Thursday, February 13, 2014

Here We Go Again

So Tuesday, aka the day after I'd finished with the whole trying to find a chiropractor rigamarole, I woke up with pink eye. That's what I get for leaving the house the day before, I guess. Or maybe I caught it from Bob Costas, even though I'm not watching the Olympics. (Which is just as well because watching sports requiring being able to see the TV clearly and that's not something I can do with my crappy eye glasses. Not only is the prescription out of date, but the glare coating is coming off, making them less transparent than glasses should be.)

So I handled it like a sane human being. Sadly, my health insurance company (and in network providers) are not sane.

  1. I called my PCP's office and asked if she could fit me in. 
  2. Her office told me that she had an emergency and had to leave the office, so the earliest she could see me was Thursday afternoon.
  3. So I make an appointment and go bitch on Twitter.
  4. One of my tweeps suggests that I see if my PCP has someone covering for her (because how could she not?) and then call the insurance company to see about going to an Urgent Care Center.
  5. I called the PCP's office again and this time they me that she's out of the country and there's only a covering doctor on Monday and Thursday. Which this is not. So it's the covering doctor I have an appointment with, but they didn't bother mentioning that. "She's on the other side of the world. She's asleep. I can't call her to see if it's OK if someone else calls in a prescription for you."
  6. So I called the insurance company. They give me the name and address of an Urgent Care Center nearby.
  7. I have lunch because I figure I'll be waiting for hours at the Urgent Care Center.
  8. I hop on the subway for three stops and walk several blocks to the address they gave me.
  9. Which is a construction site. The building has been demolished.
  10. I call the insurance company and stand on the street freezing. 
  11. After four minutes of this, I decide to go into the pharmacy down the block and ask if the Urgent Care Center just moved, or went out of business.
  12. They give me the new address, which is in a completely different direction from the subway station than the one I'd just gone. 
  13. So I retrace my steps and walk a few more blocks.
  14. While walking, I call my husband and tell him to go on the state healthcare exchange website because we are switching companies. Last straw, thy name is construction site.
  15. I find a place with several "walk ins welcome" signs. They have a different name from what the insurance company gave me, but they are displaying signs for my insurance company.
  16. Too bad they're not taking any more walk-ins today.
  17. I start to melt down and explain about being sent to the wrong address.
  18. The receptionist them tells me that they don't take walk-ins on Tuesdays or Thursdays. Which is not what she said to me 60 seconds earlier.
  19. She then suggests I go to the emergency room. For something that is so not an emergency that I'll be waiting for hours. And paying $100 co-pay. To get some fucking eye drops.
  20. I call my opthamologist and leave a message. 
  21. I go home and call the insurance company to complain about being sent to A GODDAMN FUCKING CONSTRUCTION SITE.
  22. The first guy I speak to is like, OK I'll transfer you to a supervisor so you can lodge a complaint.
  23. The second person I speak to is not a supervisor, but takes down my complaint. She is oddly unsurprised to hear that I was sent to a location that isn't there any more. 
  24. She puts me on hold and my opthamologist calls on my other phone. I explain that I'm not allowed to see him without a referral, which I can't get because my PCP is out of the country with no coverage. He calls in a prescription for me.
  25. While I'm talking to him, the insurance company woman comes back on the phone and I ask her to hold on and explain what's going on.
  26. She then calls my PCP and finds out that there's a covering doctor at another office. She starts telling me that I can go today.
  27. I scream NO! Because I've just explained to her moments before that my opthamologist just called in a prescription and I don't need help, just to formally complain. Because, demolished building.
  28. Between her incompetence, refusal to listen, and complete lack of sympathy or surprise that they sent a sick person out into a freezing cold day to go to a building that isn't there anymore…I lose my struggle not to curse her out.
  29. I hang up, google the president of the insurance company and write him a letter explaining how much they suck.
  30. By now, the pink eye has spread to the other eye, so I've lost all chance of wearing a contact lens in the good eye and wearing my eye patch over the other eye. And this is why my opthamologist nagged me about getting better glasses. 
  31. Have I mentioned that I'm also on the tail end of a cold and I have tendinitis in my shoulder?
  32. Then I get a migraine, either from the cold, the stress or the pressure of my glasses on my nose (which is why I never wear them). 
So, how are you?

Monday, February 10, 2014

How to Find a New Doctor

People always have the same worry when switching health insurance plans. Can I keep my doctor? As a techie, I had 5 jobs in as many years with the accompanying insurance switches. Plus, at one job we switched insurance while I was there. This is not a new worry with Obamacare.

The thing is that people hate change. Even more than they love their doctors. But what really sucks is finding a new in-network doctor.

I've been seeing the same chiropractor for 7 or 8 years. First, I went to him because he was in network and close to my office. As the years passed, he became one of those doctors who isn't in any network (is this just a NYC thing?). At least this guy takes payment from insurance companies. I've had other docs who make you pay whatever they say up front and then maybe you can get reimbursed. For 70% of what the insurance thinks the doc should've charged, which is about 75% of what the do actually charged. Or less.

I see my chiropractor once or twice a week depending on how I'm doing. The migraines throw my neck out of whack, which can lead to more migraines.

So it's important, but now costs $90 a pop. Which my new insurance won't cover because there's no out of network coverage. Which is fine at this point because my old insurance (which cost more) had a ridiculously high deductible, so they hardly paid for anything. Hell, they only applied 10 chiro visits to my deductible. Out of 50+


So I decided that it's time to find an in network chiro, and then maybe switch back to the old guy once the insurance stops paying if I don't like the new one as much. Though maybe not because I no longer work anywhere near the old chiro so it's a 2 hour round trip on top of however long I spend at the office.

So here's how the search went.

  1. Check insurance company website to find docs nearby.
  2. Map out each address to see who's closest.
  3. Check them on zocdoc to see if they have any really bad ratings.
  4. Find a doc 3 subway stops away.
  5. Call to verify this doc is actually in network. No one knows, but his name is in the directory and he actually does work at that number (unlike the 3 other docs I called) so I figure I'm good to go.
  6. Get referral from new PCP whose waiting room is a new kind of Hell, but she's within walking distance, so whatevs.
  7. Call to make appointment and discover that he just has walk in hours. 10-12 Monday Wednesday and Friday, last appointment at 11:30
  8. Go there on Friday rushing so I make it by 11:30
  9. Discover that he didn't come in. The front desk has no idea and the physical therapy people who works in the room he uses don't know either. Though they say he leaves at 11:40 not noon.
  10. Call the office on Monday at 10:30 to see if he's there.
  11. He isn't. Front desk and physical therapists have no idea.
  12. Repeat on Wednesday. No one has any idea if he's ever coming in again.
  13. Repeat steps 1-3, finding exactly one doc who is in network and located where I can get to in less than an hour each way. But he may not accept my plan. The office insists they have to call the insurance company even though the insurance company thinks that those other docs are in network when they're not.
  14. Call insurance company to complain and ask for help.
  15. The customer service rep calls doc 3 subway stops away and gets the same vague nonsense about the walk in hours.
  16. CSR then says that I don't have chiropractic coverage. Arranges to have a supervisor call me back.
  17. Check the manual and dog ear the pages explicitly stating that I have chiropractic coverage.
  18. Do not hear from supervisor. Do get a migraine from the stress.
  19. Worry that the one doctor called the insurance company and got the same nonsense about not having coverage.
  20. Call the new new chiropractor and be told that he takes it as long as it isn't the Medicaid plan, which it isn't.
  21. Make an appointment for the one day a week this guy is in the office.
  22. Call insurance company to make sure that no one tells the office that I don't have coverage. New CSR tells supervisor to educate the last CSR.
  23. New CSR also tells me that they haven't certified that specific location for the doctor, so no go. They have to inspect it in person, etc.
  24. New CSR calls several chiropractors on the list with the same results I got - no one listed is actually in network, working at that number, or answering their phone.
  25. Oh, and by the way, the CSR says that the online search on the insurance company's website is no good for some completely inexplicable reason. She says it's just a google search, which it totally isn't. (The ex-techie part of my brain can tell the difference.) This means that there are less than 10 in-network chiropractors (listed in the big book they mailed me), as opposed to the 20 listed online. None of which are in-network anyway.
  26. This means that the jerk who didn't show up at his office wasn't in network and would've turned me away if he'd actually been there.
  27. New CSR sends the list of in-network chiropractors to the provider relations department so they can figure out WTF is going on. 
  28. The provider directory is updated quarterly, so I'm screwed until April. So back to the old chiropractor in the meantime.This is the first time this company has offered any chiropractic coverage, so it's a complete mystery whether they'll convince any chiropractors to join the network.
  29. I consider canceling the appointment with the new new chiropractor, but decide to see what they say about the uncertified location BS.
  30. The new new chiropractor calls - they were told nothing about having to certify their location. However, they were told that I have to pay $2,000 out of pocket before the insurance will start paying. This is completely inaccurate. This plan has no deductible, and the $2,000 is an out of pocket maximum, after which I won't even have to pay co-payments.
  31. Call the insurance company so we can get accurate info and call the doctor's office together. Explain everything to customer service rep. I get put on hold and then disconnected.
  32. Call again. Explain everything again. I get put on hold while CSR #4 (I think) checks. The hold music keeps stopping and going silent, which is not great for my stress levels.
  33. Rep gets back on phone and tells me that I can't see the doctor at the uncertified location. She then starts trying to call his other, certified locations and the numbers are still as bad as when I called them. She tries to find a correct number for one of the certified offices while I listen in to her talking to herself. She keeps saying, "Why is it only giving me a fax number?" It's because your software system was designed by Kafka.
  34. She calls the uncertified office and they don't know anything about the chiropractor's other offices. Just like when I spoke to them. We leave it that she'll speak to the actual doctor the next day (the only day of the week he goes to the uncertified office) and see if she can get a working phone number for one of the other locations out of him. She says she'll call me back after speaking to him, but I know better than to believe her.
  35. I spend the rest of the day nursing another hangover.
  36. Call the chiropractor to cancel the appointment. I explain why and the person I speak to says she'll take the certification issue to management.
  37. I'm tempted to try out the guy anyway, since his visits cost $50 instead of $90, but there has got to be an out of network chiropractor closer to my apartment.
  38. I consider calling the doctor when he's in the office to ask about the other locations myself, only I lack the emotional strength.
  39. I google chiropractors in my neighborhood, and find one two blocks away. I call, and get her e-mail address from her outgoing voicemail message. I send an e-mail, but it bounces.
  40. I call the voicemail again and discover that I only copied down her e-mail address wrong, and she does actually exist. Re-send e-mail.
  41. She calls & leaves a voicemail saying that she's going on vacation and won't be back until the end of the month.
  42. I call the one other chiropractor in the neighborhood and he doesn't accept private patients. I'm totally OK with this since he's in the same medical complex as my primary care doctor and I'd rather not visit The Waiting Room of the Damned on a weekly basis.
  43. So I e-mail the doctor who's about to go on vacation and tell her I'm in.
  44. And then I schedule an appointment with my old, $90 a pop chiropractor because I can't go much longer without an adjustment.
And this is why we need nationalized healthcare. One fucking network.