I'm a little angry right now...

[LunaLee]

Umm... since when did physicians begin including chlamydia testing as part of a physical for pre-teen to teens?

 

First I am a little angry because I wasn't notified that this was a test that was going to be performed (through urine not a swab). Second, now I have to pay the bill for it.

 

Am I over reacting? I really don't feel like this is something that I should have to pay. Since when do dr's start ordering tests and sending them to labs that aren't authorized by the patient or patients representative? If this was part of a urinalysis, I get that, but it wasn't. They didn't even do that-just the chlamydia test.

 

I am really debating wether or not I need to fight this.

:angry:

 

And FWIW I have worked many years in the medical field so I do kind of know what I am talking about in regards to billing and office procedures.

[LunaLee]

No he didn't ask her and the office did not inform me at the time of the visit that this is was a new policy.

 

This is where I have whole problem with patient confidentiality. Children are children. They are not informed enough to make medical decisions for themselves without the guidance of an adult. I could understand if a child was "at risk" for these kinds of things and asked a physician for this but even then, I got a bill that said "CHLAMYDIA TESTING" how is that going to protect a child if they are in danger at home or whatever.

[Starr]

I would be furious too. I would think they would have to inform one of you for consent to testing. I continually tell my dd that she has to speak up if a doctor sends me away and she wants me to stay. How this came to be and we have to pay I'll never understand. I'm also a health care professional. :confused:

[GESTEP]

If she answered that she is "active" they will probably do the test automatically. If she is not, there would be no reason to test for it (at least I would think so). If that is the case I would contact the office and request a credit-it is unnessary testing. It is also possible the wrong test was ordered or billed?

 

Gina

[Heather in WI]

I would be angry, too, but in defense of the doctor, they are most likely just performing due diligence.

 

Half of all teens as young as 13 are sexually active. 1 in 4 teens contract an STD. Chlamydia is one of the most prevalent STDs and it has no symptoms. It can cause dreadful consequences in women if left untreated. I believe standard procedure is an annual test for all sexually active women.

[LunaLee]

She's not "active" ;-) She's never even been kissed so there would be no point.

 

I guess the whole of teenage population is rife with STD's they don't even know they have and so in an effort to stop the spread of disease they are automatically testing. Whatever...

 

While I can imagine that a phone call that goes something like, "Mrs. So and so...? Yes this is Stephanie at Dr's Xs office. Well unbeknownst to you, at your childs last physical we tested her for chlamydia, and well the test came back postive...", would open the doors of dialogue, I'm just not sure that's the best way to unlock it.

 

And no the right test was billed for-was the first thing I checked.

[Chrystal]

I would call and speak to the office manager and tell her that you did not authorize this test and did not know it was being run.

 

I would also speak to the doctor as to why he or she ordered this test.

In most states 13 is not old enough to consent to testing or treatment.

 

You are not overreacting. Any and all tests should be discussed with the patient or parent prior to being run. Especially if you are private pay. Apparently this doctor either didn't realize or didn't care that you would be handling the bill personally.

 

Bottom line: I, personally, would not pay this bill and would dispute it.

[mcconnellboys]

Well, am I wrong in that it can pretty easily be picked up from toilets, etc.? At least I seem to recall that's the case. And I believe that the longer it goes untreated (and many never know they have it), the more problems it can cause with infertility, so I would tend to think it might be pretty common to order it for teens now days. Is it very expensive? I think I'd certainly say something about it, but if it's not that expensive I don't know that I'd be mad that it was done.

 

I had tons of infertility problems after I got married and chlamydia was one of the first things they checked for. That's when I did all my reading on it so it's been quite a while since I've looked at it. I thought more recent health campaigns I've seen have characterized it as highly pervasive within the teen/adult population, just as many women and men are now strep carriers. At the time I was undergoing treatments for my problems, that still varied some by population areas, but I've heard that these type infections have just continued to grow as the years have gone by, so I would expect the problem to be even more pervasive now.

 

It is my understanding that one does not have to be sexually active in order to contract either of these problems - that they are transferred through bathroom facilities, etc.

[Faithr]

I do not believe Chlamydia can be passed via bathroom facilities. Here is just one website saying that it is not possible. http://www.youngwomenshealth.org/chlamydia.html

[Sahamamama]

I would call and speak to the office manager and tell her that you did not authorize this test and did not know it was being run.

 

I would also speak to the doctor as to why he or she ordered this test.

In most states 13 is not old enough to consent to testing or treatment.

 

You are not overreacting. Any and all tests should be discussed with the patient or parent prior to being run. Especially if you are private pay. Apparently this doctor either didn't realize or didn't care that you would be handling the bill personally.

 

Bottom line: I, personally, would not pay this bill and would dispute it.

 

:iagree: I couldn't have said it better. Agree with every word. Fight this bill AND fight this way of handling your child! THAT'S the part that would make me livid, the handling of my child in such a manner. And the bill would tick me off, too.

 

I hope you can work this out. :grouphug:

[happyhomemaker25]

The fun thing is that if the test did come back positive you would not even have the right to be informed. The Drs office would want to talk to your daughter. You have no right to know what is going on there. Thanks to HIPPA! :ack2:

[TXMomof4]

I do not believe Chlamydia can be passed via bathroom facilities. Here is just one website saying that it is not possible. http://www.youngwomenshealth.org/chlamydia.html

 

Also, if it's transmitted via bathroom facilities it seems young girls would be even more at risk - let's face it they are way more likely to touch something disgusting in the bathroom than a teen. Last I checked they aren't doing chlamydia testing on preschoolers.

[IsabelC]

I think it is very simple: if you did not agree for the test to be done, you are not obliged to pay for it.

[Jean in Newcastle]

Are you in the U.S.? According to this link http://www.guttmacher.org/pubs/tgr/03/4/gr030404.html minors in all 50 states have the right to request testing for STDs. Was your dd alone with the Dr.? Perhaps she asked for it or he asked her and she felt like she had to say "yes" because after all he is the Dr.? She must have been asked to pee into a cup at least.

[Moxie]

I can see both sides. I think I would be upset if I had to pay for a test I didn't authorize on my child BUT I've seen the statistics on % of kids that are active vs. the % of parents that think they are. There are LOTS of clueless parents. The doctor does have to cover himself in case you are one of those clueless parents. If you trust this doctor (and if you don't, find a new doctor) I would pay the bill and be happy the test was negative.

[melissel]

While I can imagine that a phone call that goes something like, "Mrs. So and so...? Yes this is Stephanie at Dr's Xs office. Well unbeknownst to you, at your childs last physical we tested her for chlamydia, and well the test came back postive...", would open the doors of dialogue, I'm just not sure that's the best way to unlock it.

 

So how would you expect that door to be unlocked if a parent was clueless about their child's activities and the child obviously wasn't speaking up? I don't think there are too many sexually active 13-year-olds out there who are forthright with their parents about their sexual activities and knowledgeable about the risks therein. And I'd imagine that any sexually active 13-year-old would be engaging in some pretty risky activity :(

 

I can understand your being annoyed about paying for the test, and I would fight that. But I think your outrage over a noninvasive test for an STD that constitutes a significant public health risk is misplaced.

 

I can see both sides. I think I would be upset if I had to pay for a test I didn't authorize on my child BUT I've seen the statistics on % of kids that are active vs. the % of parents that think they are. There are LOTS of clueless parents. The doctor does have to cover himself in case you are one of those clueless parents. If you trust this doctor (and if you don't, find a new doctor) I would pay the bill and be happy the test was negative.

 

:iagree:

[LunaLee]

I have also seen the stats on STD's in teens and young adults. I also know that Chlamydia can go undiagnosed and easily spread because it tends to be asymptomatic. And yes, I completely agree that a teen has the right to request STD testing, if there is a need to. With DD there is not. Yes, there are a lot of clueless parents, but I am not one of them. DD and I have a very open and honest relationship so I have no reason to doubt that she is being honest with me when she says there was no need for it and that she was not informed of it. We assumed the peeing in the cup was just for a typical dip Urinalysis which is typical at a physical or at least it was when I did back office.

 

As far as if it had come back positive- I can't imagine, or would find it incredibly difficult, to contact a minor, advise them of a positive test, call in a prescription and have the child have the money to pay for it all without a parent not knowing. I suppose if the parent was uninvolved in the childs life...maybe.

 

I don't know...I'm sorry if I sound defensive, but this is one of the things that really gets my blood boiling-The "governments" continuing crusade to take away the rights of patients by "giving" them rights and telling me I have no say in the medical treatment of my child because of HIPPA. Oh and in regards to HIPPA- she signed the consent form that says the dr can talk to me about her health.

 

I will be calling the office and speaking to the Dr and office manager to at least tell them how I feel and that they should at the very minumum have some kind of form stating that STD testing will be performed at the patients request or something to that effect. Then I will be contacting the lab to notify them that I will not be paying this bill because it was not authorized by either the patient or myself.

[melissel]

My point is more that I don't think there's some nefarious plot on the part of healthcare professionals and the government to trick you and your daughter into giving up rights. It's not as though he surreptitiously gave her the HPV vaccine or a Depo Provera shot. She was peeing in a cup anyway, I'm sure, and that's probably just one of the routine tests they do when they have urine handy from a child who's just moved into the sexual activity age range. I don't see a negative outcome from knowing that you have an STD, but I do see a negative outcome from NOT knowing you have an STD. And when you give blood or urine for a well-visit, does your doctor give you a line item of every single test that will be run on your samples? I know I'm always surprised at some of the details on my lab report. They run all sorts of things as standard procedure--seems like more every time I go!

 

And I think it's wonderful that you and your daughter have an open, honest relationship. But how would the doctor know that? As MelissaD pointed out, the % of sexually active teens and the % of parents who know their teens are sexually active do not match up. When I was 13, there was a guy who pressuring me to have sex with him, and I had a huge crush on him. Had I succumbed, I would not have been hopping off to my mom or my family doctor to discuss my sexual health, and we did and do have a terrific relationship.

 

As far as if it had come back positive- I can't imagine, or would find it incredibly difficult, to contact a minor, advise them of a positive test, call in a prescription and have the child have the money to pay for it all without a parent not knowing. I suppose if the parent was uninvolved in the childs life...maybe.

 

As for this, I think that's the point. The clueless parents of a clueless sexually active child would never know this was going on in their child's life unless they or the kid got the phone call saying, "We have some bad news..." There would just be radio silence. You are a good, involved parent with an open relationship with your DD. That's wonderful and as it should be. Many teens do not have that kind of parent. Some do, like me, but would still never in a million years talk about sex with them at 13, or 14, or 15, or 16...

 

In the end, from a purely financial standpoint, ITA with you and would discuss it with the office and lab. But I would not discuss it from a "you robbed me of my rights!" standpoint, because I don't think that's what's happened here, and I think the policy does more good than harm, across the board.

[Sebastian (a lady)]

I have moved about quite a bit. When I lived in California, testing was a requirement. When I moved, the next Dr's practice told me they rarely tested because there were so many false positives (though that is only a statement about the test available at the time, over 15 years ago).

[catalinakel]

I would call and speak to the office manager and tell her that you did not authorize this test and did not know it was being run.

 

I would also speak to the doctor as to why he or she ordered this test.

In most states 13 is not old enough to consent to testing or treatment.

 

You are not overreacting. Any and all tests should be discussed with the patient or parent prior to being run. Especially if you are private pay. Apparently this doctor either didn't realize or didn't care that you would be handling the bill personally.

 

Bottom line: I, personally, would not pay this bill and would dispute it.

 

:iagree:

[kalanamak]

 

In the end, from a purely financial standpoint, ITA with you and would discuss it with the office and lab. But I would not discuss it from a "you robbed me of my rights!" standpoint, because I don't think that's what's happened here, and I think the policy does more good than harm, across the board.

 

:iagree:I encourage you to consider if you would have had your response to, e.g. a screening fingerstick (one drop of blood) for TB in an "endemic area". For we are in an endemic area for chlamydia.

 

Plus, if it is "standard of care" in your area, one scarred set of tubes because this doc didn't live up to standard of care, and doc just lost a lawsuit.

[Danestress]

As the mother of an individual girl (which I am not, having only boys, but of course boys also can get chlamydia) I would not think testing is necessary if I knew my child as not sexually active. As a public health measure, however, I can see the wisdom of routinely testing kids this age.

 

Chlamydia is so destructive to fertility, and many women apparently don't know they have it until they have had it for years. I think there are probably a lot of mothers of 14 year olds who are sure that their daughters don't need to be tested, when in fact they do. So I can see why routine screening would be a good policy. It has the potential to save many women and girls from a lot of heart ache.

 

However, I can also see calling and letting them know that you object to paying for this test since you did not approve it. I just wouldn't let myself be truly angry about it, because I think it's a reasonable choice for a doctor to make.

[Karenciavo]

I would dispute the bill.

P.S.: I don't think you are being overly sensitive or out of line.

Edited January 5, 2010 by Karenciavo

[Haiku]

I could understand if a child was "at risk" for these kinds of things and asked a physician for this but even then, I got a bill that said "CHLAMYDIA TESTING" how is that going to protect a child if they are in danger at home or whatever.

 

I would think that if a child tested positive for chlamydia, that could be an indicator that they AREN'T safe at home. When I worked in foster care I had several kids come into care because their doctors suspected sexual abuse and ran tests to confirm it. These were kids 11 and under, and the doctor doing these tests is what revealed what was happening to these kids.

 

Tara

[Anne in CA]

I would talk to the administrators and the doctor carefully about why you are not going to pay. You didn't know about the test and there is no reason for you to pay.

 

I suspect their answer will be something along the lines of "Most parents are so irresponsible that they don't know their children are s@@ually active, so we must do this."

 

If you can't do better than that as an answer, I would switch doctors now, because we had a very similar issue with my dd's doctor when she was 13 and another when she was 14 and when she was 17 I was almost charged with medical neglect for not allowing dd to take medicine she didn't need but the doctor felt she should take "just in case". One possible side effect of this medicine was sudden death! The doctor felt I was so unreasonable to question her, because no other parents ever questioned her so I must be stopped.

 

In my opinion, a doctor that can't treat you like an adult who will make informed decisions about your child's health is not going to provide good medical care anyway.

[Paz]

I just got a slip for routine bloodwork and this test was on my list, as well. Aparently it is a standard test now. I hardly think that I and my 72 year old mom need it either. (We go to the same doctor.)

[GESTEP]

I realize girls lie, parents have no clue and the doctor does not which parents do have a clue and which girls are telling the truth so they just screen everyone. In any event, the patient or parent (since consent was given) should be informed and given the option to decline the test.

I would definitely speak to the office manager at the doctor's since the billing dept will not be able to credit the lab and explain that the test was done without consent and was unnecessary for the circumstances. I know alot of parents would decline the test thinking that it is unnecessary when in fact it would be but it would be documented in the chart as "declined" and should have documentation showing that the child stated they were not active. The test should not be done unless there is some reason to suspect a need (suspected abuse).

I don't believe in forced medical treatment/testing based on the moral decline of society.