As a family doctor I like to take care of my patients. I’d rather that they, and I, do not need to think of their insurance limitations. But I do. And they do.
I have been keeping a little list in recent days of “Things I or my patients said recently but wouldn’t have to say if we had single payer medicare for all”
Without further ado, here is the list. Read it and weep…. or better yet, make it change-—
1---Sorry, we have the vaccine here but your insurance requires you to get your vaccine at the pharmacy.
2---Sorry. I did not notice your insurance when making the referral. I will find another specialist in your network.
3---I just found out its going to cost me $350 to get an x-ray so I don’t know if I should (She needs it)
4---The insurance denied the rx we advised. Perhaps you can afford to buy it with cash. I do think it’s worth a try.
5---Pt’s husband says it is not right that insurance company should decide which medications are covered. It should be the doctor’s decision.
6 --- (e-mail chain)
----- Message -----
From: J. E.
Sent: 9/10/2019 9:51 AM PDT
To: Aaron Mellor Roland, MD
Subject: 9/3 message
Good morning,
Someone named "Rachel (SCC) A" sent a message 9/3 that I just received because My Health had a problem. She said "always check my insurance benefits before scheduling an appt" (in ref. to nephrology referral).
Does this person work in your office? Why would my appt not be covered? I already had the ultrasound she ordered, extensive labs, and other testing.
Very concerned; please advise. Thank you~
Rae is our office manager and chief referral coordinator.The message she sent is one she attaches to all referrals as sometimes we have had surprises. I appreciate your concern and will suggest that she change that part of her message to something like "Although we try to refer only to providers who are covered by your insurance, sometimes we have encountered surprise so always check your insurance....."
If (when?!) we have a universal Medicare For All this kind of problem will no longer exist as we will all have comprehensive coverage with complete choice of provider that is free at the point of care.
7--- I wanted to let you know that I no longer qualify for Medi-Cal and that I do not have insurance at the moment. I'm hoping my my situation will change by next month.
8--- I know. That medication used to be dirt cheap and then something happened and it is now super expensive.
9--- The problem is that your insurance is denying this test because it didn’t show that you had the problem that we were checking for when we ordered the test….. which, of course, is crazy because we ordered the test to see if you had that problem, or not.
10—The insurance denied the stress echocardiogram because I did not say you had coronary artery disease which, of course, is the reason I had ordered the test, to see if your pain might be due to coronary artery disease.
11—Up till now my office staff has spent 120mins on the phone trying to deal with this and I have spent 28 minutes on the phone, so I’d like to try to get this managed right now if possible… (now on hold again)