How to talk to your doctor about getting the labs you want run for you or DIY-ing it and getting money back from your insurance.
A lot of what we do here at Biomentals involves delving into lab results. Knowing how to ask your doctor for them is a big question we get since paying out of pocket for them can be expensive.
Here are 5 tips for getting the labs you need affordably.
Tip #1 - Remember your doctor is a person like you.
The doctor-patient relationship, like any relationship, is made up of imperfect individuals. Doctors should welcome your questions and feedback, including learning about new labs they may have never heard about. Even if they're brilliant, they won't, they CAN'T, know everything. Just like you, they can become accustomed to do things a certain way but may be open to new things if they're persuaded it's worth it.
Tip #2 - Explain the reason you want the lab.
In order to adequately explain why you are asking for the lab, you need to have done your homework. It's what we offer in our coaching sessions. This will take time and effort on your own, so we break it down for you. Write down talking points to bring to your appointment, and heck, even bring articles or links to where your doctor can research for themselves. That will go a long way to making your case. Make sure they're peer reviewed. (Doctor's love that!)
"If you have a strong enough why, you can endure any how." – Friedrick Nietzsche
Tip #3 - Follow me, rinse and repeat.
Sometimes, it's about just asking the right questions and helping the doctor think through the reasons for the lab. When my son had first been diagnosed with autism, it was like there was a block for his pediatrician to see anything else. I asked if we could be referred to a gastroenterologist, since he was experiencing major digestive issues to which the doctor responded, "That's common with autism." My answer was, "Even so, if a broken arm was common with autism, you wouldn't just not treat the arm." He gave me the referral.
After the gastroenterologist had run every test they had on him - since he was also emaciated from "failure to thrive" - we ended up with zero answers. When the doctor said there were markers for malnourishment and inflammation but nothing clear about what was happening since he was clearly eating well, I asked if we could get an endoscopy and colonoscopy. She asked, "What for?" To which I replied, "If he is eating well but clearly malnourished, maybe there's a blockage or something in his intestines keeping him from absorbing his food." Bing, bing, bing...wish granted! We signed him up to be scoped the next week. Sure enough, he had lymphoid hyperplasia of the ileum causing swelling in an area involved with the absorption of nutrients. We then went on a path to fix that and problem solved!
Tip #4 - If at first you don't succeed, try, try again.
If all else fails, simply go to another practitioner. You can always research to find one that does those tests by looking for them online. Some practitioners doing testing that's off the beaten path don't deal with insurance, so you have to swallow the cost of the tests. Going out of pocket can be very expensive, but you can charge those to your HSA card or ask the practitioner for CPT codes so you can make a claim on your insurance. You can even order tests from reputable laboratories like AnyLabTestNOW! and so many others, ON YOUR OWN. If you order your own tests through a lab, they'll have a Medical Director from whom you can request the codes (they are tied to the ordering physician.)
Tip #5 - Educate yourself on your options and your rights.
If your insurance denies a claim, you can appeal multiple times. You can pester them for reasons, and they have to give them to you in writing. Like doctors, people who work for insurance companies can make mistakes, so sometimes they'll realize they did that. You may need to go over the fine print of what they're supposed to provide you. Remember that the third time's often the charm: this is the case with appeals because the insurance company has to send the third one to a third party who is likely to be more yielding. As they say, "Things often come in threes."
You are your strongest advocate for yourself!
If you're not good at any of these things (or too sick to do them), enlist reinforcements in the way of family and friends who can help you in any of these areas where you may be weak. But, at the end of the day, your health is in your hands. No one else is going to suffer the repercussions of ill health more than you. Take back control and advocate for yourself. Your doctor and insurance providers work for you. Don't take a back seat to your health and be led to things you know nothing about, and don't abdicate the responsibility of ensuring you're getting what you need to somebody else.
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