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arkia 05-22-2008 03:37 PM

Ameritox drug screening
Back in February I was switched to the care of a PM and as part of being a new patient had to give a UA....not a problem.

In March I received the bill from Ameritox.....a whopping $400...along with a form to fill out and attach my income tax to in order to receive either free or 50% discount. Today I received a letter stating I qualified for 50% discount. Still, $200 every time my doctor wishes to do a drug test?!?

The letter also stated that it is valid for 1 year for any tests that come to them and I will need to reapply in a year.

Holy I the only one with this high of a bill for a drug screen? The one I had at my previous doctor only cost me $50.

ms_west 05-22-2008 04:30 PM

Re: Ameritox drug screening
Oh my goodness that is outrageous. My doc has never done one on me. I guess I would have assumed that it was covered under insurance. ;)

Boxerluver 05-22-2008 05:16 PM

Re: Ameritox drug screening
My new doc doesn't do them, but my old one did a blood and UA every appointment. The results were used in a study to see the medication varience month to month. But insurance always paid for it.


momhurts 05-22-2008 05:43 PM

Re: Ameritox drug screening
I was at my appt. yesterday and the ameritox rep was with the PA so I saw the Dr instead. Are they new? Or does this mean my doctors office is going to be using there services??

Executor 05-22-2008 06:45 PM

Re: Ameritox drug screening
I am very disappointed to hear about this.....Seems like these folks are taking testing to the next level....And then some. As you all know, I'm a very big advocate of UAs....I've even stated that I would like a system where every patient was required to have a quick blood test @ each appointment in order to filter out those who are abusing and/or diverting. I think most abusers would eventually be identified and make life easier for those of us who are serious PM patients.

However, these folks take it way too far, IMO. I did some quick research on them, and it appears that the reason why the test is so expensive is because they have a very radical testing system. They market themselves as having the lowest threshold in the industry. Additionally, they measures compliance by comparing normalized values to established prescription-specific ranges. They use a patented algorithm to personalize lab results specifically to your a patients' demographics and prescription regimens. Results are specific to each patient, according to height, weight, gender, and age as well as prescription regimen.

Furthermore they market their services to physicians as a scare tactic....Saying that they help protect their practice from being closed by the DEA....Quoting what I think are outlandish %s:

- Up to 50% of all patients ignore directions on how to take their meds.
- Up to 21% never fill their scripts.
- 60% of patients can't identify their meds.

While I think there are patients who fit into all of these categories, I would challenge the high percentages. I don't believe for a second that over half of patients can't identify their meds. These percentages imply that a vast majority of patient are either dishonest or incredibly stupid. While abuse exists, I don't think it's anywhere near as rampant as they suggest. IMO, the media has made drugs like Oxycontin appear much more abusive than what really happens. I'm frustrated because it hurts the entire PM industry, and [U]most notably those of us who suffer in pain every day.[/U]

In summary, I'm all for prescription monitoring and reasonable testing....But not this commando statistical analysis that force ranks every patient into an algorithm that some statistician has decided is "the norm." Patient's bodies are complex machines and I don't believe you can force rank patient results into a distribution curve. As a ex university professor, I understand how statistical analysis works and I also know how data can be misleading. Please, for god sakes, lets leave the doctoring to the physicians and not some third party who profits from some so called "advanced testing methodology.":dizzy:


kim46 05-22-2008 08:30 PM

Re: Ameritox drug screening
I agree Ex - major medical is dictating the terms of all medical treatment - it is disheartening.

Sorry for those whose practice engage this firm.

arkia 05-22-2008 08:47 PM

Re: Ameritox drug screening
I almost brought the cost to the attention of my doctor after receiving the $400 bill, then decided I would wait to see what the outcome of the percent off would be. It seems there are 3 categories in which each patient, this is just going by my memory of the original letter and is info for a family of 4.
1. Full price for family of 4 making over $60,000/yr.
2. 50% discount for family of 4 making less than $60,000.
3. Free for family of 4....unfortunately I do not remember the $/yr on this.

I have decided that when I see my doctor next week I will let him know how much this test ended up costing. As Ex says, I, too, am all for drug testing, but I also believe the doctor needs to know what the cost is to his patients so (s)he can decide if it is the company the would like to continue doing business with.

I can understand sending a new patient's UA through something so sensitive, but once the patient is established and shown to be a "good" patient, then perhaps a less expensive means could be use, say just a urine dip looking for illegal drugs.

cmpgirl 05-22-2008 08:48 PM

Re: Ameritox drug screening

- Up to 50% of all patients ignore directions on how to take their meds.
- Up to 21% never fill their scripts.
- 60% of patients can't identify their meds.


I totally agree Ex. If they are basing their results on patients who receive prescriptions for opiates/opioids for [I]acute[/I] pain, due to sudden injury, etc., then these statistics might make a modicum of sense.

I've known many people over the years who do not have CP, but have had back strain, a broken bone or a wisdom tooth pulled, who might fit this profile, but [I]chronic patients[/I]..........highly unlikely that even a fraction of those stats would be true.

Just my humble opinion.......

butrfligirl28 05-23-2008 08:03 AM

Re: Ameritox drug screening
First of all, I would double check just to make sure they filed this with your insurance company. I have found that even places that have had your info for years, still make mistakes and forget to file certain things with insurance. I would call the lab and make sure they have your info, and ask them to file the claim again.

I agree with Ex. These insurance companies will come up with anything and everything to get out of paying for something. I am going through that now. They purposely make it time consuming, irritating, and a lengthy process. I wonder how many people just give up, so they don't have to deal with them anymore.

One of the last conversations I had with my carrier was straight and to the point. I told them that they were a bunch of liars who really didn't care about people and their health needs. All they care about is $$$, and figuring out some loop hole to keep from paying a legitimate claim.

What really makes me sick, are these comercials I see. "Oh with this insurance they took such good care of us, and we never had to do ANYTHING. They knew this was a tough time, so they took care of everything!" LOL YEAH, Right. Whatever. I flat out told them that they were FULL OF CRAP.

I think that the doctor absolutely needs to know how much these tests are costing his patients, but he should have made you aware that your insurance may not pay for the test. When a doctor investigates new drugs, new products, ect. it is their job to see how implementing a new UA brand will effect their patients. And, you should have a CHOICE and not be forced to use their provider over another. This practice is flat-out disrespectful to you and his other patients. Where is the compassion, the ethical choice to "do no harm" because he wants a fancy test?

If it were me, the next time I was asked to do that test again, I would refuse. I would offer to take other screens, do bloodwork, ect. But I would never shell out another $200.00 to make sure I appear to be "compliant." But hey, that's just me. :) I have had it with selfish companies, doctors, nurses, facilities, pharmacies, and the like. I have put my foot down and will not take this crap lying down. I don't think you should either. My 2 cents. LOL

Your Friend,


sandy0224 05-23-2008 04:45 PM

Re: Ameritox drug screening
I have to pay 10 dollars each time and that is the part that the insurance co doesn't pick up. Unbelievable!

Executor 05-25-2008 06:13 AM

Re: Ameritox drug screening
Not only is the cost outrageous, but more importantly, so is taking your blood work results and jamming them into some statistical printout seeing how your serum levels compare to the general population of other patients on the same meds. I'd hate to see a time and place where things are going fairly well for a patient and then some printout comes back where you are one of the outliers, and then they try to change your therapy.

There has to be a better way.


Shoreline 05-25-2008 08:32 AM

Re: Ameritox drug screening
MY group of docs switched to Ameritox 2.5 years ago and 400 is the price because they use GC/MS to confirm presumptive findings and to detect meds that other tests simply can't, like Soma. My docs know how much the test cost, we sign a waiver up front saying that we understand the cost, the discount plan and any uncovered portion will the patients responsibility before we pee in the cup.

It's amazing, nobody has asked why it's expensive, It's because they are that much more accurate than anyone else and follow proper protocol. I've never seen another lab use GC/MS, I remeber someone posting about it a few months ago,,but more than likely it was to confirm a presumptive positive or to find a drug that can't otherwise be detected. A rapid urine test is presumptive, How many would rather take their chance with inferior tests than use technology available that isn't going to put their continued care at risk and get them booted because it was too expensive to confirm the 20 dollar presumptive test that protocols say must be confirmed by further testing because the rapid test are so inaccurate at detecting synthetics.

I've seen more people on this forum alone get dumped by PM docs because a rapid test is being used that isn't capable of detecting oxycodone or some of the other synthetics than I have seen financially harmed by paying a portion of a drug test once a year. You get what you pay for, just like anything else in life. Is accuracy and continued care worth $400, absolutely.

Why are they getting upset when they have to use more advanced technology to find the drugs many have actually specifically asked for based on their vast medical knowledge and research that wouldn't have ebven been prescribed to them 12 years ago. What's the point of even bothering with a rapid UA test the doc probably doesn't even know the brand name , that may be well documented not to have the ability to detect synthetics, specifically Oxycodone and no confirmation testing is being done when a rapid test gives a positive reposnse. There is no such thing as a false positive at Ameritiox, That alone should comfort people rather than enrage them about the cost. If you want to rage, lets talk gas or oil prices set by OPEC when we only import 20% of the oil we consume.

The rapid disposable test used by price concious labs aren't being confirmed by GCMS despite all drug testing protocols. There is a protocol for drug testing and ameritox is the only company I have ever seen to actually follow it. It's not scare tacticts, It's the right way to do it.

I've never asked for more than anything but help in dealing with pain and if part of that help means drug testing I'm more than willing because the option of continued care or 0 quality of life isn't a hard choice for me. iF your not faced with the same choice, simply opt out and go find a doc that will prescribe to anyone up until the day the DEA slams his door or you get a false positive from a 20 dollar test and find yourself going through withdrawal.

Everyone claims they couldn't function, couldn't work, couldn't be a parent without their meds, Their pain effects their quality of life but 400 bucks is too much when it comes out of our own pocket?. Is 400 really that much when it comes to your quality of life. One Coach handbag, One round of golf at Kings mill, Going without one cup of starbucks a day for 20 days a month will cover the cost.

Graciously this company discounts their cost to anyone making less than 60K a year but that's not enough? You can't have absolute accuracy for free, You can have a disposable inaccurate drug test your doc can't even name that doesn't confirm their presumptive findings for 20 bucks a pop, but it may cost you your continued care. The decision really doesn't seem that hard to anyone that truly needs these meds to function.

Anyone that knows UA protocol please name the alternative so we as patients can dictate to our docs what lab we use, what test we should allow and what test we should refuse. If that sounds absurd, it's because it is. GC/MS confirmation is the proper protcol. Those that want less, find a doc that doesn't know or care whether the test or lab he uses follows proper UA protocol.

There is a reason beyond some conspiracy theory scare tactic that makes Ameritox 10 times more expensive than the rapid test most docs are using. It’s because they are accurate without any doubt. They confirm their initial testing and follow the protocols every Tox screening company should be following.
Take care, Dave

Kissa 05-25-2008 10:49 AM

Re: Ameritox drug screening
Personally I can not afford $400 a month, it is the difference between eating and or paying my mortgage. $200 a month would still mean I would have to go without some necessity such as medication or food. It would be especially difficult if this where something that were done on a regular basis. I would have to find a new PM or suffer in pain.

I would never qualify for free because of the amount my husband and I make on disability. It also doesn't take into consideration my mortage and monthly medications. We didn't plan to stop working, no one does, and when we purchased our home that wasn't a factor nor was the fact that we take at least some 20 medications a month between us. We spend sometimes more on medications which are necessary than our mortgage.

I see your point, accurate is very important, no arguement there at all. But unfortunately not everyone is blessed enough to be able to pay such a tremendous amount.

Executor 05-25-2008 05:41 PM

Re: Ameritox drug screening
Shoreline (Dave)- Your point of accuracy is a good one. However, if accuracy is the only issue, there are other urine tests that are far less costly that have reasonable thresholds. Additionally, blood tests are deadly accurate and far less expensive. Legit PM docs shouldn't be dismissing patients with $20 UAs. Additionally, proper PM protocol calls for Docs to discuss any testing issues with the patient before dismissing.

However, with all due respect, I think you missed the point that most are worried about....It's not just the cost (although that is a major issue), but the statistical analysis that accompanies the test. A good portion of the $400 fee goes to the statistical analysis that gives Docs recommendations based on your serum levels & etc. Part of the fee goes towards this vast database. I have little to no faith that this data is of any real value.....The company is heavily promoting the concept of adjusting meds and changing regimens based on the testing outcome. However, everyone metabolizes meds differently and everyone gets different therapeutic effects from their particular regimen. Granted, part of this is a horse and pony show to justify their cost structure, but nevertheless, I don't want my test results / medical history pooled in their data base.

Thus, it's my opinion that the test is overkill....One doesn't need such a comprehensive UA. I'm all for regular UAs or blood work....But the cost must be reasonable. I also strongly disagree with medical tests and procedures being priced according to income. The middle class are being hammered already.



Shoreline 05-26-2008 04:43 AM

Re: Ameritox drug screening
Kissa, Your preaching to the choir abut med costs,. I went 3 years without any prescription insurance and I still hit the doughnut hole every year since medicare came out with a prescription plan. . I still have to make sacrifices and pick and choose what meds I take long after loosing my home from being dissabled by intractable pain and going 2 years with 0 income and no insurance. The cost is a problem and if you and your husband make less than 60K that cost is cut in half or waived entirely. Yes the cost is expensive but what does it cost when you lose your doc because some local tox lab claims to be using the most advanced rapid testing methods but not following protocol and confirming the presumptive results from the UA. I spent years on meth which was horriable but I had no choice, I've gone without heart meds following a heart attack beause I had to choose between feeding my daughter and taking a med that may or may not help prevent another MI.

So my opinion doesn't come from a place of it doesn't effect me so it doesn't matter. I have topay the entire bill because my wife and I Have never qualified for any type of assistance despite the loss of 2/3 of our household income. However an innacurate test that hasn't been confirmed would effect me even greater and cost me far more than 400 bucks should I have to start the PM jouney all over beause a lab doesn't follow protocol or uses blood testing that has a huge problem due to the limited acuracy window.

Exec, I have no clue where you get your information as far as how Ameritox spends their money or comes up with their price, but even the most expensive UA still has to be confirmed by GC/MS or they aren't following protocol. I know this because my brother is Quality control and the FDA liason for one of the largest and oldest pharamcuetical companies in the world. Where are you geting your info Exec?

Blood testing has the shortest testing window as far as detecting illegal drugs, so it's not an apropriate way to rule out the use of illegals. Some meds can only be found by GC/MS. Please name the UA and manufacturer that makes a test so acurate that confirmation by GC/MS isn'tt required, Which test did you say your doc uses that doesn't require confirmation of a presumptive positive?

Even if a lab used the cheapest test available, if they follow medical protocol for confirming any positive results, you would still pay for GC/MS confirmation. It would drive the price of a cheap test to the same level ameritox is charging if they actually confirmed their presumptive results. Ameritox uses a standard of chain of custoody that can't be disputed in court and follows protocall that can't be disputed in court, But you know blood work is more acurate than GC/MS? It's kinda strange how people feel entitled to the best of evereything untill they actually have to pay for it. Then there must be some conspiracy to defraud the patient by actually following standard protocol.

Your basically saying don't bother with confirmation or use blood that has a window so narrow most could indulge in anything they want up to days within a doc apt and not worry about a thing if they tell their doc they are happy to comply with drug testing but only blood work, because you know that's the most acurate way to prevent abuse and diversion based on your years of medical training. Many docs would say your wrong, blood work isn't more acurate than GC/MS for the purposes these test are being given. You once said you have one of the best docs on the east coast, does he do blood testing and why not if it's so accurate.

Ameritox isn't making recomedations to adjust medication levels based on the results or any information they gather that your suggesting, They simply follow protocol, They send the patient and the doc the results and it's up to the doc to decide what to do with dosing if testing determines a level is disproportionate to the actual dose. I've actually seen and gone over my own ameritox drug report and there were no sugestions made based on statistical analylysis. How much do you think GC/MS costs and how many times have you dealt with Ameritox to make those assertions about the cost of doing things the right way?

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