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You’re kind of all over the place....
Was the rep mad at you or on your side?
By unregistered do you mean not actually a patient on the record? Or doesn’t have an appt? Those are drastically different
Is your ethical problem about payment? They are right, not your concern
Them jumping line? Again, not your concern
Not being able to do an appropriate workup to medically justify the treatment(ie being told to write a rx for a patient you did not examine)? Because then you are right
It’s important to note even if you are 100% right you can get burned, being right doesnt mean you are safe