WOMENS-HEALTH Messages for January, 2000: Managed Care can be a pain -- Part 2

Managed Care can be a pain -- Part 2

From: AMD (anonymous@obgyn.net)
Mon, 10 Jan 2000 16:33:18 -0600 (CST)

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I finally went to urgent care on Saturday after the insurance company told me I could get a back-dated referral from my PCP on Monday. An $85, 3-minute visit got me a "could be strep, but not definitely, but here's the amoxicillin to cover strep in case it is because it would take 2 days to get a culture back".

I finally got hold of someone at my PCP's office Monday morning (after 20 minutes on hold). They informed me that they were no longer taking new patients with my insurance and they had closed their roster several months ago. So, since I'm not really their patient, they can't write the referral. I called the insurance company back and they told me I needed to change to a new PCP, and have the new PCP write the back-dated referral. I found a new PCP who will do it, but the whole thing seems silly. Is the PCP's office simply a paper-pusher now?

I also found it curious that several of the doctors I called from my PCP list were no longer accepting patients from my insurance company. They all say they have notified the insurance company. I almost wonder if the insurance company is deliberately slow in updating their information so potential customers can be impressed with the size of their network.

And I've learned something else about doctor's offices. I didn't hear back from the PCP's office last week because they only have one phone line that can dial numbers with anonymous call blocking. I know I need to "unblock" my phone when calling a doctor after, but it never occurred to me that an office would have difficulty calling me.

Dr. Hill -- I appreciate your insight into the workings of medical offices and the insurance industry. As the patient, it sometimes seems that the doctors and insurance companies are conspiring to keep you from care. It's good to be reminded that the doctors are as exasperated with the system as anyone else.

Andrea

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