Why I Hate Insurance Companies: Saw a new patient a while back. Had no complaints, that's exactly what she said, "I don't really have any complaints," but she did want to stop smoking. So we talked about it and she left with a prescription for a smoking cessation drug. Got a call today, very irate, says I should have charged her for something other than smoking cessation, like the rotator cuff problem she mentioned. Yes, it's true, that was mentioned, in the context of "things that have been wrong" otherwise known as the past medical history. No need for treatment, an orthopedist was taking care of it. So where did she get the idea that I should have charged her for something I didn't address? Her friendly insurance company representative who not only told her I not only should have charged for some other service, but that she "couldn't believe a doctor would be dumb enough to bill for smoking cessation." There's a name for billing for something you don't do. We call it fraud. Do those insurance companies even bother to train their customer reps? Grrrr. posted by Sydney on
10/17/2006 06:52:00 PM
How about those medical geniuses who want to override your diagnosis with one of theirs, and pushing you to prescribe someone, while they're in a psychiatric inpatient unit.
The insurance company customer service reps are people in low-paying, burnout jobs. They are trained on most of the features of benefit plans and (usually) little else. Not at that level - at any company. You know this. I think your patient knew this, too; or if not, she does now.
The larger problem it seems to me is the mind-set among so many patients that every last cent of expense - including the cost of this office visit that was in fact social, not medical, be paid by insurance and oh by the way, insurance is too expensive isn't that outrageous?
So that annoys your patient. If she wants to blame her insurance company for annoyance, nothing is going to stop her. (Annoyance is not covered BTW). But that doesn't mean you own any of her angst. Be of good cheer, you are making your corner of the world a much better place.
This happened to a patient of our practice, but at a much greater cost. The patient wanted surgery because of family history. So she went out and purchased insurance. Well, she knew the insurance company wouldn't pay for "preventative" surgery and so she stated she had other symptoms, that had been bothering her for quite a while.
The insurance company pre-approved the surgery- but you know that fine print about possibly not paying for it- when the path came back negative, they refused to foot the bill.
They told her the nurse had documented longstanding symptoms in the chart and that it was a pre-existing condition. The patient actually called the office and chewed out the nurse for daring to document what she had been told. I don't know who was the most wrong in this case but, it wasn't the nurse.