Here is a story that is going on that I thought I will share with everybody. I usually don’t post too much personal stull on here but I have to vent some and I thought I tell you a story and see what you all think.
Earlier this year my company has made adjustments to our health insurance. I have found out that with this new insurance and also with our previous insurance that our health care provider, Humana provides free yearly physicals exams that are 100% paid for. After discussing this many times with my HR department and our Humana Rep I finally agreed to get a physical that have been long overdue. During this time I had to find me a new family doctor for my last doctor retired many years ago and I thought getting a physical with a new doctor would be good to get to know one another.
I have scheduled a physical on 2/11/13 with Dr. Reynolds for he was accepting new patients and my older brother attends the same practice (I have verified with the office 2 months later to see what I was scheduled for and I was in deeded scheduled for a complete physical). When I get to the office I told the nurse that I was here for a physical. When called in (after a long wait) the nurse took the basics, blood pressure, weight, height, etc. and asked why I was there. Again I responded I was there for a physical. The doctor came in, asked questions check heart, breathing and the basics, and then we sat down and went over the paperwork that I have filled out. In response to some issues that I had he told me that he would prescribe me some medicine for some issues that I had. I did not ask to be diagnosed or to have any treatments. He told me what I was to do and that I would need to come back in 30 days. With that in mind I was not even thinking of coming back at all. He then asked if I ate and yes I have had breakfast for my appointment around 11:00am. In response to that he said when I come back we’ll do the blood test for I needed to fest. Nobody told me to fest in the first place for the blood test so now I have to come back for the blood test.
For Humana to cover the physical a blood test has to be performed so I set up a second appointment telling the nurse that I have to come back for a blood test and that it would be a continuation of my physical for nobody told me that I had to fest. Waiting for me next appointment I receive a bill from the Christ hospital saying that the first visit was an office visit. I checked in with my insurance and they are charging the visit because it was labeled as an office visit and not a physical. I also asked Humana about the second visit and they said that I need to call the doctor’s office and have the visits changed to a physical and then they would pay for my visits and blood test. Humana gave me the name of Bev as the office manager to talk to. After numerous calls I finally got to speak to her and explained the coding issue and that it need to be changed from office visit to physical so that my insurance would pay for like I was told.
On 3/13/2013 I went back the doctor’s office to get my blood test for my physical. Again when I get to the office I told everybody who asked me why I was there that I’m back to finish my physical and get my physical blood test. On 3/14/2013 Dr. Reynolds insisted that I come in to talk to me about my blood test. During his talk he told me what was going on and then told me what I was going to do. First thing is I don’t like to be told what to do. I expect things to be talked about and then given options of what it is needed to be done. He went ahead and ordered me more meds. I still have not stopped by and picked those up and I don’t plan on taking anything. I would more than likely seek another opinion then do anything he tells me to do.
4/3/2013 I just received another bill for all three office visits. I log into Humana and still the visits are listed as office visits and not physicals. To me this is some kind of bait and switch. You go in for one thing and then told that it’s another and you owe them money. Humana has denied the blood test for it was not coded as part of a physical. I will take responsibility of the last visit when the doctor had to see me and discuss my results for I do believe that would be a diagnoses and not physical.
On 5/17/2013 I received a call from a Theresa that is the coding person for the office. I called her back and things did not go to well. Since I received a prescription (one I never asked for) for my nasal problem (I was using affrin for years and knew that it can be addictive but never asked to be treated for symptom or even cured) and for my asthma (which was just talked about but never diagnosed for no tests were ever done but again did not ask for treatment for symptom) that a physical was never performed so it was coded as an office visit. Now understand the only reason why I went in the first place was for a physical and now I am being told that none was performed. I asked Theresa what a physical is so I can better understand of when the physical was performed and when the diagnosis has started. She could not answer the question. Of course they do not call it a physical, they call it a wellness program. So I keep repeating that I was there for a physical and nothing else and she kept cutting me down. I then kept saying that I did not request or wanted any treatments but tremens were performed her response to that was (can’t quote me exact words but along the line of) if you come into our office and the doctor sees that you have a heart problem and dose nothing about it. Then he lets you go home and you have a heart attack what’s going to happen… (I was speechless) you would come back and sue the doctor.
I’m like WTF. If the doctor did nothing I can see that, but most doctors would talk to you and let you know that there is a major problem and discuss (this is a magic word, for this doctor told you the problems and what he will be doing to fix them but not give you any say into what you want) the problem with you. She then told me that they were nice enough to charge me only for the office visit and not for both the office vista and a physical. I like so I didn’t get charged for a physical that I was there in the first place and she said yes that if I wanted I can come back and get one since I was never billed out to the insurance in the first place that I was still entitled to a physical and if I wanted I can go to a different doctor for it. After a time we both started to raise our voices and I was pissed so I just told them that they can talk to the insurance company and my lawyer.
So after that very uneventful phone call I had my HR email our insurance company and the response is that they can only go off the coding of what the doctor’s office puts down. So let’s get this straight. The only reason I went was for a physical that was not a physical but I have received a rebate check from the insurance company because they think that I went for a physical that was not a physical. So in turn I and the doctor’s office just committed insurance fraud for it was to be a physical but the doctor’s office decided to use the office visit code to make more money. Beware for this doctor is here to make money and not to help you at all.
6/1/2013 I have just received another bill for all three office visits. I plan on paying the third visit for it was a diagnosis on my blood work and have considered maybe on paying the second one for I was stupid for going in and should have just say bite me in the first place but I will not pay the two hundred plus bill for the first visit because it was to be a PHYSICAL!! That is paid 100% from insurance.
Wwwhow sorry about the rant but I don’t like getting screwed so I normally don’t post much on Facebook but since I can’t get anything done to correct their mistakes I will just raise my voice and complain to everybody and tell them to avoid The Christ Hospital Outpatient Anderson Family Medicine .
Anybody have an opinion or comment please respond.