Land of Lincoln Health
For those of you that are not aware, the Affordable Care Act has hit us square in our face. Some people call it the Obama Care. No matter what you call it, it’s going to cost you big time!
My insurance requirement could not have hit at a worse time. In a few months I would be able to get Medicare but no, I was not going to have that luxury now. Basically I will pay an outrageous amount of money for getting next to nothing.
On Christmas Day I had a stroke that left me paralized on the right side of my body.
Now you might not believe it but trying to get service from my insurance company is nearly impossible. Why I say that is because for the last 26 days I have tried to leave a message or better yet talk with somebody but to no avail. I was not the only one either. A few nurses have called and even someone from their own network called them and had to wait four days for a response.
Here is the simple thing that needs to be done, in my way of thinking.
Call original doctor who put order together for my rehab and ask him to do another one for a different health insurance company, fax it over and be done. Have the rehab people come in asap.
You guessed it. Nothing could be so easy because I was told by someone in the docs office that it wasn’t so easy. But she is also the person that thought it was important to hear a message I had left a day earlier when she was now talking with me. I told her the message was now irrelevant because I am on the phone with you. Let’s just go from here. What is obvious is nobody checked the message machine! What is also obvious is that she just wanted to get more money for the doc or found a quick way out of not dealing with me because she somehow knew I could not afford a doctor for full price. That’s one reason she was happy to hear my insurance was not part of the docs plan.
But let’s go back a little. The first problem was getting a rehab program that would take me. Sounds simple, right? Far from it. I needed both the physical therapy and occupational therapy together. I did forget to mention that they wanted a nurse to boot and I streered them away from the speech therapists, who the last time she was here, we played some childs games; rest assured that I am not going to play any game and pay $150 per hour for playing either. Anyway, the nonsense began to build.
Back to the insurance company. Before the nurse made the call but now she was trying to back off from any involvement. I was going to do this myself.
By now the only thing I had in my hand was an insurance card with several phone numbers on it. Its value was quickly diminishing with each call I made. I tried calling several times on the same day, but, as you might think, that didn’t work either. I tried to leave a phone number so that they could contact me but that didn’t work either.
After 16 days of failed attempts, I called the local rehab unit for another hospital. This is where the nurse left off. I got through without a problem and talked to someone. Fortunately they called the insurance company but did not receive a call back right away. Actually it was four days later.
You might be wondering at this point why I could not call. The answer is somewhat obvious in that I couldn’t leave a number to call me back – actually called using two different cell phones on two separate networks. Neither one worked. Then the other reason was what I was told by the docs secretary. She said she is used to talking to nurses and not patients. I wondered how many others thought the same way? Might be a road block for me.
Well here we are a couple days later. With pen in hand, the only hand I can write with even though it is not my regular hand for writing, I am ready to call the doctors office.
Ring, Ring. Hello. I ask if this is doctor so and so’s office. The reply was yes it was. Ah, I said to myself. Finally. Is she part of the Presence Health Plan? No, she is not.
What, I said to myself. I told the person that the insurance company gave me her name, as working under the Preferred Plan that they have. The reply was no. She moved to Adventists a few months back.
I thanked them for their time and hung up.
Then I looked at my insurance card i received. It said Adventist Land of Lincoln Platinum PPO 250. I thought I had discovered something. With excitement I called them back.
Well, when I presented my finding, I was told it’s not the same Adventist. Well, I was not going to prusuit this any further. Back to square one.
Does the hospital maintain records for doctors which shows the insurance plan a doctor is associated with?
How about something even simpler like a list of doctors that are on staff? This way one could try to cross-reference a list with the isurance companies, assuming you could get such a list from them. Maybe have the data sorted by grouping by such things as family doctor, internal doctor, etc. Maybe the can even do a better sort, for example, if there are two or more medical groups in a single facility, sort on the medical group and then the other group.
All this seems to be clouded in a shroud of secrets with nobody knowing anything; one line of none sense after another.
Anyway, I did look over the list that the insurance campany provided but mind you, this is no guarantee that this information is correct. For example, one of these alleged doctors that was part of this plan was not really a part of it at all! This was discovered after the fact when I had spoken to someone at the insurance company.
So my task today was to try and get a doctor that i could not be financially obglitated to for full price and was a part of this preferred insurance plan.
There I was all ready to go. Pulled up the first doctor on the list which consisted of 7 people that deal with internal medicine and another 5 that deal with family practice.
The phone number listed for a man named Joseph. That led to a place where they knew the name but told me that he was no longer associated with the place. They gave me another four names of people I could use that they said were associated with this thing called Preseence. When I fiinished getting the names I asked if they could connect me with any one of the doctors. After all I figured they would know who they worked for, right? Again I was told I would have to contact the insurance company.
Well I already had the names from the insurance company and the names I was given was not any of those dozen names,
Are you ready for names two, the second on the list?
Well I hit pay dirt and they even found my records with the resurrection. So I will let you know in a couple days how the rest of the story goes. It marks 23 days to straighten out something which should have taken no more than 1/2 hour.
Break it….
I am sure that at some point in your life you have heard of Murphy’s Law, right?
Well here we go again…
We got to the doctors office and filled out the paperwork then we were told that this doctor is not part of the preferred plan. What? I could not believe it. The info we discovered on the web showed the following:
Provider Details
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