Wednesday, August 10, 2016

Problems with Insurance Referrals

I am going to say it, I miss Regal Group. When I was under Regal there was never any issues getting problems fixed (hell, I only had to call their patient advocates like 3x and they called me once after an ER visit to check up on me), getting referrals in a timely manner, or getting doctors near me. In Dec we got switched to St Vincent Group and trouble began. I got severely sick and the closest Urgent Care and Hospital was in Silver Lake. So here I was driving around town while coughing up blood, being told "go here, they are in plan and will take you" only to find out "no." I drive for two hours to get to the one in Silver Lake. They tell me I'm no longer on St Vincent and I go "since when?! yesterday I was refused because I was on St. Vincent." They made a way for me to be seen by calling the other group and making a deal so I didn't have to keep driving around. I fought for meds, they were not the right meds, but they were close enough. I called the HR rep at work and had her deal with the insurance broker to straighten out who I had and got a new insurance card issued to me. So now I'm on Prospect. I get some doctors in the valley, Urgent Cares are here which is the important thing, mostly my doctors are midtown (Beverly Hills down to Culver City). 

So how is Prospect? Absolute shyte! I had to get 3 specialists off the bat: gyno, endo, and neuro. My gyno went off without a hitch. The endo they gave me was an internist who was not seeing new patients! His office assistant didn't even bother calling me back to tell me. I had to call a couple days in a row to figure this out. Then called my insurance to tell them. Two weeks later my gyno had to rip their asses hard to force a new option for an endo. My "emergency right now" appointment is like mid to late Sept. At least I got one, le sigh. The neuro is proving absolutely impossible so far. I've called my doc 3x to make sure they switched the CPT code to the proper one for me to be seen, YES IT IS. I have called the neuro, NO the thing they have received 3 TIMES from the insurance is WRONG. I call the insurance to figure out what the hell is the problem, one out of the four times I got some help, but it was still the wrong code. The other times I got "patients are not to call us, call your doctor. It can take up to five days to get your referral." I've been hearing this for TWO MONTHS! Oh my fracking gods.... My seizure meds are running out and still no movement on getting the proper referral for my damned neuro. I'm about to call the insurance broker to get things going on that, while I make a GP appointment because I need my seizure meds from someone. 

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