Conversation today, probably one that millions of people suffering under HMO regimes across this great land of ours have experienced in the last 24 hours. Oh, for the balanced democracy of a PPO!:
Me: Hi, I got a message that I'm being referred to Dr. Urologia. I wanted to check to see if you all had sent the referral yet?
Nurse Perkypants: Yes! It's on Ms. I-Do-Referral's desk and should be processed. All you need to do is call and make the appointment!
Me: [to self: Mmmhmm, I'm sure it will be that easy]. [To Nurse PP]: OK! Thanks!
[Click]
Three hours later....
Me, after significant period on hold: Hi, I've been referred by my primary care physician to Dr. Urologia for an appointment.
Appt Dragon Lady: What ist thy insurance plan?
Me: The HMO from Hell, or HFrH, as we like to abbreviate it.
Appt. Dragon Lady: Well, hast thou a referral? If thou art on HFrH, we cans't make thy appointment without thy referral. [Translation: You do not exist to us unless your PCP confirms that you exist and, more important, that your bladder exists.]
Me: Yes, they said they've processed it. But just for the record, I technically do not need a referral because my insurance has a pay at point-of-service option.
Appt. Dragon Lady: Well, thou still needest thy referral. We shan't maketh thy appointment without thy referral in this, the kingdom of the urological speciality where Dr. Urologia reigns as queen.
Me: No. I do not. But anyway, I should.
Appt. Dragon Lady: [Pause. Pause. Pause.] I looketh. Dids't they at least giveth thee a referral number?
Me: No.
Appt. Dragon Lady: Well, I doth not see nary a referral for thee here!
[Dead silence. More dead silence. I feel my existence fading away, pending the transfer of said referral.]
Me: Well, I guess I'll just sit here and suffer until that it arrives! Hope I don't go septic! Thanks so much!
[Click]
I never had this kind of trouble in the Republic of PPO. Viva la Revolucion!
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5 comments:
Yikes! Are you okay?
I'm still trying to remedy the double-charge our pediatrician billed us in November. We need a new medical system.
Love the tags -- mockery! bullies! -- for this post. Thou hast made me wetteth my pantaloons.
Well if it makes you feel any better, our insurance is considered "choice plus" and they don't require referrals or give authorization numbers. but you call and make sure it is a covered benefit, and then you go through the procedure, and then the insurance denies it. Then when you call and say "Hey you said this was covered?" They say "Yeah, I see that here in the notes." and then after being transferred for hours and hours and days and weeks and months someone finally says "Nah, that's not a covered service. You can appeal if you want." If I only got paid for resolving our insurance crapola, maybe I could pay off our deductibles... I feel for you!!! Not sure which is worse: health insurance or special education.
Well there is always the alternative approach
http://uk.youtube.com/watch?v=HAtA2NH6Xfg
So frustrating being on hold and those Dragon ladies get every where!
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