Monday, January 12, 2009

Knittin' in the ER

(NOTE: No babies or mommies were harmed in the experiencing nor writing of this post.)

Gosh, where to start? I feel like a different person since Thursday afternoon. I'm going to have to give you the bullet point version of this story, or Zuul will be off to college by the time I finish.

- Thursday afternoon I got a call from my OB's office telling me that they were no longer contracted with my insurance coverage AS OF NOVEMBER and that would affect the out of pocket cost of seeing them. "Some people got letters." I wasn't one of them.

- I freaked out, but I had an appointment already set up for my regular check-up on Friday and decided to handle it with them at that time.

- Friday morning I saw first the Billing Lady who made me cry by telling me that instead of costing us $200 out of pocket for delivery (not including the hospital's fee) it would now cost us over $1000. This does not include any other visits either. She could not tell me exactly how much the difference would be, only that I would be responsible for 40% of the cost and the insurance would cover 70%.

- Apparently my baby is special and requires a total monetary contribution of 110%.

- I was sent back to the waiting room crying to wait to see the office manager.

- The office manager came out to get me and asked me if someone was going to be able to look after my baby while I went to her office. "I don't have a baby yet." I guess she saw someone else's empty baby carrier and got confused.

- She told me that I needed to tell her what was said to me because "nothing you've been told should have brought you to tears." Um. I'll be the judge of that. Perhaps you should wait to find out what exactly I've been told.

- At some point she said, "Ah, so you've already delivered." Um. No. Are you talking to the right person, lady? I'm sitting in front of you with a giant belly crying because my insurance changed MID-pregnancy. Isn't that what we've been talking about?

- I was sent back to the waiting room, having told my story to someone who did or did not know who I was, who told me that she would work out a "continuation of coverage" with the insurance company.

- I waited an hour. At that point I decided to stop being polite and start getting real. "I've been here for an hour and still haven't seen the doctor. You guys don't seem busy, did you forget about me?" They had to find my chart and brought me in.

- The doctor was nice and apologized for the misunderstanding about the insurance and assured me that everything would be fine. She also reminded me that I would need a Rhogam shot that day due to my negative blood type. Oh yeah.

- I scheduled my next two routine visits and left.

- Halfway out of the parking lot I remembered that I wasn't given a shot and went back in. Good thing my medical caregivers are thorough and remembery.

- They informed me that I would have to go over to the hospital across the street and get the shot from Labor and Delivery. I went, carrying my prescription and a print out of blood details.

- Labor and delivery doesn't do these shots. They sent me to the in-hospital lab.

- The in-hospital lab doesn't do these shots. They sent me to the ER.

- The ER can do these shots but don't seem to know much about them. They checked me in.

- I told them I needed the shot because of my negative blood type. (Should I have to explain to nurses about my routine medical needs?) I answered a bunch of questions that seemed strange to be asked, and they put me in a room.

- They tested my blood to verify my blood-type. Why they couldn't call the doctor across the street for verification of my blood-type, I don't know. I didn't think to insist that they call because I was trying to keep my cool in the face of the frustration, and I shouldn't be telling my medical care professionals how to take care of me, should I? Or should I?

- The nurse who took my blood accidentally pricked her finger, so I had to sign a waiver allowing them to test my blood for HIV and Herpes in case she had been exposed to my deadly germiness. (I know this is not a personal thing, and that they would have done that with anyone, but it's a strange position to be in, especially when I could hear this nurse down the hall going on and on about how scared she was about it)

- TWO HOURS LATER: A different nurse came in to give me my shot, and then left because she forgot to bring a syringe. She came back to find my sleeve rolled up. "This shot goes in your leg." "Oh, bummer," I said as I prepared to drop trow. "Although, you've got meaty arms, so we could try to do it there." Thanks tiny nurse, what a strange way to kick me while I'm down by insulting my weight!

- I got my shot.

- I asked if I could talk to someone about billing. They said they don't have a list of fees and that I should call the actual billing department. They gave me a number.

- I was discharged, finally, a full 6 hours after I'd shown up for my appointment that morning. Not having eaten nor had anything to drink since 8am.

- Once I got home, I called billing. They don't have a list of fees and asked me to call the ER. I told them that the ER gave me their phone number. Apparently, no one knows how much anything costs except that just to check in to the ER charges $200 to the insurance. I kept thinking as my blood began to boil that it wasn't even an emergency.

- I called the doctor's office to tell them what had happened. The receptionist said she'd have the office manager call me back.

- She did. I picked up the phone. "Hello?" "Hello, is this Cynthia Strong?" "No, but it is Natalie Strong, am I who you are trying to reach?"

- I let her have it. Once again she didn't know who she was talking to. She made a bunch of excuses for everything, none of which were valid, including that she didn't know what had been said to me about my insurance that made me cry (didn't we talk about that in person?!) and that they are really busy because they just opened a cellulite treatment and liposuction division of their practice (are you telling me that bumpy asses are more important than properly treating a pregnant woman?! You can kiss my bumpy ass!!)... and she followed it all up by letting me know that she has a background in law (um. Ever heard of malpractice? Maybe you should help your doctors avoid that.)

- The weekend passed pleasantly once I stopped crying again.

- Today I called the insurance company to apply for the continuation of coverage that was supposed to be so simple to get. The insurance company only allows you to apply if your coverage has lapsed, which ours has not. If the provider drops them, they have no obligation to me whatsoever.

- I'm waiting for a call back from the office manager and have set up an appointment with a different doctor who is in my network and whose office is much closer to my home and who went to USC. It sounds like the best solution... mostly.

- I don't actually want to switch doctors, 'cause I like the doctor, but the staff is too inept for me. I can't hold their hands through my first pregnancy. Perhaps the next time around I'll be a better help.


viejo fuerte said...

What you should do but probably won't...
1. file a complaint with the county medical society.
2. Call the hospital, make an appointment with their patient advocate..No patient advocate call the administrative office and ask for an appointment with the hosptial president. you will get to talk with someone. You cannot imagine how much they hate unhappy customers. Present your hospital visit case calmly. Give 'em hell.
3. Look into filing a complaint with the state medical insurance commission.
Remember..there is always someone in charge and they hate problems.

Rebecca said...

how awful and frustrating. i hate that you had such an experience. i suggest you take viejo's advice stat!

amanda said...

1. I concur with Rebecca: listen to Viejo. Remember, he spent 37 years in the healthcare indusry before slipping into retirement.
2. I'm so happy that you're willing to hold the staff's collective hand during pregnancy #2... that means there's going to be a pregnancy #2!

Senora Fuerte said...

I am seriously considering these options. What do I absolutely plan to do at the very least (or to start with) is write a letter to the actual doctor and tell her what is going on in her practice. I truly believe that the office manager of her practice has behaved badly both as an office manager and as a human. She did not treat my problems as personal and serious matters, as I believe she should have done, and she made her personal matters a part of our interaction, which I don't believe she should have done.

Shannon said...

I would like to apologize on behalf of doctors everywhere...