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doitwithlife 05-16-2012 03:19 AM

Challenging a vet bill, bad diagnosis and contesting charges
 
Weeks ago my horse came in from the pasture lame with a really swollen knee. Called the vet who came out and did an exam, lameness exam, x-rays, etc. Vet declared after looking at the x-rays, no bone damage, then stated that he had tendon or ligament injury.

Treatment was typical, call water, surpass, stall rest. Suggested cold laser to improve his recovery from the injury. I told him that no way I could afford daily treatments if I was going to have to pay a barn call each time. He told me not to worry about it, the treatments were $60 each. I brought this up a number of time, always told $60 for each treatment.

After 2 weeks, swelling was down, but still a sore horse. Actually swelling went down the next day. The vet is now telling me a torn ligament and its going to be a very , very long recovery.

Took him to a specialist who re-xrayed and , wow, bone chips clearly in the x-ray. Ultrasound showed no joint, tendon, or ligament injury. They believed he got kicked in the knee and they diagnosised a hemotomal to the bone, per ultrasound. Basically a bone bruize and for now the chips don't seem to be a problem.

Took him back 2 weeks later and did a cortizon injection in his knee. This vet contacted the original vet and explained what was found and forward all test results to the 1st vet.

Happy, happy, me, my boy is doing amazingly well with the new treatment. Unless I tell someone he is recovering you can't tell anything is wrong. The great vet is allowing ground work and limited turnout. This is 5 weeks after the initial injury. We expect that at our next visit to the vet we'll be under saddle in the arena doing rehab. Did I mention I'm happy about this. I was happy to pay the 2nd vet bill and can't say enough good about his care.

Now finally I get the bill from the 1st vet. He wants $1400+. Actually more than the 2nd vet charged for all the treatments and exams. I'm stunned to see barn calls for each day along with a $7 fuel surcharge for each visit.

I believe the 1st vet should get paid for coming out and treating the swelling. I'm having a hard time paying for a blantently wrong diagnosis as well as for charges I was told would not occur and fees which were never disclosed.

Other than trying to get the charges reduced to what was agreed to, what recourses are avalible?

Thinking about filing in small claims court to recover the x-ray, barn calls and fuel charges.


Whatever happens I'm happy to have a healthy horse, and now looking for a new general care vet. Just don't feel good about paying for something done wrong, plus being held accountable when the vet didn't honor his word.

Thoughts?

wyominggrandma 05-16-2012 11:08 AM

Since I work with vets, I don't think you will be able to recover anything other than the difference in what the vet told you and the bill you got. Nobody will be able to say the first vet did anything wrong. The bone chips might not have shown up in the first xray,( my daughter always has to have second exrays if a broken bone is suspected, seems they never show up the first time, even if the doctor suspects them too)and the 1st vet did the treatments based on what he diagnosed at the time of the first exam. Things change over the course of two weeks. If an ultrasound was not done on first exam, then he diagnosed what he saw at the time.You agreed to the treatments.When it didn't get better, you chose to have a 2nd opinion.
The second vet did another xray and the chips showed up.. He did an ultrasound and didn't see tendon injuries.(usually ligament/tendon injuries only show up on MRI or CT scan, am surprised an ultrasound showed that, we do ultrasounds all the time and don't diagnose soft tissue injuries) So, he treated the chips. You also chose that treatment .
Now, to be honest, you chose to accept both treatments by both doctors. I know it happens in humans, you go to your family doctor, you choose a treatment based on what the doctor sees. If it doens't help, most folks will choose a second opinion, where the second doctor might see something that did not show up the first time, give a different diagnosis and treat it and all is well.
You will have to pay for the first vets treatments, you accepted them and agreed to them. It is not as if the first vet did harm, the xrays did not show chips right after the injury, sometimes swelling, blood, etc can hide chips and breaks, then they show up after a week or two. Maybe the second vet's xrays equipment was newer and better, who knows.
Now, that said, if the vet kept saying $60 for each treatment then either his bookkeeper did not know the vet agreed to $60 and billed you the regular charge which included the gas and visit, OR like most doctors, human and animal, there is always an office call included no matter what is being done and the vet figured you knew that.
We have folks ask what something costs all the time, we always give the cost of the procedure and then say" the farm call, or office visit is not included in this amount, that will be extra".. When you come in to get vaccinations on your pet, the shots this much, the office call is this much. The only time we do not charge for an office call is for stitch removal. We always charge ranch calls, no matter what the procedure or check up is, and I beleive most vets are the same way.They may divide them between one or more folks at the same place, but the ranch call is always there. Or say, the procedure is x amount and the call in included in this price. Again, knowing vets like I do, he probably said" it is $60" and figured you would know the farm call was not included. I don't know many vets or doctors who do procedures without charging the office/ranch call.
If you go into an emergency room, besides the doctors treatment, it costs so much to just walk in the door. At the doctors office, you may be going in for a return procedure, but you still pay for the office call.
You can possibly talk to the vet himself, not his office manager and explain you thought each visit was $60 including the call when he kept saying $60, and he may reduce it, but there is no way you can expect to not pay for the xrays, etc because he DID do them, whether he saw the chips or not at the exact time of the injury.
A judge might also say" you should have known the ranch/fuel charge are always a part of any treatment, the vet needs to charge for his time and costs, just like any other business.
Truthfully, if the vet is nice and you talk to him nicely, he might reduce the ranch/fuel charge, but in my experience, just because you don't like what the first vet did,and the second vet found something in the xrays the first one didnt, you can't expect to not pay. He did a service to your horse. You chose to find a second opinion when the first one did not help. The first vet did not commit malpractice in any sense, he treated an injury how he saw it should be treated.

CLaPorte432 05-16-2012 11:24 AM

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Swelling can also hide things on xrays. Maybe that's what happened with first vet, and he made a diagnosis off of what he could see at the time.

I don't see you having a case. You agreed to the treatments. 7 bucks for fuel is nothing. Be glad he didn't charge you more like a full barn call fee.

I'd say pay the bill and don't lose him as a vet I case you have an emergency and he's the only one you can reach. Don't burn bridges...they can't be rebuilt.

WickedNag 05-16-2012 11:46 AM

I think your first vet did what he could do. My brother broke a little ankle bone...went unnoticed by more than one radiologist and doctor before it was found. I understand your frustration but imo you owe the bill and should pay

Nitefeatherz 05-16-2012 12:13 PM

I agree with wyomingrandma. You may be able to get them to discount the charges that you weren't aware would be on there but if a service was rendered (ie, drays or treatment, etc,) then the vet should be paid. Imo if they were going to add fuel charges and vet calls then they should have mentioned that in detail when you were questioning cost and that money was an issue. I also work in an animal hospital asa veterinary nurse. We always make an owner aware if they are going to be charged for something: if an emergency visitis $130 we mention that ahead of time to make sure the owner is aware. That way we aren't rendering service the owner isn't prepared to pay for. If you mentioned cost as a concern then they shouldhave made you aware of ALL potential charges. I would call the 1st vet and complain: state your case. They may discount it rather than lose you as a client. If they didn't make sure you were aware of all the fees involved that is their fault..

Golden Horse 05-16-2012 12:15 PM

Vets are not gods they are people, they use their best skill and judgment to diagnose and treat, given the symptoms and test results on the day.

I think your first course of action is to go and speak to Vet 1, and explain your worries over the bill, especially the $60 promised treatments. A friendly approach would be better than an all out attack in the first place.

NorthernMama 05-16-2012 12:32 PM

I think all you can do is discuss the charges and try to get them reduced to what you understood to be expected as a daily charge. Don't niggle over the $7 for fuel, just the barn call charge. But that's only if it was very clearly discussed that there wouldn't be a call charge daily. No one is perfect and your vet made a mistake. Unfortunately we pay for those. But do we give the vet a bonus when (s)he gets it perfect the first time? Are you going to add a "you got it right" charge to the 2nd vet when you pay the bill there?

Don't burn your bridges. But you should be able to expect fair treatment. If the 1st vet gives you a really hard time about the charges, tell him it's a lesson for both of you and ask for extra time to pay, interest free.

churumbeque 05-16-2012 05:45 PM

Quote:

Originally Posted by Golden Horse (Post 1502745)
Vets are not gods they are people, they use their best skill and judgment to diagnose and treat, given the symptoms and test results on the day.

I think your first course of action is to go and speak to Vet 1, and explain your worries over the bill, especially the $60 promised treatments. A friendly approach would be better than an all out attack in the first place.

Yes a nice conversation and work out a bill you both can be happy with. Explain the situation and see what the vet says. I would also have the 2nd vet look at the 1st vets xrays to see if something changed over that period of time or if he was negligent. I have had 2 vets from the same office dissagree over xrays and treatments


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