Friday, January 13, 2006

Tangled Web is Costly

What a tangled web they weave when first they set out to say they are "free."

My internist said I needed a follow-up MRI for my lumbar spine, due to recurrence of symptoms. (Short History: lumbar disc surgery 1993, physical therapy off and on since then, epidural steroid shots in 2000, nerve root injections in Jan. 2002 and Jan. 2004). He said he could not order another nerve root injection (which is helping me delay a second surgery) without the MRI because no doctor would touch me without it. Last one showed arthritis, scar tissue, disc injuries, and more.

Since then I found out my doc is not on the in-network insurance list anymore. The receptionist incorrectly took my insurance card on 1-3-06, and charged me an in-network copay. She messed up big-time. I refuse to pay out-of-network price for that visit, because the receptionist should have told me that my card was no longer accepted. It was their choice not to be in contract with the insurance company, so they need to keep track of that. No way a patient should have to look it up on the internet before every visit to see if their doc is still on the preferred list.

Today the Kentucky Diagnostic Center called to schedule my MRI-it had been approved by Humana, ordered by my not in-network doctor. I asked how it could be approved if my doctor isn't on the plan anymore. I wanted them to double check because I didn't want to pay full price for an MRI just because of a clerical error on their part. They checked into it, and sure enough, Humana made a mistake to approve the MRI, and I cannot go there until I find a doctor to order it who is on the plan, even though the diagnostic center is on the plan. What a mess!

This also means my prescriptions are being questioned, and I can't get the bloodwork to monitor my use of Methotrexate (a low dose chemotherapy for my autoimmune disease). Normally I have to get my liver functions and blood counts checked about every 2 months, and it has been since September, due to all of the various runarounds I've been getting (doctors leaving the area, doctors changing insurance, etc). Admittedly, I had also canceled an appointment out of frustration when I found out my rheumatologist was moving away-I should have kept that appointment.

What happens to people who don't ask questions of these "professionals?" No wonder medical care has bankrupted so many patients. Who can literally AFFORD the errors and incompetency of the ones we trust with our health?

It shouldn't be called health insurance. It should be called "we get you coming and going" assurance.

Okay-off my soapbox.

1 comment:

Terri said...

I wish we could go back to the good old days where we paid our doctors cash and didn't rely on insurance companies. If we put our insurance premiums in the bank when we were young and invested them, we'd have plenty of money in the long term to pay for our care. (at least most people would) Insurance is a business, medicine has become a business, regulation and litigation have skyrocketed costs of medical care. Socialized healthcare won't help us (people with power still get seen way faster in those systems than the average person, and more needed treatments are denied than with our system) There must be another solution! Where's the genius who'll figure it out? (