It should come with a warning. WARNING!!-This insurance plan will cause extreme frustration!! HM O-crap!! They always require referrals. To those of us well trained in home surgical procedures and festering stuff out…we don’t need referrals. Just a needle, and egg shell lining, some thread and a stick…some leeches are good too but not totally necessary unless the hunting knife slips. Then you really need the iron to cauterize anyway….I digress..
So I was at the neurosurgeon’s office the other day (stop laughing!!) I was patiently waiting for my visit. My insurance does NOT require a referral to a specialist because I am a certified calamity on feet. I must have the freedom to find a specialist or specialists for any reason. For this reason I do NOT have an HMO. So I was serenely twiddling my hair waiting, waiting, waiting….then I noticed her. Electric pink toe nails, black bedazzled flip flops, a ream of paper and a cell phone with some odd bumper guard also be dazzled, pink fingernails. I saw those nails and thought…uh oh this one is going to be trouble! NO ONE wears fluorescent pink nail polish past the 4th of July! Or is it labour day? Memorial day? She sits down and starts playing on her phone. The office manager calls her up to get her license and insurance card.
Pinkie says “here are all my cards” The office manager said “we don’t have both of these cards on file only this one. This other is an HMO and requires a referral, do you have a referral? ” Pinkie says- Well just bill this one, because I don’t have a referral” The room stopped dead…you could hear the dust falling off the silk flowers in the corner. The other patient (mental health professional…I swear I am not making this up!) and I stare at each other and glance at OM, because we know it’s going to be good.
Mental lady goes for a bag of chips, I resume hair twiddling in double time.
OM says “we can’t bill just one because one insurance won’t pay if you have two and we don’t bill both” Pinkie- “just bill me” OM-“we can’t, we have a contract and agree not to bill excess” Pinkie- “but why can’t you just take one of them” OM-“because we can’t just bill one, we have to bill both, each of them pays part” Pinkie-“I’m sick I have to go back to work I need this done I need to know what’s wrong drove for an hour this isn’t fair no one told me” OM-“I’m sorry if you can get a referral from your primary care doctor we can still see you” Pinkie “Ok”
Pinkie gets on the phone and leaves, OM, mental and I all look at each other and snicker a little. Pinkie can’t get a referral for 24-48 hours.
Pretty much the same conversation ensues “bill me, we can’t, bill them, we can’t, we just can’t see you today, why, because you don’t have a referral…etc” ….Plus we get to hear how it’s the office’s responsibility to ask how many insurance carriers she has. Then we are treated to an indignant yell off about how it took 2 weeks to get an appointment…REALLY 2 weeks ONLY that’s a walk in the park! They even managed to get her in next week! Pinkie leaves…
Finally I get called back. OM and I burst out laughing. I tell her how awesome she is and admire her patience. We went over it a bit to make sure she was REALLY clear. She made perfect sense. Staring out the window twiddling my hair…I hear OM shriek
“She’s back!!” my very calm surgeon says “ NO WAY!” “tell her we simply can’t treat her today and send her on her way”
More conversation…’why? Because it’s not how it works. I don’t understand, just talk to my carrier! I can’t just get a verbal on the phone. Why?’
Surgeon finally comes in, looks at me…we laugh. I tell him OM is awesome. We discuss HMO-no’s.
Leave the office, front door now locked and lights off. Tell poor OM she needs a stiff drink and some chocolate…maybe a long hot soak
BTW my visit was filled with awesome news :)