About a month ago, I mentioned in a post my frustrations with my insurance company and some issues between them and my DME provider. You may remember this lovely picture of my notes and frustrations in dealing with this issue in the first place.
The first thing is that my files are now much more organized and sorted out. The frustration has been lowered, so I was able to address the organization skills I needed to deal with these things. After a long time I finally heard back from my Health Insurance provider:
The letter states two things, first they screwed up entirely in their benefit quote to both myself and DME company and what my coverage should be, but also that this time only they will reprocess the claim for me. The funny thing is a day after I got the letter I received an EOB from the insurance company, with the old numbers on it, but saying it was amended, plus a new bill from the DME provider stating this was the reassessed bill. According to them I owed about $615.00 still. At this point, I was done with this. The numbers had changed barely, but I was just going to pay the bill. I HATE having pending bills.
Friday if you look at the bottom of the letter from the insurance company you will see a NEW EOB. This was the real, reassessed insurance claim. Apparently now I only owed $13.14, but wait I just paid the bill on Friday. So now what? Well I called the DME provider and spent a good 20 or so minutes on the phone with the billing representative. I truly felt horrible for her, I can only assume that her computer desktop was in the same state of everything else I was dealing with. Screens all over the place. There were payments, reversals, and everything else from the insurance provider along with other things going on.
Finally we sorted this crazy stuff out. Lo and behold they are able to refund $600 and change to my credit card, since they were obviously going to keep the $13 they were entitled from me. What a headache, but I won this battle!!!
While this was going on, there was another battle ensuing. And I am hoping I might be able to get an opinion on this situation. I haven’t really been happy with the staff of my doctor’s office for some time. Their ability to return calls and handle simple things hasn’t been the easiest for me. Back in November/December when I was trying to reschedule an appointment after needing to cancel it, it took me more phone calls and messages than I should have had to deal with to get my appointment.
This time the issue is with refills. Granted the first half of this story is not the fault of my doctor’s office, I think. Usually when I get to the last bottle of insulin, I know I have x days until I will be out. So I usually check my pharmacy to see where my refill status is. The morning I checked I was able to refill both my thyroid medication and insulin. The one issue is that I was out of refills on my insulin. Normally not a problem. I went to the pharmacy early in the day and got my one prescription, the insulin was not called in yet. No problem.
Tuesday comes and goes and no email saying my prescription is ready. I call the pharmacy Wednesday to see if they heard from the doctor’s office. Not yet, check back later in the week. I give them a chance to gather themselves on Thursday and call again on Friday. Still nothing. Monday rolls around and I call my doctors office and leave a message with the refill department and check with the pharmacy to see where things stand. Still nothing. At this point I am beyond frustrated. The pharmacy technician is understanding and says we’ll have the pharmacy call Dr. N’s office…. Wait, who? Dr. N. Oh, well that’s the problem. (Dr. N was the first prescribing physician who had my Humalog prescription when I started pumping. I’ve been on a different doctor and insulin for years.) Apparently, when they transferred the prescription over, they never changed the doctor’s name, granted I am using Novolog anyway. So the pharmacy now calls the right doctor and we wait. Wednesday rolls around and nothing, so I call and leave my second message of the week with the doctor’s office. Thursday, NOTHING. So Friday I call again, and finally hear a voice and not a message.
TWO WEEKS to get a refill, mind you the first week was the pharmacies fault, but you would think Dr. N’s office would respond back and say, “He isn’t a patient of ours.” Nope. My doctor’s office never returned any of my calls. The first one would have been simple to say, “Sorry we never had a request.” NOTHING. They took a week to get things sorted out, after multiple calls and requests. What’s the point in driving the hour to get to an office, that isn’t really all that helpful?
I like the doctor, more or less. I am just not that happy with everything else that is going on there. Now, I don’t have an emotional bond or tie to Dr. M. He’s nice, but there are other nice doctor’s out there. Would you stay with the office or strongly consider leaving it?
Filed under: Diabetes
