Dear Debt Adviser,
This doesn’t seem terribly important in the current economic crisis, but perhaps someone else is experiencing this problem.

My physician ordered a test that I didn’t want done, but he convinced me that it was necessary. We did the test, but now my insurance company won’t pay for it because they say it wasn’t necessary; my symptoms didn’t fit the criteria for having that test run. The doctor’s office is billing me. I don’t think this is my responsibility and don’t want to pay the bill. However, my credit rating is in the high 700s, and I don’t want to lose a good credit score. I plan to talk to the doctor and ask him to write it off. But if he doesn’t, will having this bill sent to collections ruin my credit score?

— Allie

Dear Allie,
You have found yourself on the receiving end of one of our country’s biggest problems — health care. It is expensive and very confusing. Keeping track of the huge number of plans and providers adds to the expense of our health care system.

Doctors today are faced with a dizzying number of insurance policy provisions from a dazzling number of providers. It is virtually impossible for the doctor to know what is covered and what is not without a time-consuming and expensive call to your insurer. Of course, the call is expensive for both parties, so the expense of an inquiry is doubled, and passed on to you. When confusion and medical care meet, the result is usually more expense than anyone was planning or wants.

President Obama’s stimulus bill will be directing some $19 billion into making the health-care system more efficient through improved health-care information technology. I spoke to one of the wiz kids at a company called Availty in Jacksonville, Fla., that makes software for doctors’ offices that could help people like you. They see a future where you will swipe your health card at the doctor’s office and learn instantly whether you are covered for a procedure or test and what your co-pay will be.

It will be sort of like getting an authorization for a debit or credit card purchase when shopping. I recall store clerks looking up card numbers in mini-telephone directories to be sure your card was in good standing before checking out your purchase. Doing business that way today would be unimaginable. So while I feel your financial pain, I think the medicine may be on the way.

You are right to speak to the doctor about the charge. If you can reach a compromise on the bill and maybe the payback period as well, that may be the best alternative. Good doctors are hard to find, and you don’t want to toss one away if you can avoid it. If however, you feel strongly that you should not have to pay for a test you did not want and your insurance company agrees you did not need, I’ll give you the consequences for not paying the bill. You can make a choice.

If matters escalate to a collection agency, most will report the account to the credit bureaus. You mentioned that your credit score is now in the high 700s. With that score, you get some of the best rates for loans. Once a collection account hits your credit reports, your score will go down. How much exactly is hard to say, but it will be noticeable.

A lower score, say in the mid range of credit scores, may increase interest rate charges or keep you from getting a loan at all in the current tight-credit environment. It also may trigger universal default on credit card balances, jacking your interest rates to as high as 30 percent. The collections account notation will remain on your report for seven years. The further away from the initial reporting, the less impact it will have on your score. In other words, three years down the road, it will not continue to cause as drastic a decrease in your score, everything else being equal.

Additionally, you’ll have to deal with efforts by the company to get you to pay up. Depending on the amount that you owe, you could expect daily phone calls and perhaps eventually a summons to court.

My advice, although it may make you feel sick, is to compromise.

Good luck!