At my six month check-up, my surgeon/urologist agreed that I could switch my PSA testing to my primary care doc, with the agreement that I let him know if the PSA level ever became detectable.
I have a huge out-of-pocket cap on my insurance, and a fairly high up-front deductible. I pay the first $5K per year, and then I pay 20% of everything until I've hit $11,600 out of pocket for the year. I got stuck with the worst insurance of my life not long before I got my initial diagnosis and health care costs are killing me.
The bill for my last visit to the urologist, including the PSA test, was close to $500, while a 15 minute visit with my PCP plus the blood test is closer to $150. The out-of-pocket difference for me is significant.
So, I had my blood test done 2 weeks ago, and after 12 long days, I got the result this week. It read "< 0.09". Perfect, I thought. As a courtesy, I sent a scanned copy of the result to the urologist's office. Apparently, he looked at the report and didn't like it at all. His nurse told me he didn't like the lab where it was done, although I'm sure something was lost in translation there.
At 3 months, he had done the regular PSA on me, with a result of "< 0.10". At 6 months, he did the ultra-sensitive with a result of "< 0.03". Maybe he wants the ultra-sensitive result and didn't tell me that, and I deliberately did not ask my PCP for that test - for both cost and potential anxiety reasons.
Perhaps he misread the report. The formatting is a little bit funny, with some underscores, and it really looks like "<_______0.09". Maybe he missed the "less than" sign and thinks the PSA is now detectable. Or maybe it's something else.
But, his nurse called me and told me that he wants to see me within 2 weeks and I need to be re-tested by the lab where he works. This will be another of those $500 visits. He gets to code the visit with the prostate cancer diagnosis, which increases the complexity of the visit, and allows him to bill more money. My PCP isn't seeing me in the context of PCa, so he doesn't code it that way. I'm really unhappy about
this, especially given that the visit notes for my last visit with the surgeon explicitly say that I'm going to be tested by my PCP going forward.
So, next Thursday, I get to miss an afternoon of work, I get to drive almost 100 miles round trip, and I'll get to pay about
$100 out of pocket for an unnecessary (in my opinion) re-test.
I keep wondering what would happen if I refused to do it.
Post Edited (dmlvt) : 10/24/2014 1:31:55 PM (GMT-6)