Innacurate Echo leads to unnecessary scans/high bills...what would you do?

[HopefulHeart]

All of us heart patients have to undergo lots of diagnostic testing....particularly if we are being monitored until surgery becomes necessary. I had an echo which indicated that my aneurysm was a lot larger than it was the previous year.....a 4.2 was showing as a 4.8 on the echo. My Cardio went into a heightened stated of concern and order an MRI and an MRA to be done....which showed there was NO change at all in the size of my aortic aneurysm. All the echos, and I mean ALL since 2006 had always been accurate....up until I had this one. I now have a bill in the amount of $4300 that I have to pay out of pocket for the 2 MRI scans plus $187 for the radiologist who read the MRI scans.....all because of an echo that was wrong. Would anyone, if they found themselves in this position that I am in, pay the $4300 for the MRI scans??? Or would you refuse to pay the bill for the MRI's based on the fact that they were unnecessary since the echo was done wrong and yielded incorrect results in the first place???

I know this is more of a money question instead of a heart condition question, but I feel that it is still relevant since I am probably not the first heart patient that has been faced with paying sky high bills for extra diagnostic testing caused by echo errors. I'd love to hear about anyones experience that may be similar to mine. Thanks for reading this and for any help or advice that you may have.

 

[ski girl]

Echoes are always a bit of a guess . . . that's why they follow up with MRIs etc instead of just hauling you into the OR based solely on the echo. When you say they've been accurate since 2006 you don't actually know that - you really mean 'consistent'!

In your case I'd be happy that the MRI showed all is (relatively) well and hand over the dosh. After all, you DID receive the MRI so you do have to pay for it!

The only exception would be if the person doing the echo screwed it up, then I'd be asking the echo provider to pay the money. And good luck with that Maybe for next time just ask for a repeat echo!

 

[AZ Don]

Given the echo results, it is not the fault of the Dr. or the MRI facility that you had tests that may not have been necessary. I think the question is whether the facility that did the echo was negligent. Given that it is well known that the test has limited accuracy, I think that would be very hard to prove, and my guess is that it would take a lot of time, effort, and a lawyer. You could at least complain to the echo facility and see what their response is. At a minimum I would hope they would work with the technician that performed the echo to try to help him/her improve their accuracy. At most perhaps they will refund your out of pocket cost for the echo. I would be very surprised if they take any responsibility for the cost of the MRI/MRA.

I had an echo done after your first post on this subject and I asked the technician about the accuracy of the test. She said that it is difficult to accurately measure the aorta. The test was done at Mayo clinic in Phoenix and she also mentioned that if they (the technicians) have a question they are supported by Dr's that are leaders in the field, and she viewed that as a very big advantage in performing the echo accurately. I think your chances for an accurate echo are increased if you can find a superior facility, though that may be difficult to do and is no guarantee they will always be accurate. I've only had a couple echo's and a couple CT scans, all at Mayo and the results for all were consistent. Although I had my aneurysm repaired, my valve was spared so I am back in the waiting room. Due to insurance changes this year I will not be having future echo's at Mayo, so I will be trying to find a "superior" facility for my future echo's, but I'm not really sure how to go about that. There is an accreditation for facilities that perform echo's: http://www.intersocietal.org/echo/main/patients2.htm. Based on the number of local accredited facilities, I suspect that most are accredited so this may not be much help.

 

[TheGymGuy]

On one hand you should be glad that the echo was wrong and now you have some really accurate MRA scans which can be used for more detailed overview of your heart and arteries, on the other hand $4300 is whole lot of moneys and if you did not absolutely have to spend it why did you have to.

I would contact the lab that did the echo and try to get them to offset the cost of the MRA. First thing to do is to contact your cardiologist's administrative office and make your complaint known. Be very nice about it and see if they can pull some strings and get the MRA lab to lower the costs or use some credit towards future or something. Second thing, if this fails or does not resolve to your satisfaction, is contacting MRA office and stating that you have financial hardships and cannot pay the whole bill. Generally, labs, doctors, etc., would rather capture some revenue than no revenue at all and collections agency bill. They will try to workout a number that you can pay, its almost like bargaining or haggling, but you could say that you thought it was going to cost $1,000 and that its all that you can pay and see how low you can go until they get to that number.

Several years back I've heard of someone who had an emergency room bill that was pretty high and they told the local hospital that they cannot pay it and likely collections won't get much either. Hospital negotiated with them and basically asked them what can you pay and took a much lower amount to settle the tab. True Story.

 

[tom in MO]

If the bill was not covered by insurance, you should talk to the provider or as Gym guy says, just ask for a dicount due to financial hardsip. I know in my area, hospitals will often discount by 50% a bill if you don't have insurance. The reason being is that there is no "set price" for any procedure. They give deals to insurance companies that a person off the street cannot get right out of the gate.

 

[Rebecca]

I once had an echo that the numbers were way off. I don’t know if the echo machine was off or if it was the tech that did my echo. My cardiologist told me that he thought it was time for me to have surgery but he first was sending me to another cardiologist to review my case because my numbers just didn’t look right.

I stop by my cardiologist office and pick up my DVD of my echo on my why to see the other cardiologist. The other cardiologists that worked at a hospital call the hospital lab and told them to have only one of their echo techs redo my echo. Luckily it was not time for surgery.

I had good health insurance at the time and was just glad that I did not need surgery.

I agree with what the others have said. I also would call up the place that did the echo and tell them that there inaccurate echo cause you do have other tests done which cost you $$$ amount of unnecessary bills.

My sister had some minor surgery done at a hospital. A few days after surgery she was having dental pain and finally made it to a dentist and her front tooth root had crack. She had to fight with the hospital but in the end the hospital ended up paying for a dental implant.

 

[HopefulHeart]

Thanks for all your responses. I do have insurance, but I have the high deductible plan so my bills get lowered a small amount, but I'm still out of pocket for most of the bill. I definitely can't afford to take a $4300 hit all at once. I think you all are right. I think I'm on the hook for the cost of the MRI and MRA, but I may still try to fight the bill for the echo. I know echos are not completely accurate in measuring aortic aneurysms, but I've had 8 echos at the same hospital since 2006 and all have been consistent until this one. So I have to believe the echo tech did something wrong. It would probably take a lawyer and lots more money out of pocket for legal expenses if the hospital were to fight me on that. As for the echo I'm due to have for this year, I plan to tell my Cardio and his nurse that I do not want the same guy doing my echo that did it this past Nov. and caused the additional scans. I will give them a very clear "heads up" that if I walk in and see that same guy, I will walk right back out and refuse the scan. The ironic thing is that I hear about lowering stress everytime I'm in my Cardio's office for a check up......yet these sky high bills and wacko echo results do the exact opposite for my stress level.

 

[HopefulHeart]

By the way, ski girl.......I like your suggestion of asking for a repeat echo (with a different tech, of course). I will do that if I find myself in this position again. Once bitten, twice shy.....Ha!

 

[scott.eitman]

I may be wrong and I know 4.8 is close, but I believe under 5.0 does not require surgery. I am surprised they would not have just suggested coming back in 6 months for another echo. It sounds like they are not very confident in their Echo techs and the Cardios who read the results.

I believe in 26 years, I have only had one MRI for my heart and that was 3 years ago right before my redo.

 

[Lsimon]

I may be wrong and I know 4.8 is close, but I believe under 5.0 does not require surgery. I am surprised they would not have just suggested coming back in 6 months for another echo. ...

I think the guidelines depend a lot on other factors as well. I have a family history of aortic dissections and a casual conversation with a relative's surgeon last summer indicated that with that history I should have my aorta replaced if it was over 4.5. It was 4.7 at the time. I also think the rate of change makes a difference.

In my case it all is moot point as I recently had both an the MRI series and another Echo, both at Northwestern. Both showed a big change since my last Echo with root at 5.4 (MRI) and 5.1 (Root). There were some inconsistent numbers in my ascending between the tests and they doctors indicated this is not unusual but that the MRI is usually the most accurate. Now scheduled for aortic root replacement in two weeks.

 

[Lsimon]

Deleted duplicate post

 

[Eva]

..... but I may still try to fight the bill for the echo. I know echos are not completely accurate in measuring aortic aneurysms, but I've had 8 echos at the same hospital since 2006 and all have been consistent until this one. So I have to believe the echo tech did something wrong. It would probably take a lawyer and lots more money out of pocket for legal expenses if the hospital were to fight me on that. As for the echo I'm due to have for this year, I plan to tell my Cardio and his nurse that I do not want the same guy doing my echo that did it this past Nov. and caused the additional scans. I will give them a very clear "heads up" that if I walk in and see that same guy, I will walk right back out and refuse the scan. The ironic thing is that I hear about lowering stress everytime I'm in my Cardio's office for a check up......yet these sky high bills and wacko echo results do the exact opposite for my stress level.

I could have gotten as upset as you did if not more, despite the comforting results! It's the unnecessary emotional and mental painful upheaval you had to go through, which to me is more costly than the monetary expenses!

I very much like the other members' positive and calming views--they must be much kinder persons than I am! I agree with you about fighting the bill! I had my own share of similar unnecessary stressful experiences when my *toooo-busy* professional doctors referred me for more testing only to take a short cut so they could have time to see more patients!

I cannot judge your cardio, as I'm not sure how long you have known him or trust him. But I'm sure of my own cardio and his genuine care.
My last echo (done with a new tech who supposedly has 20 years of experience) showed a high increase in my left atrium size! When he saw those numbers, he doubted that increase. So, he looked at the echo and focussed particularly on me left atrium portion of the echo. He realized the tech was wrong! To reassure me, he drew on a plain paper how and why sometimes measurements differ from one tech to another!

So, I'm not sure if your cardio could have detected the tech's fault by looking at the echo more carefully! Or maybe it is not as easy as in my case!

As you do not want this to happen again, I agree with you that you refuse that tech. Also, I would see the cardio and I would casually ask him, as a worried patient, about the method the tech based his measurements on!

Tell your cardio how stressful you feel due to these expenses that could have been spared!! He may have a suggestion/helpful solution!

Ask for CDs of the last two echoes plus the reports, for comparison in the future, or in case you simply show it to a different cardio recommended by friends or relatives just to verify if measurements can be verified with a caring eye.

Those are simply my 2-cents thoughts!

Good luck. I hope you can resolve this to your liking.