Healthcare is something I never gave much thought to. As a young person getting started in the world, jobs with medical benefits weren’t that important to me. Of course, I was blessed with good health and rarely went to the doctor so it was just not something I thought about. It wasn’t important. I’d rather have higher pay (more money in my pocket) than a lower check with all those deductions for medical benefits.
Now that I’m older and supposedly wiser, medical benefits play a much bigger role in my life. Especially since my mother suffered through 2 bouts of cancer and my dad has some heart issues. Granted, I’m still in good health and still rarely go to the doctor, except for my annual routine exams, but I know how important insurance is – just in case.
Well, recently I was at one of my annual routine exams and was informed that some follow-up tests were recommended. Just to make sure. Um. Okay. Well, no problem, I’ve got insurance. I’ll go take the stupid tests. Just to make sure.
Let’s take a look at the circus this whole thing turned out to be, shall we?
Monday, on telephone.
Dr. We recommend a second test. There’s something unusual with the first one.
Me. Okay. (followed by discussion of what was unusual).
Dr. Can you come in tomorrow?
Me. Yes. I’ll be there.
Tuesday morning.
Dr. We’re still not liking what we’re seeing. We probably should look at it another way.
Me. Um, okay. (followed by discussion about the “other way.”) Okay, let’s do it and get it over with.
Tuesday afternoon. (I’m still at radiology)
Dr. Yes, we definitely need to perform another procedure. It’s very clear from the films.
Me. Okay. Let’s do it.
Dr. Well, we can’t do it now. You’ll need to schedule it.
Me. Okay. Let’s schedule it.
Dr. We can’t schedule it. You’re primary care doctor has to set that up for you.
Me. But, you set this follow-up appointment. Why can’t you set the next one?
Dr. This is an actual procedure, not a test.
Me. Okay, well, they’re right across the hall. Can I just go over there and get an appointment?
Dr. Well, they’re going to refer you back here for the procedure. The appointment has to come from us. After you get the referral.
Me. So, I need a referral from my primary doctor, who has no idea what’s going on at this point, to come back and see you, who knows exactly what’s going on?
Dr. Yes. In order to perform the procedure, we need a referral from your primary doctor.
Me. So, you need to send your recommendation to my primary doctor, who’s right across the hall, who will in turn refer me right back here to you?
Dr. Yes.
Me. So you can schedule an appointment?
Dr. Yes.
Me. That makes no sense.
Dr. I can’t perform the procedure without the referral.
Me. How long will that take?
Dr. Depends on how backed up they are. Maybe a week.
Me. A week? They’re right across the hall. I’m pretty sure I can get the paperwork over there faster than even instant messaging or e-mail.
Dr. They’ll need to review the reports first.
Me. So, they’ll review your reports and, on your advice, they’ll refer me back here to take your own advice?
Dr. That’s how it works.
Does anybody else’s head hurt? Mean time, I’m stuck wondering, how serious is this abnormality they’ve discovered. How long will I have to wait to get it fully examined? What if my primary doctor doesn’t recommend the procedure?
It’s all such a headache.
How about you faithful readers, do you have any interesting stories from the medical arena to share? Any ridiculous “rules,” you’ve encountered while seeking medical treatment? I know it’s all an insurance scam to make money, but holy cow, this is just so stupid.
Word of the day: Entresol
Fun fact about me: I’m not typically a worrier.
Original post by Jansen Schmidt, September 2017. Photos courtesy Google Images.
I hope, after you’ve jumped through all the necessary hoops, that everything is okay with you! We deal with the same ridiculousness with Jack’s dad all the time. It seems like such a waste of energy, but I suppose there are some hidden rules that only health insurance companies know about and make people follow just to annoy the general population and make everything harder for medical staff to do their jobs. I have nothing nice to say about health insurance companies, so…may you be well, have a fabulous week, and I’ll send positive thoughts that your medical procedures are scheduled soon!
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Thank you my dear. I have an appointment next Tuesday for “the procedure,” which hopefully will be the end of it. It’s also annoying when you don’t get to choose your appointment time but are simply told, “that’s the only time we do these procedures.” Because, I don’t have a business to run or anything. (sigh) Oh well, when it’s your health, you don’t have a lot of options sometimes.
Have a great week and keep sending those positive thoughts this way
Patricia
Oh – by the way, I read your novella (the Druid, the Witch and Something or Other) while I was help captive in my room during Hurricane Irma. I really liked it. Tried to leave a review on Good Reads, but I didn’t see it there.
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This is a big part of why I retired from the health insurance industry, Patricia. During my career, healthcare was a matter between doctors and patients, and all the insurance companies did was reimburse their part of the expenses.
Medicare started the whole “managed care” concept and the big insurance companies jumped on it as a way to hold down claims costs. The small companies I represented continued to operate the way they always had until around 2007 or so, when they either changed or just went out of the health insurance business. That’s when I gave it up.
It never made sense to me to have some person in an insurance company’s home office – whose qualification may be a high school diploma – telling a doctor what he can or can’t do, or forcing a patient to play this merry-go-round game you’ve been forced into.
Fortunately, we found a company which provides Medicare Advantage plans that DO NOT play that game, but it only operates in our local area.
I hope whatever you have is not serious.
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I meant to ask you if either of these office was located on the entresol.
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Most of the time I don’t have any issues with health insurance because I so rarely use it. Annual visits and check-ups are almost always freebies and office visits require a small co-pay so it’s not that big of a deal. It’s just frustrating that a doctor – a so-called specialist – can’t do his/her job until a primary care doctor says it’s okay to do it. Wouldn’t the advice of a specialist be preferred over a general practice doctor? It all seems backwards.
Nevertheless, I have the appointment scheduled and will hopefully be done with this little game by the middle of next week. Stay tuned.
As always, thanks for visiting.
Patricia
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Come on up to Canada! Hope your tests prove all is well.
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Thanks Patricia. I’m sure everything will be fine. And Canada does hold a certain appeal. I’ve visited several times and always thought it a lovely country.
Thanks for visiting.
Patricia
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Ugh, what a pain! I am lucky that my insurance doesn’t require primary care physician referral – good insurance is one thing that keeps me in my day job. Hope whatever’s going on with you turns out OK!
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I know what you mean about keeping a job for the benefits. My husband took a job outside the inn last year for that very reason. Our plan is good but still has drawbacks. I guess it teaches patience if nothing else.
I’m sure everything will be fine. I have an appointment early next week so, with any luck, that’ll be the end of this mess.
Thanks for stopping by. Hope all is well with you and your house plans and move.
Patricia
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