Okay, get this:
Since moving to my current community and finding a doctor, who started out in a private medical practice, I have had three different “practitioners” as my go-to doctor. One after another, these associates left the practice, and I ended up seeing someone new. I’ve seen three different doctors and a nurse practitioner over an eleven-year period. It’s always been a mystery to me who my official primary care physician is.
Is it the head doctor on the stationery or the nurse practitioner or new doctor who’s actually looking at me? Who am I supposed to write on all the forms when I go to see a specialist? It’s always been confusing.
Well, anyway, a year or so ago, the head doctor (or whatever he is called) decided to hook up with a larger medical entity. I didn’t know what that meant, but okay, fine, it wouldn’t really affect me. Except suddenly I could never again get a quick, that-day appointment for, say, bronchitis or an ear infection or if my daughter ended up scratching her cornea with a flake of mascara that fell as she tried to build four-inch black lashes that would do Katy Perry proud (yes, that just happened this week). Before the switch, the scheduler would always squeeze me in to see one of the doctors, somehow, that day or early the next morning at the latest.
Now when I call for that kind of unexpected problem, I usually get a machine, and I end up leaving a message. Two or three hours later, I receive a call back telling me there are no appointment times, and I am directed to go to the walk-in clinic. We have had to do this at least five times.
I’m laughing (not really) because this time, when I finally got the call back about the eyeball that was swollen half-shut and as red as the planet Mars, I was already AT the walk-in clinic, one step ahead of the game, for once. I’ve now been properly trained to just go to the clinic unless I have a scheduled appointment. Only took me a year and a half.
So, I’m wondering. Does the walk-in clinic cost my insurance company more money? Probably. And it gets better. Read on.
This year, the medical entity–with which my doctor’s office had aligned a year or so ago–merged with an even larger medical entity. The nurse practitioner I had seen for my last appointment was let go. I don’t get sick too often, so I only saw her once for a yearly check-up last summer (I’m a woman; you can figure out what that entails), but if this trend continues, how many more doctors/nurse practitioners over the years will have to get up close and personal with my up-close-and-personal? I’m getting a little testy about it, and not just because I’m peri-menopausal!
Since Christmas, I have received three separate letters telling me that I have to reschedule three appointments (a follow-up and next year’s annual exams) for myself and daughter because of the lay-off. Today, when I called to do so, I found out that the doctor who is taking over the patients is now going to be my PCP (Oh, really? That’s news. At least I know who to write on the forms, though), and she won’t do a physical until I have an office visit with her FIRST, as a new patient.
Um, I’m not a new patient. I have been a patient of this practice for eleven years. It was not my idea to switch to her, thank you, so why do I need to have an extra appointment to see a replacement doctor? I’ve never had to do that before. And what is the purpose of that appointment?
Because I am over 40 and could really care less about offending anyone, I politely asked: So are you charging my insurance company for a visit that is for NOTHING? What will it be coded as?
It will be coded as “an extended office visit.” Huh.
I don’t know about you, but that sounds to me like (ch-ching!) charging the insurance company for absolutely no reason. I said as much.
Did I want to talk to the office manager?
I was transferred. To a voice mail. But that was an accident. When I called back later, I scheduled the appointments. And then I asked more questions, and got some solid answers.
Here is the deal: My doctor is now working for the large medical entity rather than having his own practice. That is why the larger medical entity could lay-off the nurse practitioner as soon as the merger between two hospitals went through and the process of reorganization began. Still doesn’t explain why I (and my insurance company) have to pay for an extra appointment to see a doctor when we didn’t initiate the change, but I’ll explore that more later. Possibly when I alert my insurance company.
And remember the walk-in clinic? It is also owned by the larger medical entity. Do they charge more for walk-in care than a visit to a doctor? If so, does this explain why any non-scheduled health problems get sent there instead of to the doctor’s office?
I’m not a big fan of insurance companies, but, gee, this seems slightly fraudulent. Thanks to the Affordable Care Act (Obamacare), my husband is now paying more out of every paycheck for the insurance we already had. No wonder. Maybe the insurance company is being ripped-off, too! Additionally, I was told recently by the spokesperson for the “larger medical entity” that the hospitals in question were looking at a 33 MILLION DOLLAR deficit of free and reduced-cost care costs for those unable or unwilling to pay for the medical treatment they receive at the hospital. Looking at it that way, I kinda can’t blame the hospitals for trying to cut costs where they can and billing the insurance company more when they can. So for those who think that Obamacare is some “new” socialist agenda, realize that your insurance company–or you–was/were probably being charged extra anyway to cover the costs of free care for other people. (Libertarians, please feel free to chime in.)
This is not to say that my doctors haven’t been good. They have. In fact, I really appreciate the work they do, and I’ve been super happy with the care I and my family have received. It’s all this other stuff…the administrative stuff, the money stuff…
I’m not going to draw any more conclusions out of this today.
I’m sure you all have your own stories about healthcare in America gone-awry. Go ahead and post! We can all contemplate the crazy together.
And if you live in my neck of the woods, check out my series of articles about alternative and complementary health care in the Waterboro Reporter.