Monday, May 6, 2013

Time for a Change

Time for a rant! I have been using the same OB for over 5 years now (since I was first pregnant with Belle) and I have *generally* been very happy with them. There are two doctors there, one of whom I like better than the other... That being said, both doctors are very nice, one is very spunky and outgoing (I love her!) and the other is more down to business. I started seeing them because a friend recommended them, they were close to both my office and my home, and they deliver at the hospital I wanted to go to. 
Until this pregnancy, the only problem I ever had with them was that their reception staff NEVER (and I repeat NEVER) returns phones calls AND 90% of the time, when I call, I get sent directly to voicemail instead of a receptionist actually answering the phone. After I had Belle, this led me to an abscess in my breast, which led me to the ER and ultimately, getting cut open to drain (yeah, probably more than you wanted to know), BUT I do believe that if they had answered any of my first 7 calls, the mastitis probably would not have turned into an abscess, and if they had answered any of my next 7 calls, the abscess probably would have been treatable with antibiotics. BUT since I called multiple times a day, for TWO WEEKS, and only got a return call when I finally got through to a nurse, things progressed to a pretty scary state for me. 
However, being the loyal person I am, I gave them a shot again when I was pregnant with George (in part because their office was close to mine). The only issue I had with them during my second pregnancy is was with billing. After about my 3rd visit, they showed me a paper ("that my insurance company faxed over") stating that I didn't need to pay copays for my prenatal visits ($40 each). I was very excited about that, THEN about a month after George was born, I get a $400 bill from them for "unpaid copays"! I called and talked to the billing lady about the insurance paper that they said they got that supposedly said I was not responsible for copays, etc. Finally, I agreed to pay it, but, since I was on maternity leave and not getting paid myself, I would need to make payments and I specifically asked if they would continue to send a bill every month to remind me - I tend to forget to pay bills if THERE IS NO BILL in front of me). She assured me they would. However, after a few months, I forgot about it and never received another bill, until then sent me a nasty letter telling me they were going to send it to collections if I didn't pay it, blah blah blah. So, again - talking to the the billing lady to see what the heck was going on and just ended up paying it in full because I was back to work by that point. (And by the way - NEITHER of my doctors delivered George. It was some on-call lady who was a total B-I-T-C-H... but that's another story).
Fast forward to #3. I am no longer working, so going to this doctor is actually no longer convenient at all, as it is located about 30-35 minutes from our house, BUT I do NOT want to deliver at our county hospital, so sticking with my doctors, who deliver at the hospital I want to go to was why I stayed. This has been the progression of issues (maybe not in order) that I have had with them since being pregnant this time. *I should note that we have switched over to an HSA insurance plan instead of a regular plan which just covers everything, after copays are paid.
1. Took 5 phone calls to get through to schedule the "confirmation of pregnancy" appointment.
2. Nausea hit early on (while we were on vacation in Michigan). Took 4 days to get through to them to get the doctor to write me a prescription for it.
3. At my next visit, I talked to the doc about the fact that the reception staff is ridiculous at answering calls and NEVER returns messages. She said other people have been having similar issues and thought it was a glitch with their phone system.
4. Got a call from their billing department one day saying that I needed to pay 3 LARGE lump sum payments over my next 3-4 visits to cover the pregnancy and delivery. I did not have a problem with this, as we had saved enough money in our HSA to cover us up to our deductible AND insurance would be kicking in after that deductible was met, so there was a good chance I wouldn't have to pay all that money anyway.
5. Paid the first $800. Went to the next visit (after checking my insurance online to see where we were at as far as meeting our deductible, and noticing that they had not billed that $800 to the insurance company) and refused to pay the next $900 (or whatever ridiculous amount they wanted) because THEY HADN'T BILLED ANYTHING TO MY INSURANCE COMPANY for the FIRST $800. The receptionist assured me that they bill everything to the insurance company and just keep watching for it. Which I did. And about a week before my NEXT appointment (this has been almost 2 full months now), they STILL hadn't billed to my insurance company (which means, I have paid $800 to them and it is not being applied to my deductible). I call the doctor's office to speak with the billing lady and, of course, get no response. So I talk to her at my appointment the following week and she says they bill $920 up front for delivery (as a coinsurance - the amount my insurance company will not pay after my deductible is met), and I am responsible for that amount right now and we will revisit the deductible balance a couple weeks before delivery to see what else I owe. This didn't quite sound right to me, but I wasn't sure (never having dealt with an HSA plan before), so I agreed to it and went on my way.
6. Went in for my glucose screening at 24 weeks (when the doctor told me to come in for it). I got a babysitter for that visit, because I didn't want to make the kids sit through waiting for that. At the previous visit, I told the receptionist that I needed to do my glucose screening at the next visit and she scheduled the visit for a Wednesday - which meant I was NOT 24 weeks, but 23 weeks and 6 days at that appointment. When I got in the exam room, they told me I could not do my glucose screening that day because I was not 24 weeks! I was FURIOUS!!!! Not only was I paying a babysitter for this particular appointment, now I was going to have to come back, kids in tow, and make them sit through that miserable wait anyway!
7. A little later, I get a bill for lab work for over $1200! So, I check online before paying it to see where that puts me with the deductible and I see that of that $1200, only $26 is going to be applied to my deductible!!!! WHAT THE?!! NO WAY! So, I called the insurance company to see what was going on. Turns out, the doctor has been sending all my blood work to out of network labs, so they are not being applied to the deductible! I talked to the insurance lady to see a. why my doctor would send stuff to an out of network lab and b. what I could do about it because I am certainly not going to pay that amount if it's not going to be applied to my deductible! At this rate, this kid is going to cost us a FORTUNE out of pocket and we will never hit our deductible! So, she said she would call them to see why they were sending to out of network labs and if they didn't have a "justifiable" answer, I would have to submit an appeal to both the doctor's office and the lab. So, I started going through all my insurance claims and see there is over $500 in other bills - THAT I HAVE ALREADY PAID - that are not being applied to the deductible because they were submitted to out of network labs. Lovely. After a few days, the insurance lady hasn't called me back, so I call them again and she says she hasn't been able to get through to them. What a surprise. So, she is persistent and FINALLY gets through to them later that day and said I need to bring all my bills for the wrong lab into the office and they will sort them out with the lab. I had an appointment a day or two after that, so I brought everything in, and had to explain it all to the nurse, because they wouldn't just get the stupid billing lady in there, the nurse has no idea what I'm talking about, so she finally gets the billing lady, (who has been completely unhelpful to this point) who says she will have to give it to another lady to take care of. !?! Whatever. I don't CARE who takes care of it, just DO IT!
8. It has been 2 weeks and I have not heard from them regarding the billing. So, at my appointment today, I asked for a status update on it and they said the lady who is taking care of it is working in a different office today, but that they would call her to get some info for me - which they did not. Now, I was 10 minutes early for my appointment today (had both kids with me), and we sat in the waiting room for 30+minutes. When we finally got moved to an exam room, we had to sit for another 45 minutes before the doctor came in! AND she only came in, when I was FURIOUS and walked out of the room, demanding to know what was taking so long, and found her sitting at the desk, looking at a computer!!! WTF? I had heard her leave the room next to me at least 15 minutes prior! How long was she sitting there? And how long would she have left me, with two children, sitting in that room if I hadn't gone out there? I was IRATE! So, by the time she came in and did her thing, I was so mad, I couldn't even ask her any questions without completely blowing a fuse. 
Alas - I have FINALLY decided to find a new doc - even though I am almost 30 weeks... I really can't handle the stress of dealing with them every week and fighting over billing and whatnot. So, tomorrow I will be calling a new OB and hopefully it doesn't take long to get my $920 refunded for the delivery "prebilling" that the old doc charged so that I can actually pay the new doc when they need it. AND I still have to deal with these guys about all the labs... UGH. So frustrating! I guess I should have made the move long ago, but I do hate to change doctors when I find one I like. Unfortunately, I have only seen the one doctor that I like once this whole pregnancy and I've had enough of the other lady, leaving me sitting in waiting and exam rooms for an hour every time. Here's hoping the last 10 weeks go much smoother than the first 30!

1 comment:

Never enough Time said...

So sorry you've had so much trouble with you doctors at a time like this! Ugh! I can relate, but I just don't take the crap anymore. Just remember, they are only human. Good luck to you!