Well that's all fair and just as you say but if that's true why did the insurance not cover over $600 of the mandated amount. Sounds fishy to me!!! And yes we are elgible for the discount but we are preferring to send the bills to State Attorney General and State Insurance Investigators pending review.
Well that's all fair and just as you say but if that's true why did the insurance not cover over $600 of the mandated amount. Sounds fishy to me!!! And yes we are elgible for the discount but we are preferring to send the bills to State Attorney General and State Insurance Investigators pending review.
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I would absolutely report Ameritox to the States Attorney's Office, as well as whomever else you need to share this info with. This company has been "bilking" insurance companies, Doctors, and patients for millions of dollars. If you have absolute evidence of this; definitely run, do not walk, take your documentation and be sure to have the "whistle blowers on to this organization of crooked cowards".
Yes I have irrefutable proof of their duplicitious billing practices. And I am going to expose them.
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It isn't against the law to bill cash pay patients at a different rate. I would however, call them before you see an attorney. I had a similar situation and as it turns out, they didn't have accurate insurance information for me so I got the bill. I gave them the correct information and I haven't heard anything since. That was months ago. Just a suggestion...
They have all the correct insurance info. and the insurance company denied payment of over $600 of the $1000 bill. And as far as not taking it to me attorney I will take it to him because I trust him he's very ethical. I will also take it to the media as American's need proof that insurance companies are billed an insanely immense rate compared to the uninsured. The legality falls under ethics, unconscionabiliby, duress and good faith. Furthermore, while our country is currently dealing with mandated healthcare I believe FOX would have a field day exposing this. Believe me when I say I am going to ride this train to the end. I have an endless passion for something when I believe it is unethical.
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Believing you are right and being right may be two separate things.
Let's just talk facts. Ameritox publishes its billing practices and provides that information to the physicians office in a small pamphlet that should be given to each patient.
Fact: Ameritox can bill what it wants, but it accepts what the patients insurance mandates. Any co-pay is the portion the patients insurance company says is the patients responsibility. Ameritox does NOT Balance Bill.
Fact: Current policy is to only charge patients with no insurance coverage a fee of $99.00. This is intended to provide reasonable access for those who are uninsured. It is a service, not a fraud.
Fact: Patients are encouraged to contact Ameritox with questions about any billing and waivers and reductions are readily available. Fact is, most patients pay very little or nothing at all. AND this information is readily available to any practice that requests it.
No one likes getting medical bills. And medication monitoring isn't popular. Especially from those with something to hide. But FACT is, prescription drug misuse and abuse is an exponentially growing problem and physicians need every tool at their disposal to responsibly prescribe for their patients.
The services from Ameritox support physician decision making and are clearly stated by the company to be utilized as part of their clinical armamentarium, not as a sole definitive tool.
Before anyone guesses, yes I am a representative for the company and joined them within the last year. I fully checked out their reputation and business practices and I would never have joined if I perceived anything unethical. I work to help my physicians help their patients, and to make sure we do all we can to make the care affordable.
The lady who was upset about being charged a $100, should be grateful to a company that tried to help her because she was uninsured. By this definition every hospital and health care facility in the country commits insurance fraud.
Don't wear your ignorance on your sleeve...cite facts and know the law if you're going to threaten.
Let's just talk facts. Ameritox publishes its billing practices and provides that information to the physicians office in a small pamphlet that should be given to each patient.
Fact: Ameritox can bill what it wants, but it accepts what the patients insurance mandates. Any co-pay is the portion the patients insurance company says is the patients responsibility. Ameritox does NOT Balance Bill.
Fact: Current policy is to only charge patients with no insurance coverage a fee of $99.00. This is intended to provide reasonable access for those who are uninsured. It is a service, not a fraud.
Fact: Patients are encouraged to contact Ameritox with questions about any billing and waivers and reductions are readily available. Fact is, most patients pay very little or nothing at all. AND this information is readily available to any practice that requests it.
No one likes getting medical bills. And medication monitoring isn't popular. Especially from those with something to hide. But FACT is, prescription drug misuse and abuse is an exponentially growing problem and physicians need every tool at their disposal to responsibly prescribe for their patients.
The services from Ameritox support physician decision making and are clearly stated by the company to be utilized as part of their clinical armamentarium, not as a sole definitive tool.
Before anyone guesses, yes I am a representative for the company and joined them within the last year. I fully checked out their reputation and business practices and I would never have joined if I perceived anything unethical. I work to help my physicians help their patients, and to make sure we do all we can to make the care affordable.
The lady who was upset about being charged a $100, should be grateful to a company that tried to help her because she was uninsured. By this definition every hospital and health care facility in the country commits insurance fraud.
Don't wear your ignorance on your sleeve...cite facts and know the law if you're going to threaten.
Anonymous
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Anonymous
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Believing you are right and being right may be two separate things.
Let's just talk facts. Ameritox publishes its billing practices and provides that information to the physicians office in a small pamphlet that should be given to each patient.
Fact: Ameritox can bill what it wants, but it accepts what the patients insurance mandates. Any co-pay is the portion the patients insurance company says is the patients responsibility. Ameritox does NOT Balance Bill.
Fact: Current policy is to only charge patients with no insurance coverage a fee of $99.00. This is intended to provide reasonable access for those who are uninsured. It is a service, not a fraud.
Fact: Patients are encouraged to contact Ameritox with questions about any billing and waivers and reductions are readily available. Fact is, most patients pay very little or nothing at all. AND this information is readily available to any practice that requests it.
No one likes getting medical bills. And medication monitoring isn't popular. Especially from those with something to hide. But FACT is, prescription drug misuse and abuse is an exponentially growing problem and physicians need every tool at their disposal to responsibly prescribe for their patients.
The services from Ameritox support physician decision making and are clearly stated by the company to be utilized as part of their clinical armamentarium, not as a sole definitive tool.
Before anyone guesses, yes I am a representative for the company and joined them within the last year. I fully checked out their reputation and business practices and I would never have joined if I perceived anything unethical. I work to help my physicians help their patients, and to make sure we do all we can to make the care affordable.
The lady who was upset about being charged a $100, should be grateful to a company that tried to help her because she was uninsured. By this definition every hospital and health care facility in the country commits insurance fraud.
Don't wear your ignorance on your sleeve...cite facts and know the law if you're going to threaten.
Wow! One year of work and you could not detect their slimy billing practices? You must not have worked or had piss-poor "perception." Ameritox has their own definition of what balance billing is; since it is different than the standard insurance definition of balanced billing, well then of course they don't balance bill.
Wake up moron! They just got busted for 16.3 million in Medicare fraud and more will come. The CEO bailed and the former SVP MW was fired or "left to pursue other options." as they had put it despite helping to grow the company. Have fun riding the new Titanic.
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For those who think drug tests are totally accurate could not be more mistaken. The Society of Analytics pegs them being wrong 14-20% of the time.
Especially the newer synthetic opaites.
I'm suffering from severe radiation neuropathy, neuritis, advanced prostate cancer and fibromyalgia.
My doctor uses Ameritox and I consistently fall in the low or out of range (low end) for Oxycodone. Every test. I take the medication exactly as specified 3 times a day. Yet I'm back in trouble again (I'll be tested again this week). I've been in this program for over 6 years and while I'm in this pain the stress levels dealing with the bullshit of drug testing is horrible.
Just read several papers from Pain Management groups / associations that clearly state there is no totally accurate way of determining the levels of synthetic opiates.
Yet I keep getting tested with all the inherent problems. Oh forgot to mention but the test is now $1781.00 a pop. They raised it from the $963 amount it was last year.
And everyone complains about the cost of health care. Ameritox by the way got caught in a fraud case for over billing / false billing and settled out of court.
Especially the newer synthetic opaites.
I'm suffering from severe radiation neuropathy, neuritis, advanced prostate cancer and fibromyalgia.
My doctor uses Ameritox and I consistently fall in the low or out of range (low end) for Oxycodone. Every test. I take the medication exactly as specified 3 times a day. Yet I'm back in trouble again (I'll be tested again this week). I've been in this program for over 6 years and while I'm in this pain the stress levels dealing with the bullshit of drug testing is horrible.
Just read several papers from Pain Management groups / associations that clearly state there is no totally accurate way of determining the levels of synthetic opiates.
Yet I keep getting tested with all the inherent problems. Oh forgot to mention but the test is now $1781.00 a pop. They raised it from the $963 amount it was last year.
And everyone complains about the cost of health care. Ameritox by the way got caught in a fraud case for over billing / false billing and settled out of court.
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So if you had low levels and are still in pain, maybe you should take the appropriate dose?? It is proven that those that don't comply with the dosing regimen prescribed don't get better. One may think you are diverting?
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Or there's me: I don't have pain problems. I was told by the Ameritox rep that a urinalysis was being done at the request of my doctor for her records, and not to worry--I might receive a bill but it was not something I would be responsible for. At no time did anyone tell me I was being screened for narcotics/controlled substances. Not the Rep--who also didn't disclose the cost/potential cost, nor the doctor. I call foul on both, and will be seeking a new GP. If one of those damn idiots had told me I'd be getting screened for narcotics and other controlled substances to the tune of hundreds of dollars I would have said "thanks, but no thanks." I don't want to pay for drug tests that screen for substances I've never abused, nor even taken for longer than a week, ever. I am very. Very. VERY. Irritated.
Yes, Ameritox has told me not to worry about the bill, after I described to them the situation under which I gave my consent for the test. I was deliberately misled, and would have elected to see another GP if I had known what was happening. STILL, I am suspicious of a company that tells me not to worry about a bill I owe. I am afraid that crap will come back to bite me...and they know that--they know people like me will feel nervous about not paying, so they will pay something anyway.
Yes, Ameritox has told me not to worry about the bill, after I described to them the situation under which I gave my consent for the test. I was deliberately misled, and would have elected to see another GP if I had known what was happening. STILL, I am suspicious of a company that tells me not to worry about a bill I owe. I am afraid that crap will come back to bite me...and they know that--they know people like me will feel nervous about not paying, so they will pay something anyway.
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Or there's me: I don't have pain problems. I was told by the Ameritox rep that a urinalysis was being done at the request of my doctor for her records, and not to worry--I might receive a bill but it was not something I would be responsible for. At no time did anyone tell me I was being screened for narcotics/controlled substances. Not the Rep--who also didn't disclose the cost/potential cost, nor the doctor. I call foul on both, and will be seeking a new GP. If one of those damn idiots had told me I'd be getting screened for narcotics and other controlled substances to the tune of hundreds of dollars I would have said "thanks, but no thanks." I don't want to pay for drug tests that screen for substances I've never abused, nor even taken for longer than a week, ever. I am very. Very. VERY. Irritated.
Yes, Ameritox has told me not to worry about the bill, after I described to them the situation under which I gave my consent for the test. I was deliberately misled, and would have elected to see another GP if I had known what was happening. STILL, I am suspicious of a company that tells me not to worry about a bill I owe. I am afraid that crap will come back to bite me...and they know that--they know people like me will feel nervous about not paying, so they will pay something anyway.
If this is true, your GP probably noticed some mental issues. Are you bipolar? If a doctor sees some issues and consults with your family, they may decide to drug test you. Of course being over 18, they have to find a way to get your consent. Have you ever watched the HBO show "Intervention"? Very similar to an episode.
Once again if this is a true story, you have much bigger issues.
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So who among you MORONS actually believes a patient would post on this site?
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So who among you MORONS actually believes a patient would post on this site?
I do. When you use Google for "Ameritox", the second non-Ameritox site to come up are these Cafepharma board posts! :0
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I am an Internist at a FQHC and getting disgusted with Ameritox!!
They USED to just put "negative" on the initial screening when it WAS negative and confirm the positives with GC/MS
Recently there are low level positives for PCP (angel dust) cocaine THC amphetamines on ALL or MOST patients and I accuse them and they get mad.
I am told if it is below the cutoff say-800-for amphetamines- not to stress over it.
In Conway SC we have MANY bad patients and I don't know what to DO anymore!!
I hate labcorp even MORE
They USED to just put "negative" on the initial screening when it WAS negative and confirm the positives with GC/MS
Recently there are low level positives for PCP (angel dust) cocaine THC amphetamines on ALL or MOST patients and I accuse them and they get mad.
I am told if it is below the cutoff say-800-for amphetamines- not to stress over it.
In Conway SC we have MANY bad patients and I don't know what to DO anymore!!
I hate labcorp even MORE
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My husband and I both had tests through Ameritox almost a year after our car accident. My husband has insurance, I do not. My bill was $100 and my husband's was $1000. thinking that my husband had a more extensive test, I requested a detailed bill from both of our accounts. The bills were identical, the units were identical, the CPT codes are identical. How can they do this? I have proof and I am taking it to my attorney to see what he says. If he won't listen I will write my state legislators and the AMA and the governor and any other person that will listen. They commit inurance fraud and prey on the unsuspecting. No wonder insurance is so DAMN HIGH!!!!
Would you rather that you also received your bill for $1000? Again, learn fee setting for medical billing and coding. They offered you a self pay discounted rate. THe only thing that could have been wrong was that they may have set the self pay "un-insured" rate below Medicare which is a "no-no". Check Quest, Lab-corps etc or any of the big games in town and see what their bills are. AND, they don't specialize in toxicology and often the physician has to wait 2-3 weeks before getting a test result so often they continue writing prescriptions without the report. And, more and more patients are becoming addicted. Elementary school children are selling their parents prescriptions in school. There is an epidemic out there and many patients that went in for simple "back pain" end up coming out years laters as "junkies" and are not unemployed, uneducated. Many are physicians, athletes, attorneys and yes, even politicians, housewives possibly even relatives of those of you ignorant of what truly is happening. Some of the labs are crooked, most are in it for the $$$ but don't categorize the scope of urine toxicology into one unethical mess. And, what governor would you be talking about? Florida's governor who was PROVEN to have committed the largest insurance fraud in years?
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Here is my problem - the "perks" the Dr's are given for running the drug screens through ameritox. The golf outtings, the vacations, and so on. I am the "insurance" paying for these tests, and they bill me over $1000 per test. I am also workers' comp, so I don't have these 'contract rates' - funny how someone without insurance can pay $100 but WC has to pay $1000 - for the same test; something seems illegal here, and to me it would be the "padding the dr's pocket" These Reps are giving the Dr's perks for using Ameritox - which I have first hand knowledge of from a Dr's office Mgr. If the test is so necessary and critical, then why offer the Dr. anything? I handle WC claims in 9 States, and the practice varies from State to State, and it is obvious which Dr's are getting the perks based on their frequency and use of Ameritox. This company needs to be shut down!!!
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Hey guys. Did anyone notice this? http://www.sfmslaw.com/class-action-lawsuits/cases.php?id=1135
Looks like the rumored class action from way back in 2009 has finally hit the streets.
"SFMS investigation of the Rx Guardian Pain Monitoring System and Rx Guardian Compliance Database
Summary of Investigation: Welcome to the webpage maintained by Shepherd, Finkelman, Miller & Shah, LLP (“SFMS”) for its investigation of the Rx Guardian Pain Monitoring System and Rx Guardian Compliance Database (collectively, the “Rx Guardian System”), provided by Ameritox, Ltd. Specifically, SFMS is investigating whether patients have been improperly dismissed from a pain management practice for non-compliance with their prescribed dosages of chronic pain medication, based upon testing results from the Rx Guardian System."
Looks like the rumored class action from way back in 2009 has finally hit the streets.
"SFMS investigation of the Rx Guardian Pain Monitoring System and Rx Guardian Compliance Database
Summary of Investigation: Welcome to the webpage maintained by Shepherd, Finkelman, Miller & Shah, LLP (“SFMS”) for its investigation of the Rx Guardian Pain Monitoring System and Rx Guardian Compliance Database (collectively, the “Rx Guardian System”), provided by Ameritox, Ltd. Specifically, SFMS is investigating whether patients have been improperly dismissed from a pain management practice for non-compliance with their prescribed dosages of chronic pain medication, based upon testing results from the Rx Guardian System."
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I'm a toxicologist and recently given a copy of a workbook Ameritox distributed at AAPM in Las Vegas, showing a copy of Rx Guardian with quantitative IA (immunoassay) below the cutoff. Correctly identified as 'Negative', but placed on the report for a quantitative (higher) reimbursement than a qualitative screen. Not only confusing to the user, but unethical and hopefully illegal. I cannot post a copy on this board, but a number of these quantitative negatives are on the sample report. How the CLIA surveyor allows this is only possible if the surveyor is clueless. I would expect more from the CAP Accreditation inspectors, they should know what they are doing. No reputable lab reports immunoassay quantitations below the cutoff, for a bunch of reasons. Scientifically unsupportable and patently fraudulent.
In another area, I realize many commenters on this board are not technical. Clinical and forensic testing have differing needs; on site POC testing without confirmation which detects the class of drugs the physician prescribes is fine. Pain management is for treatment, not law enforcement. Confirmation is only necessary when the detected drug class does not correspond to the physicians expectations; perhaps a complex class, i.e. opiates, and not necessary for legal drugs such as acetaminophen or cotinine (nicotine).
Ameritox RxGuardian relating quantitative levels to prescription levels is poorly supported in the scientific literature. Opiates for instance, are principally excreted in bile and feces, urine is a minor pathway. It's just marketing.
In another area, I realize many commenters on this board are not technical. Clinical and forensic testing have differing needs; on site POC testing without confirmation which detects the class of drugs the physician prescribes is fine. Pain management is for treatment, not law enforcement. Confirmation is only necessary when the detected drug class does not correspond to the physicians expectations; perhaps a complex class, i.e. opiates, and not necessary for legal drugs such as acetaminophen or cotinine (nicotine).
Ameritox RxGuardian relating quantitative levels to prescription levels is poorly supported in the scientific literature. Opiates for instance, are principally excreted in bile and feces, urine is a minor pathway. It's just marketing.
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I am a pain doctor I face a flood of fraudulent "patients" looking to abuse or divert these dangerous drugs which kill more Americans a year than MVCs or drugs like cocaine or alcohol.
POCT IS NOT sufficient those are the tests with a twenty percent error rate not gc/ms.
By the way someone who is fraudulently presenting to a dr office is NOT a patient they are criminals
POCT IS NOT sufficient those are the tests with a twenty percent error rate not gc/ms.
By the way someone who is fraudulently presenting to a dr office is NOT a patient they are criminals
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My previous doctor, now retired had the (required?) urine drug test performed by Quest diagnostics, Inc. The charge submitted to my insurer was $485.68.
My more recent Ohio Health Pain Clinic doctor had the (required?) urine drug test performed by Ameritox, Ltd. The charge sumitted to my insurer was $2,135.00. I asked what Ameritox was testing for that my previous doctor was NOT testing for - are they testing for nutmeg? The response was that I would have to contact Ameritox to find out. Really? My doctor at Ohio Health doesn't have the results from my urine drug test?
My insurer (GEHA) representative told me that they do not get involved in investigating charges that I feel are unreasonable, "we just go by the codes". Odd - becuase my insurance statment lists ten of the charges from Ameritox as "Not Medically Necessary for the diagnosis given". It also states that MY responsibility is $1,366.30.
I thought that my insurance company might be interested in what I consider fraudulent charges/proceedures! Are they all in bed together?
My more recent Ohio Health Pain Clinic doctor had the (required?) urine drug test performed by Ameritox, Ltd. The charge sumitted to my insurer was $2,135.00. I asked what Ameritox was testing for that my previous doctor was NOT testing for - are they testing for nutmeg? The response was that I would have to contact Ameritox to find out. Really? My doctor at Ohio Health doesn't have the results from my urine drug test?
My insurer (GEHA) representative told me that they do not get involved in investigating charges that I feel are unreasonable, "we just go by the codes". Odd - becuase my insurance statment lists ten of the charges from Ameritox as "Not Medically Necessary for the diagnosis given". It also states that MY responsibility is $1,366.30.
I thought that my insurance company might be interested in what I consider fraudulent charges/proceedures! Are they all in bed together?
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Anything you feel is fraudulent needs to go through the OIG. What's really fraudulent is the fact that if you don't call them or respond you will only get one more bill then it will go away. But the sucker that pays their bill bc they received it and don't question it is the one who loses out. They just really want what ins companies will pay