Gad is also expensive, roughly $200-$500 a dose, on top of the already pricey MRI. So I only order it when I need it.
A few MRI places (not most, just a few) try to push giving gad, even in cases where it's not needed, just to pad the bill. Annie and I know which ones do that, and generally don't use them. But yesterday, for various reasons, we ended up scheduling a patient at one to have a study there.
So I faxed over an order that said "Brain MRI". That's all.
Annie had to run an errand, so I was covering her calls while she was gone. At one point Mary grabbed me between patients, and said I needed to talk to the staff at the MRI place, who had questions. So I picked up the phone.
Dr. Grumpy: "This is Dr. Grumpy."
Ms. Gouge: "Hi, I'm looking at your order here, and it doesn't specify if you want gad on the study."
Dr. Grumpy: "I didn't write "gad", so therefore, no gad."
Ms. Gouge: "But shouldn't we do it with gad?"
Dr. Grumpy: "Do you have my patient info form in front of you?"
Ms. Gouge: "Of course."
Dr. Grumpy: "What indication for gad do you see on there? She doesn't have any."
Ms. Gouge: "Yeah, but it's still helpful. So just give me an order for gad, and I'll take care of it."
Dr. Grumpy: "You and I both know that she has no indication for gad, and so her insurance won't pay for it."
Ms. Gouge: "Yeah, but we can bill the patient for it."
I hung up on her. I immediately called the patient myself, and moved the study to another MRI place.