Should I just pay this bill for Psychological testing

Should I just pay this bill for Psychological testing? Or - A cautionary tale of mental health care.

I’ll try to keep it short. My wife and I see a counselor. In our conversations she recommended that we have our son evaluated, to look for learning problems and to find out where might be a good focus for his college career. She recommended a colleague - A licensed professional with a PhD.

We contacted this doctor and set up a time. I was cautious about the price so we agreed that two, 2 hour visits would do the trick. $175 per hour. I assumed (yes, I know) that since my insurance covered 1/2 of the other counseling that this total bill would probably be $300, worst case, $700 for the four hours.

Each visit I offered to pay up front, the doctor refused stating “I will submit it to your insurance.” When we got the report (6-8 pages) it was almost incomprehensible to us so we scheduled another 1 hour visit to have it explained. More on that later.

When the bill finally arrived it was for a total of $1200, substantially more than my worst case scenario. When I contacted the bill collector she stated that this was based on 4 hours of office time = $700, 2 hours of test evaluation time = $350 plus one hour of counseling time for us = $150. Totals to $1200. When I asked about insurance the told me there was no point, insurance does cover this kind of testing.

Needless to say I was stunned. I now feel like I have been worked over by a team of professional con-artists. The collector refuses to budge, stating that I agreed to the charges. Is this normal? I am willing to pay the $850 and I will just chalk it up to learning to never use a health care doctor again. The doctor wants the full $1200.

The second question is about the quality of the work. We got a very lengthy report with a lot of jargon. For example, stuff like (this is made up): “The Smith-Jones Personality test measures the level of [child’s name] personality function. A high score indicates an increased level of personality function. A low score indicates an decreased level of personality function. [child’s name] scored a X which is in the middle range for the The Smith-Jones Personality test and indicates an average level of personality function.” Page after page of this.

An hour of discussion with the doctor didn’t reveal any new understanding to us. Our son scored very low on one test (bottom 1%) and very high on another (top .1%) but we couldn’t understand what they meant. So he is one of the best in the world at some thing and one of the worst at another but we don’t understand them. The doctor assured us that he could compensate in other areas but couldn’t convey to us what they meant in a a practical sense. We certainly didn’t come out of the experience with any practical idea of what to do. So, second question: Should that have any bearing of whether we pay or not?

IANA well anything really.

Have you considered asking your first counselor for their interpretation of the results? Explaining that these results (and the explanation) were far too cryptic to be usable.

As far as the rest, if the hours add up correctly, I wasn’t sure if they billed the same period of time as both evaluation and office visit - if that’s the case, I would definitely pitch a fit. Can you get past the bill collector and go back to the PhD to ask them questions about the bill?

I wasn’t very clear. The big discrepancy is the extra $350 for basically grading the tests and writing the report (2 hours). I didn’t see that coming. The doctor (or her collector) claims I agreed, that it is standard to bill one extra evaluation hour for each hour in the office and that they are actually giving me a break.

That’s a tough call; you should have pinned them down better on what all this would involve and what the complete charges would be, but they should have informed you better of what all is involved - the time to tell you you’re being charged for three hours of testing and report writing is not after it’s done. I don’t think you have a lot of recourse except to pay this bill, but be aware in the future - maybe you can demand a pre-invoice for services that you agree to, and any further charges have to be approved by you, just like they do in the car repair shop.

Send the amount you agreed to pay in the first place. If I understand it right that’s $350. Tell them that is why you are paying $350.

If they continue to bill you ask them to provide the name of whatever ethical review organization their profession requires. You honestly feel that the cost of their services was misrepresented to you and you want an unbiased review of the whole process.

I don’t know that I would pay the full amount, since the report (and explanation) was pretty much worthless to you. If this professional can’t write a report that gives you some sort of guidance, then they shouldn’t get paid the full amount. Any follow-up re-writes (and explanations) should be on the house too, they screwed it up.

But the hours issue sounds like a learning experience, at least that’s how I would take it. In hindsight, you probably should have asked for an estimate as to the total amount for the examination, not just the hourly rate. (I can easily see myself falling into the same thing: hourly rate = X, its for Y hours, thus total charge = X*Y. When really, I forgot to ask about Z.)

IMHO, YMMV, etc.

I don’t see the part where he agreed the total charges would be $350. I get the feeling that he didn’t realize that psychological testing involves charges for both analysis and the actual testing time.

The real problem here is not the charges but that the patient (or the parent of the patient) can’t understand what the end results of the test are. This is a failure on the part of the psychologist. My boyfriend is a neuropsychologist and a large priority in his work is conveying findings to patients such that they understand. I would try to schedule another appt with this person (unpaid) to have the tests re-interpreted and explained to you, at least if you think it will help. After that I would contact the insurance company again and see if they will pay part of the bill (personal experience with insurance companies demonstrates that they’re simply more likely to shell out if you argue with them.)

If you really think the report is lacking in some substantial way (i know, as a layman it may not be obvious if it is/ isn’t) having another mental healthcare professional, such as a psychologist or social worker, look at it might be worth it.

However, if it’s legit, I think you should pay the fee. The fee may not have been adequately communicated to you and that’s a problem, but you still contracted work and are under an ethical obligation (my opinion) to pay for the psychologist’s time.

First does she have your social security number? This is the big point. If she doesn’t there no real chance you’ll wind up with this on your credit report.

This is a case where she wasn’t dishonest with you, but she wasn’t terribly fussy about the truth either.

Basically you asked for an estimate and she gave you one. But she didn’t give you a good estimate.

I also would send in the amount of money you thought you should pay. Then you should say, this is all you intend to pay. If she doesn’t have your SS# it will be hard for her to report you to the credit agencies.

If she does, I’d go ahead and pay it. Today credit card companies are just looking for any excuse to drop you or raise your rates. Even a minor ding on the report can give them the excuse to raise rates.

A) I would definitely go back to the original counselor and let them know about your experience. Make it clear that you are relaying this information to her so she can understand better what she is recommending to her other patients.

B) Write a formal letter to the psychological testing genius and explain in no uncertain terms that you are quite disappointed in the entire experience. Remind them that you asked about payments up front, that you were never told about the evaluation hours, and that what would be considered “standard” for them are NOT standard for you, as you do not make a habit out of getting psychological testing. That payment had been clearly a concern of yours from the beginning, and failure to include these additional fees is a gross oversight on their part.

Further explain that the lack of practical translation of the tests in any kind of useable format renders the entire experience unhelpful, and that you will be relating your experience to both the counselor that recommended them, as well as to the better business bureau for further enlightenment.

In light of this, you are not prepared to pay the total amount at this time. Submit to them a check for payment of the original understood amount. Write clearly on the memo line that this is full payment for contracted services rendered. If they choose to deposit this check, they should not be able to pursue you for additional funds. (YMMV)

Make sure to cc: both the original counselor and the BBB.

Very good suggestions, thanks. I will be writing the letter Melodyharmonious suggests at the very least. The part about telling them to only cash the check if they accept it as final payment is a nice touch. I seriously doubt it will deter the doctor from further predatory practices though.

The big issue to me is that she, or any doctor, can basically bill me for anything she wants and the onus is on me to disprove it, else my credit is hit. Very frustrating. I will be sending a complaint letter to the state license board and am planning to discuss with a lawyer as well, depending upon how much he will charge.

Since they won’t address your concerns about the bill or the report, why don’t you just go ahead and file a complaint?

They can ignore you, but they won’t ignore them.

The person contacting you about payment is not the doctor who you originally discussed the cost with. So you should definitely contact the doctor about the costs, with an eye toward getting the bill reduced. You’ll probably also want to mention that the report was incomprehensible.

p.s. – When you met in person to discuss the report, was the in-person explanation understandable? These kinds of reports do contain a lot of jargon, but the doctor should be able to explain what it means. Also as others have stated, your regular counselor should be able to interpret the jargon for you.

p.p.s. – The $1200 they charged you is typical for this sort of test. But that should have been explained to you up front.

I agree with ratatoskK, and will add that psychologists have an ethical obligation to explain their work in language that’s understandable to the client. This doesn’t mean that the report has to be written in understandable language–think of it as a lab test from a doctor–but it needs to be explained to you in non-technical vocabulary.

Got that link already, thanks. I know they can’t do anything about my bill but hopefully, if this is a pattern for her, they can put a stop.

Thanks, I wondered what is typical. It’s not like you can call around and get estimates. If she had said - “that will come to $1200” I wouldn’t have ever made the first appointment. So it was the deception (deliberate, I think) that got me in the door.

We met the same doctor who gave the tests when we went for the explanation. I was not happy when I left. My son was an extreme outlier on two tests - she couldn’t explain to us what impact they would have other than to assure us that they didn’t really matter - which made me ask what was the point of giving a test that didn’t matter - which lead my wife to try to calm me down. In the end we got an odd anecdote about her grandfather (the doctor’s) that confused us into silence.

I don’t mean to make this Psychologist out to be a horrible person but this will be the last time I deal with one without a written estimate up front.