... at least not while there are doctor's office like this out there.
OK, this takes a little detail, but bear with me.
My daughter finally landed a full-time job with benefits. After the 90-day waiting period, she qualified for health insurance and was more than ready to ditch Medicaid.
As the world turns, she needed the coverage even before she got my grandson to the pediatrician.
On January 5, 2009, at about 645pm, my thirteen-year-old son and my five-year-old grandson were horsing around in the basement (which is where we send them to beat on each other) and the little one jumped off an eighteen-inch-high pillow, landed on a thick carpet ... and broke his leg.
So he went to the ER, got x-rayed and set up to see an orthopede for a cast 48 hours later. This, of course, now required a call to the pediatrician's office to get a referral.
Even though that office had received both the cancellation of the Medicaid and the new insurance number, they promptly called the hospital and told the orthopede's office that the kid didn't have any insurance. Fortunately, the hospital called us back, and then we called the pediatrician's office to say, What's your problem? Oops, they said, we do have that number, don't we?
So that gets straightened out, right. Yeah, sure it does.
The next week the little guy had to go see the pediatrician for a rash that had developed around the cast.
They usher us right into the examining room without ever doing the has your insurance changed, give me your card, and where's the goddamn co-payment routine, which I found peculiar.
When we were through, I asked the doc if we needed to check out. No, she said, you're done.
Except that this new insurance has a $25 co-pay....
So I said (like an idiot): What about the co-pay under her new insurance?
What new insurance? She's a Medicaid patient, they tell me.
No, I said, she's not any more. Don't you remember that whole bit last week?
Oh. Yeah. Here it is. Right. Can we copy the card?
Me: actually, i don't have it. My daughter's at work in Pennsylvania, but I can bring it by tomorrow or the next day.
What about the co-pay?
We'll just get it then.
The next morning the doctor's billing department calls my wife to threaten that she was going to bill us for the whol cost of the appointment if we didn't get that card to her like twenty minutes ago. My wife, recovering from back surgery, still can't drive; my daughter and I are both at work until after the office closes. She explains this. She explains that they've got the account number and that they refused to take the co-pay yesterday. The woman reiterates her threats.
The next morning, minutes after the office opens, I show up with THE CARD. They take it and photocopy it, but still don't collect the co-pay. Why not? "We only take that at the time of service, or we bill you for it." The woman telling me this is standing beside a sign that reads (essentially): If you don't pay your co-pay at time of service we will add a $15 fee if we have to bill you.
I say... Well, you can probably fill in the blanks here.
She says, Well, if you couldn't pay the co-pay yesterday, then we'll have to bill you. And if you don't pay the late fee, we won't see your grandson again unless it's an emergency.
BUT I TRIED TO GET YOU TO TAKE THE F**KING CO-PAY YESTERDAY AND YOU REFUSED IT!!
(Channeling my inner donviti...)
Sir, you didn't have your card yesterday, so we had no way of knowing what your co-pay was. Therefore we couldn't take it.
But I told you what it was, and this is a standard Blue Cross policy that your office accepts for dozens of patients every day--of course you know what the co-pay is... and I told you what it was.
Sir, we have a policy, that if you don't present the card, we can't take the co-pay....
This eventually deteriorated even further but you are hopefully get the idea...
I have to be completely honest: I have spent two decades working with and through the worst that the health insurance industry could throw at anybody (I've gotten over a dozen surgeries authorized; hell, I've won appeals that extended hospital stays for as much as a week), and I have never--NEVER---had to deal with such amazing incompetence as this office.
I'd love to draw some neat libertarian conclusion about all this--but tonight I'm just pinging back and forth between bemused and pissed.
And--by the way--I have absolutely no intention of paying the $15.