Tuesday, September 23, 2014

Stress Test Times Two


Hub walked out of the doctor’s office following a routine exam with a small piece of paper marked with doctor’s scrawls, which translated into an appointment for a stress test. Nothing to be concerned about the doctor believed, but best to be sure.

A few days later – one day before the scheduled test – hub received a voicemail, “This is Dr. Smith’s office (not his real name). Please call the office immediately.”

Uh-oh.

Panic time.

All sorts of bad things began to play out in hub’s mind. Am I dying? (He can get melodramatic at times). What is the problem? Was one of the routine tests really, really bad?

Suddenly he did not feel well at all.

Was he having a heart attack? The tension of not knowing what the doctor’s office wanted was overwhelming. His blood pressure rose…his heart pounded…he became very nervous…he started to pace…and immediately called the doctor’s office.

The emergency?

Insurance stuff related to the upcoming stress test.

A big sigh of relief resulted, followed by annoyance the office created such anxiety.

Did the medical staff have any idea what fear those simple words – Call the doctor’s office immediately - produced in a person’s mind?

Obviously not.

The medical office had difficulty contacting hub’s insurance provider. The stress test would have to be postponed unless insurance authorization came through.

Hub hung up and immediately contacted the insurance company. After a couple of minutes on hold (it must have been a slow day), a real person got on the line. Hub explained the situation, was again placed on hold, and a few minutes later the customer service rep returned, assuring hub all was OK, authorization was not necessary, go ahead and get the test.

He hung up reassured.

Ten minutes later the phone rang again.

This time the medical clinic stated hub’s scheduled test would be canceled because his insurance company refused to authorize the test.

Hub carefully explained that ten minutes earlier the insurance company assured him the test was approved and covered.

The clinic required authorization directly from the insurance company.

Hub initiated a three-way call between the insurance company, the doctor’s office and the clinic, and the doctor’s office and the clinic followed up on their own with the insurance company. If approval was not granted by 2:00 p.m., the computer (blame it on the computer!) would automatically cancel the appointment.

I will not bore you with the details, but at 1:58 p.m. (really) the doctor’s office called and declared the insurance glitch resolved. Two minutes later the clinic called, confirming that he could come in the following morning at 7:30 a.m. for his stress test.

“I thought this afternoon’s insurance complications was the stress test,” said hub.

One stress test down, one to go.

“You have no idea how long I worked on straightening this out,” the clinic worker responded.

And we wonder why medical costs are so outrageous. 

11 comments:

  1. Good grief! I go through this sometimes, too. At least it all turned out for the best, and he got to see how he reacts to stress, even without the test! :-)

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  2. Since my husband's recent health problems, I have learned that the whole medical establishment including physicians, insurance providers, and even pharmacies can cause such aggravation. He has one drug that is ordered from out of state from a specialty pharmacy. It sometimes requires that I talk to four or 5 phone reps before I get to the person who can actually refill it.. It sometimes takes 15 minutes. And don't get me started with the insurance company and physicians' staffs.

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  3. It must go with the stress territory. Had the test a couple of weeks ago, after assurances our insurance covered it completely. About a week later along came a statement from Blue Cross that I owed the hospital $3,750. Ouch. I phoned Blue Cross and the rep said that was just a clerical error and not to worry about it. I will continue to worry until a followup statement showing the debt is removed appears in my mailbox. The stress test itself was not stressful at all.

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  4. What a poor choice of words the office used and what a mess. Think you are right, he doesn't need to have the test, he all ready passed a major one.

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  5. We have an HMO - makes this kind of thing much less common.

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  6. I hope the medical stress test went better than the insurance stress test. With all the studies out there about how stress affects our health, one has to assume the insurance people and the medical people are in cahoots to make us sick and keep us sick. How this benefits insurance companies, I have no idea, but they are major players in the game. Maybe they're paid off by pharmaceutical companies?

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  7. Isn't it fun?!? But great idea to initiate the three-way phone conversation.

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  8. I retired early due to working in the HEALTH INSURANCE INDUSTRY.Talk about a stress test!!!!!!!I could not make it to 62.. had to go out early at age 60.My advice:Don't even think about health insurance for 24-48 hours prior to the test so he "passes.."

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  9. Wow. I feel lucky that I haven't had this kind of stress...at least, not yet!

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  10. I totally agree with you! Medical staff should be very careful with their words, as the slightest misunderstanding can cause panic to everyone. At any rate, I'm glad the glitch with your husband's insurance company and the doctor was resolved nicely. It would've been troublesome if any other issue came up. Thanks for sharing that, Meryl! All the best to your family! :)

    Joshua Duncan @ Focus Insurance

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