Another in an occasional series, “Tales of a Family Doc”
The following is copied, with trivial alterations for clarity and to protect patient confidentiality (and to add one snarky comment), directly from the patient record. It represents about 75 minutes of this doctor’s work. Now back to direct patient care…...
-->Called CHME, pt's durable medical equipment supplier.
Told that, apparently, bathroom DME not covered through CHME
Hence got bedside commode, which he already has but which does not serve his needs.
I was advised that it may be that a different provider can provide the "shower buddy" commode and bath transfer chair which this quadriplegic patient needs.
Called Blue Cross to see where/what covered at 800-677-6669.
Used his ID # YMTxxxxxx155 but was advised this number was invalid. Used a seemingly older number, SFGxxxxxx610, which seemed to allow things to proceed.
Advised by agent, Sydney A, that the correct # to call is 855-641-4863. Called that number but was advised by agent Joella (nobody seems to have a last name) that the correct number to call was actually 800-676-2583.
Was then transferred to yet another number (which the agent could not provide me as her system has transfer capabilities but does not reveal the actual numbers) at Anthem Blue Cross provider eligibility.
I then listened to a prolonged message about COVID19 (one I had listened to before on a previous call) and was placed on a promised 4 minute hold (now 25 mins into my calling process). 8 minutes later I spoke with another agent, Ann. She said that she is at the first number which I called and advised that I call again 855-641-4863. This time I requested that she remain on the line until we ascertained that I was connected to the right agent.
Now, 47 minutes into my call I am told that the ID number I had been using in all previous conversations with other agents was invalid. I provided her with the first number I had used to initiate this process and was told that for that ID the correct number to call is 866-482-2250. Ann agreed politely to stay with me till we got through to a person at that number. At the 57 minute mark, spoke with Amy. She had the ability to provide me with a long description of the charges and copays of his plan but could neither tell me if the equipment my patient needs is covered nor tell me who would be the contracted provider for such equipment. She did offer to provide me with a list of contacted DME providers, led off by the DME provider, CHME, who told me at the start of this process that they were not so contracted.....
Spoke with a supervisor who said they did not have the capability to determine which of the 8 pages of contracted DME providers they have contracted with can provide what is needed. He guided me to the web pages where these providers are listed. He told me that if we were in Idaho, where the insurance company is based, then he might have advice, but not in California where they have customers but don't know the contracted providers.