Health Insurance is a Joke!

[LGM]

Hello,

Tried calling my doc today to get an appt. First they did not come in until 11am today so I called about 11:15 and they ask they usuall who do you see what is the problem etc. Then they said oh sorry our computers are down we will call you later. So I waited and waited and waited i finally called back and they were out to lunch. After lunch I called they said sorry what can we do. I went throiugh the whole story again and they said your doc is not in today? Why did they not tell me that sooner like this morning when I called. I guess there computer had that secret. They said your insurance since your company switched allows you to see any participating doc. Ok I called my friends got some names did some research called another docs office, yes they too were out too lunch. I patiently waited and called back they took down all my info name address emergency contact everything then said you need a card with a docs name on it call this number it will take about 4 days then we will make an appt. for you?????
All I want to so is see a doc this is crazy. I have had a very itchy rash for 6 days now and all I want is for someone to tell me what it is and what to do for it before I scratch my skin off. It seems I can get better care for my cat than for me. Oh well sorry this is so long just fustrated with my health insurance right now.

 

[Tony-NJ]

And it only seems to be getting worse.

 

[tc]

Yeah, I'm trying to figure out how to get the insurance to pay for my chiropracter. Talk about jumping through hoops, and the paperwork. Don't even get me started there. Our insurance has always had good coverage, but, when you want something done quickly, guess not.

BTW: Good to see you posting, LGM!

 

[December99]

Oh yes...insurance companies....just love 'em.....<B>NOT</B>!!!!

I am in the process of trying to have my second carpel tunnel surgery and up until now I have been totally happy with my insurance company which is a managed care company - that should have forwarned me right!!!

About 4-6 weeks ago I go to the doctor that did my surgery on my right wrist and he agrees that we need to do this. So they fax the paperwork to the insurance company for payment approval. I get denied. I call the insurance company and they tell me it is because there is not enough evidence and an EMG is needed (and this is NOT a fun test!!!). So I do the EMG last Thursday (yes, a week ago). I haven't heard anything so I call the clinic yesterday - no response. Call the insurance office late yesterday - no notice that they've received the test results. Get a call this morning from the clinic - you've been denied. Call the insurance and explain to them what I was told last night and what I was told this morning. The lady tells me they received the test results yesterday and now the appeal process begins which could take up to 15 days.....5 days minimum. I explain my surgery is scheduled for in 2 weeks. So she says she will try to hurry this through and let them know that I am waiting and have the surgery scheduled and they will call me as soon as a decision is made. Call the clinic back and explain all this to the surgeon's nurse and get hassled there and all I wanted to know is if I need to keep my scheduled surgery date or get another date. So right now I'm waiting for the insurance company to call me back and tell whether or not it's a go, and moved my pre-op appt by almost a week.....

So, yes, at this point...I hate insurance companies!!!!

 

[doxdogy]

I have been lucky with health insurance so far. But, that will change at the end of the month. COBRA kicks in for me and the premium will be $503 a month for my DH and myself. So, I guess I will join the ranks of the other Americans without insurance and just pray that I don't get ill. My doctor is getting ready to load me up on all our meds that way I can still get them on insurance and not have to fork over major bucks for meds every month.

 

[Kermit]

I seem to continuously have problems with health insurance. If they can manage to mess a claim up, they'll mess mine up. Not DH's, just mine.

Some doctor's offices are just as bad. I was about to walk out the door for a doctor's appointment last week when I got a phone call saying they had only scheduled me in for 15 minutes, and since this was my first time seeing the doctor, I'd need a lot longer, so they had to reschedule me. It was a big problem because I had to fast for blood work they were going to do, and I was starving. I told them that they had to do my blood work that day because I'm pregnant and you just don't make pregnant ladies get hungry like that if you don't have to. At first they said it was impossible, but fortunately one of the nurses is also pregnant (and so is the doctor's wife), so they agreed to let me come in for my labs. While I was there, someone didn't show up for his appointment, so I got to see the doctor anyway. It ended up being okay, but I was fuming before it was over. And I ended up not having anything to eat from 9:00 to 5:00. That's a long time for anyone.

 

[Kitty 34]

I could write forever about the problems we have dealt with as far as our medical insurance company!!!!

Listen to the latest......this happened this morning:

I woke up with another sty on my eye so knowing I had a yearly physical already scheduled next week with a PA, I called to see if she could remove a sty, also. The receptionist said PAs can't, only the "real" doctor could lance it.

So I asked if (to save me another trip) could I somehow have the new appt with the doctor the same day I was seeing the PA.

Just as she's finding (luckily) an opening with the "real" doctor right after my physical, she says sorry but my insurance won't let me see two different people in the office on the same day!!!

Can you believe that??? How crazy is that!!!

 

[CarolA]

doxdogy,
Have you looked at other options. I was going to have to go on cobra earlier this year and found a very reasonably priced product from Farm Bueara. I recommend you look around. If at all possible try to carry some catostriphic insurnace. I work in health care the bills can kill you!

 

[Kermit]

Oh Kitty, I feel for you. A sty can be incredibly painful. That's completely crazy that they won't let you see two people, especially if one is a PA and one is a doctor.

 

[December99]

You can't see two different doctors in the same day?????? Now I've heard about everything!!!! Geesh!!!

 

[WDWHound]

I am fortuanate to have a Doctor who doesn't put up with this sort of thing. I can usually see him on the same day I call (1 day delay max) and he will fight the insurance companies if he feels I need a treatment they won't pay for. I have been going to this doctor for 20 years. I don't know what I will do when he retires. Most decent doctors around here (including mine) will not take new patients.

I am curious how some of the doctors on the DIS feel about the whole situation. Eros? Deb? Any thoughts?

 

[Lynn CC]

We pay $777 a month for our health coverage
We're self employed

 

[Rock'n Robin]

My doctors all just gave notice that they are dropping my HMO because it hasn't come to an agreement with the set of hospitals that "owns" them. There are two camps in this town--my HMO is in one, all my doctors are in the other--so I have to switch. And to top it off it costs $15 each to have records transferred, even if I don't WANT to switch! They say if I don't want to switch I can pay out of pocket--yeah, right.
Now I am trying to get a new life insurance policy. I applied for it 6 weeks ago. They requested copies of my doctor's records because I have a mitral valve prolapse. The office contracts with a place called "smart copy" who comes in once a week, checks the file, and copies file requests for 2 hours--when those two hours are up, they pack up and leave until next week--whether the files are all copies or not!!! So I am paying $75 a month for "whole life" (big mistake) until they move their butt so I can get my term insurance!!
Robin M.

 

[Breezy_Carol]

LynnCC, and others, look around for coverage. And choose a higher deductible. We have to buy our own health insurance because DH is self employed and I don't work enough hours to get coverage. Our insurance is traditional, not managed care, and we pay $691 per quarter for our family of four. It is based on the oldest person's age, which in our case is 49. This is BlueCross/ BlueShield so pretty well accepted.

Another note, DH and I are both in health care. He is an optometrist and I am a physical therapist. Insurance is just as much a pain from the other side too. It is generally not the provider who is making all the money!

 

[Kitty 34]

Originally posted by December99
You can't see two different doctors in the same day?????? Now I've heard about everything!!!! Geesh!!!

Isn't that unreal!!?? I suppose if it was an emergency it would be another story...I would hope anyway!!

 

[DocRafiki]

You get better care for your cat because you pay for it yourself.

I went through the whole "gotta get the right name on your card" garbage, but I kept up with it and got them to make a few phone calls and faxes and got to get in much sooner.

 

[TheLionKing]

It's not that you can't see two doctors in the same office on the same day..... But rather you won't have both visits paid for by the insurance company.

There is a difference.

I am so "effing" fed up with insurance companies that we have decided to drop all our contracts and no longer be participating providers.

The two of us run a great practice. We are hardly ever late in the office. We schedule more than enough time to see our patients and we don't treat them like gerbils on a wheel.

If you as a patient want to be treated that way and sign up with an HMO, then you will save money on the front side but deal with the BS when you are actually in need of your care and probably be in even less of a mood to deal with it. There are some HMOs which are run very well. My opinion is that they are the exception rather than the rule. The HMOs in my location frankly SUCK!

Sure, it will cost more for the patients to see us, but frankly we feel we are worth it and don't feel it necessary to sell our services at a discount. Heck, I even drive 40 miles one way rather than them driving the distance to see a patient if the need arises. That's almost as good as a housecall!!

I am not naive to know that not all physisicans will agree with my statements.

Deb and Eros are involved in academic practices with some similar issues and some different issues. They may have different feelings regarding these issues.

The bottom line is frankly, I am pretty pissed off about the "business" side of medicine. Health Care reform is just as bad as Tax Reform. Too many parties involved with lots of money at stake and someone wins with reform and someone loses and everyone is lobbying to be one of the winners.

 

[Pin Wizard]

Do you know if your insurance will cover you at a walk-in clinic? That might be an option for you.

Ohhhhhhhhhh, the good old days when they used APPOINTMENT BOOKS and NOT computers!

I had a co-worker who went to a doctor's appt. Her annual physical I think. The question of a pap test came up. The doc told her she would have to schedule another appointment with her to get that done. RIDICULOUS!!!!!!!!!!!!!

 

[CarolA]

Speaking from the hospital side I can tell you that it is no better on this end. However, it does seem to vary depending on where you live. California is one of the worst! Managed care is VERY strong there and the docs and the hospitals have a really hard time jumping through the hoops to get paid! Some places are not as bad since the managed care programs are basically competing with more tradional plans.

 

[Galahad]

Deb and Eros are involved in academic practices with some similar issues

They may have it worse (if that's possible). Thier groups may have to deal with the same billing issues with one group of patients and then the endless public (and private) special contracts (Treat [business-wise] these patients this way, those patients another way....). If Deb and Eros' situations are set up anythhing like they are here in Tampa it's probably very frustrating. As for what you have to deal with TLK, DW has foresworn ever leaving academic medicine again because of just what you are fighting. I think there is a crisis coming whose end result may be worse medical care and less competent doctors.