I just got dumped by my doctor! (RANT) - Page 2 - The Horse Forum
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post #11 of 15 Old 05-23-2012, 02:32 PM
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Originally Posted by NdAppy View Post
Even for those obvious things 90% of the insurance companies require that you follow their steps, which is go to the primary care first, get a referral to and then see a specialist. The only ones that I can go in to see without referrals is my eye doc, my primary care, and urgent care. Anything else? You better have a referral or you will be fighting an uphill battle to even have them consider covering it.
The insurance in my current company was like that too. Then they were able to negotiate to the "no-referral" one. Simplify life a lot. I wonder why one has to go through primary doctor first, because in this case insurance will have to pay to both - primary and specialist as well. I guess too many people go to the wrong doctor with wrong diagnoses?

P.S. In my insurance ophthalmologist is considered as a specialist. I assume you are talking about optometrist when you say "eye doctor"...?

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post #12 of 15 Old 05-23-2012, 02:52 PM
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Yep optometrist. I was brain farting on the right name.
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post #13 of 15 Old 05-23-2012, 06:51 PM
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Wow, how wierd. My DH keeps excellent records. He told me we had nearly $800 in credit at the dentist. I called and said I didn't want to carry a credit there, please just send me a check. Well, they said it was only 200. Really? I said I would recheck the numbers, but asked them to verbally go through a few. They got defensive! WoW....red flags!!!!! I had one missing piece of info and said I would check it and call back. The next time I called, there records magically went to nearly 500...finally, we took the records to them...and their records "magically" agreed with ours.
The point is....I wonder what would have happened if we had said, after one of us had a visit, "oh, I don't think I owe you anything - I won't pay you". Or, in the OP's case...if every patient said, "Oh, any amount of time I sit waiting past my scheduled appt - I will bill YOU for".
Doctors...ugh...I don't even want to get started!
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post #14 of 15 Old 05-23-2012, 08:15 PM
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I was a nurse for too long to be told who and when I can see. I will not be a part of an HMO. Believe me this becomes a hot topic at times-I have a dear friend who is my "adopted Grandmother"....she is 89, and her DH started Kaiser. It is all I can do when she starts complaining about healthcare she gets to bite my tongue. No HMO's ever. Thankfully, I love my Primary, but I have to drive from Va to MD to see him.......he understands I will see who I want when I want and if I need suggestions I will ask. Perfect.

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post #15 of 15 Old 05-23-2012, 09:01 PM
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Originally Posted by franknbeans View Post
I was a nurse for too long to be told who and when I can see. I will not be a part of an HMO. Believe me this becomes a hot topic at times-I have a dear friend who is my "adopted Grandmother"....she is 89, and her DH started Kaiser. It is all I can do when she starts complaining about healthcare she gets to bite my tongue. No HMO's ever. Thankfully, I love my Primary, but I have to drive from Va to MD to see him.......he understands I will see who I want when I want and if I need suggestions I will ask. Perfect.
I HATE Kaiser. I was stupid enough to get it for a year, and my mom kept it for a year or 2 as well. The worst insurance EVER with the worst choice for doctors. Plus private plans are the most expensive believe it or not.

BTW, I've had HMO Carefirst for years, never had a problem.

"Life isn't about waiting for the storm to pass: it's about learning to dance in the rain..."

"When we are no longer able to change a situation - we are challenged to change ourselves."

"How people treat you is their karma; how you react is yours."
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