shows he billed for something he shouldn’t have. Ins. companies have certain time frames to put in an appeal, so you want to get it in before the deadline. Then wait to hear from them and they’ll tell you what your next step is. The worse that can happen is they deny your appeal, so you’re no worse off than you are now. It doesn’t sound like you should be going back to this doctor. From what you’ve said – I wouldn’t go to him. He sounds very arrogant. The insurance company could end up being your friend, if this doctor is making claims for services he hasn’t performed or making diagnosis on tests that weren’t performed. If you give the right information, they might do some investigating, instead of you having to prove everything. It’s a pain in the ‘you know what’ to do an appeal, if you’ve never done it before, but it would be worth your while to give it a try. It's the only way you're going to be able to straighten this out. Make sure you keep copies of any letters and records you mail to them. I don't know how much time has gone by, but I wouldn't pay the debt collector. I'd tell them I was appealing the insurance decision and it might hold them off until you hear the response about the appeal. Get a folder to put it all in – and good luck!
    KeepOnTryin 3 Replies Flag this Response
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