What's On Our Minds

Hospitals and HMOs

Thursday, August 5th, I asked to work at home because I've still been really sick and the new medication isn't working at all. In order to get new medication, my doctor wants me to have special enzyme and genetic testing to make sure it won't make me sick (like most of the other meds for Crohn's Disease). This has to be done in a hospital, so I took the day to get this taken care of.

John planned to go to work late so he could take me. So, I go to the hospital and the Out-Patient Testing clerk tells me the order isn't signed by the doctor and if I don't have pre-authorization the test could cost me $1,800.

So I call my doc, she calls my doc, she faxes the form... all this stuff and no response. I sit there and 45 minutes later I get a return call. Doc's secretary tells me to go home while she figures out what the problem is. Hours later after calling the office a few times, I find out that recently they've started requiring a doctor's signature, but this is new to them. Also, she promises that her contacts swear I don't need pre-authorization and I WON'T be billed for the testing. She gives me a name and number to confirm this.

Long story short... instead of faxing the new order to the hospital later that day, she puts the script in the mail. I stayed home for nothing.

So Monday comes and so does the doctor's order. After work John got the doctor's order from the mail, picked me up and took me straight to the hospital. I went back to Out-Patient Testing like I did last time only now there was NO ONE there. We sat there for a while and then started calling around the hospital. No help. We finally went back up front and they told us I had to be admitted up there. So more rigamarole with the "your HMO might not pay for this and it's a million dollar test and do you have authorization."

I told the girl that I went through this last week and my doctor's office called around and assured me that I don't need one. I'm already angry from sitting around all this time.

She fills out a billion forms and sends me back to Out-Patient Testing. No one there still. John decides to run an errand since we had a friend coming over later and we were running out of time. He leaves and the plebotomist (blood-work technician) arrives.

Now she has me filling out more paperwork. And am I sure that the insurance will pay? Yes? Are you sure, because it's an expensive test...

I lost it. I told her to give me the testing kit and the paperwork back, I'm leaving. So I left once again without getting the testing done. I called John and he came back for me. I was so frustrated, I just cried and cried and cried. HMOs suck. Health care sucks. Everyone vote for Kerry/Edwards in November. At least they want to fix this kind of madness.

Posted by Robyn at August 9, 2004 09:38 AM