Appointments That Are Not Kept

<p>I have not had this happen to me for the longest time, if at all. This week not one, but two different professional offices have not followed through because of poor office management. I am really angry at the lack of consideration of our time, and the money I am paying for gas to get to these offices for nothing. </p>

<p>One appt. that my son had, they were supposed to get pre-certification for some medical treatment. They scheduled my son for his treatment, we arrived on time and their paper work was not done. I stormed out. The office manager called to apologize, but so what! I am still out the time and gas money, and my son does not care to waste an hour for nothing either.</p>

<p>Then there was a second appt. for my son was to see another "professional". We got there, and this person was given the day off. They never checked that this person was still scheduled on their calendar to see my kid. I literally organized a couple of days around this appt. for no reason. The person left in charge apologized and told me that I should call the office manager to let her know. Are they for real? I got there early, so we sat in their waiting area for 20 minutes, before someone woke up!</p>

<p>If this has happened to you, do you take it on the chin not to create ill will, or do you go over their heads. One of these places has a regional operations manager, and I really feel like giving them a piece of my mind, yet we are still using their services, for the moment anyway. Is it worth speaking up. I doubt that they will "give" me anything to make up for their incompetence.</p>

<p>I'd suggest writing the regional office manager. You have nothing to lose, and your being assertive may prevent your being inconvenienced again.</p>

<p>I'd like to do that, but my son thinks that it isn't worth the hassle, and it just "gets them to hate you", which is probably true. Meanwhile, as I was typing this, I got a phone call from the folks at appt. number two (on a Sunday) to apologize, rechecking to make certain there won't be a foul up on the next appt. and thanking me twice for my understanding (whatever that means, because I am not understanding, I am angry).</p>

<p>if I were you I would ABSOLUTELY tell the regional office about these inexcusable foulups. You will find they will treat you and your son with kid gloves in the future. If you don't report them them they will do the same thing again to someone else, because they suffered no consequences from doing this to you and yor son. It's called tough love, and some people need to feel it's sting in order to learn .</p>

<p>You should see the numbers of patients who cancel appointments mulitple times at the last second, show up hours late expecting to be seen right away, abuse the staff if the time they want is not available, and numerous other poor actions such as continuing cell phone conversations after they have been called to see the doctor and keep talking right on into his office and beyond. My wife is a scheduler and MA in a practice.</p>

<p>barrons, I am sure that is true, and I have seen this too. Behavior of the person/people before me, does not excuse them from teating us in a lousy way. The fact is that I made appts., I showed up early, I complied. What some other patient/customer did or did not do, is not my concern.</p>

<p>menloparkmom, I am really thinking about it. I just wonder it will be to our benefit. My son thinks that it might be harmful to take this further, and we are stuck here for some services right now. Otherwise, I'd be gone!</p>

<p>barrons-that behavior annoys me to no end, but if you think about it, that should give them even more reason to treat the ones who do it "right" better. </p>

<p>Two wrongs don't make a right. Definitely write a letter or make a phonecall.</p>

<p>Feel free to create all the havoc you wish. It won't change anything and they did try to apologize. What should they do-KYA? You had some bad luck--get over it. They are humans too and mistakes happen. They are not picking on you. A busy office has scores of appointments per day.</p>

<p>Please consider that there may be other variables involved in all this. It is very easy to blame the provider or the providers office, but that may not be the complete story, at least in the first situation described. Often precert forms are filled outappropriately in advance, but the insurance carrier either fails to respond in a timely fashion or throws some other barrier in the way that impedes the pre-auth process. This might include checking for pre-existing conditions,requiring additional medical information (that the office may or may not have) or some other reason to try to stall or deny authorization (like trying to se if the procedure was due to an accident, at which point they may try to cost shift elsewhere). If a drs office says they don't have the authorization, it may be the fault of the insurance company or of another provider who may have to send in information or a referral, not the Doctors office. And while yes, it would be helpful to alert the patient that the forms aren't back, often they come in at the last minute, so there may not be a need to cancel or reschedule an appointment on short notice (that is also annoying to patients) when the authorization might come through at the 11th hour. Some doctors offices do not want to schedule the procedure until the authorization is approved, just to be sure, but this too is sometimes an inconvenience to the patient.</p>

<p>I think in today's healthcare climate is is advisable for any patient to recheck their appointment a day or 2 before, especially if the appointment/procedure has been scheduled a while in advance and expecially if it requires precert.</p>

<p>Don't some doctor's offices charge a fee for a no-show or a less-than-24hours-cancellation? I'm not sure how it is enforced, but I have heard of it. Well then, why not the same courtesy in exchange. As far as patients cancelling last minute, it is common practice for doctors to overbook anyway, or to have a booking every 15 minutes, when in fact the average time taken is longer than that. If patients cancelling was that common, I would never be waiting in the office for 45 to 60 minutes every single appointment, every single family member, 12 times a year. I think the schedulers have the system down pat.</p>

<p>Northeastmom: It's too bad you are "stuck" with these providers for the short term, but since you are, I'd suck it up for the time being. The good news is that they now seem to be handling you with kid gloves. Once this episode of your son's needing care is over, then write your letter, and move on to someone else.</p>

<p>Oh yes -- and tell all your friends not to patronize these docs, too. Sweet revenge.</p>

<p>Seriously: The only "weapon" you have is your business. </p>

<p>JYM: I agree that "stuff happens," but I also think a well-run office knows how to work the system and should have dotted their i's and crossed their t's beforehand.</p>

<p>BTW: I have a rule in a doctor's office: I will wait 30 minutes beyond my appointment time, and then I'll leave. Not for obgyns, eye doctors, and others who handle emergencies in their offices -- but certainly dermatologists, internists, endocrinologists, rheumatologists, and the like. (Yeah, I've got a bevy of docs!!)</p>

<p>There are many different kinds of practices with many different kinds of scheduling and insurance issues. I am not excusing mistakes made, but from the providers side, there are just many many more issues at hand than is apparent on the surface. Some practices are owned by conglomerates and make unreasonable expectations for the number of patients a doctor is expected to see in a day, or the amount of time a doctor is permitted to spend with a patient. For doctors that do both inpatient and outpatient work, scheduling their days to see everyone can be challenging. And any kind of doctor can have to deal with emergencies-- even dermatologists. My boys' pediatrician's office has a sign that says something to the effect "please be patient if we are running a bit behind schedule. We want to be available to address all patients needs, and hope that others will be patient when we give you the amount of time you need" (I am paraphrasing, but the message is similar).</p>

<p>It is not a perfect system. The healthcare system is in a mess. But when insurance companies are increasingly difficult and unreasonable, the mound of excessive paperwork increases, the load on the providers gets extreme. Add to that the patients who show up late, don't have their insurance information with them or their forms filled out as requested, etc etc. The stress in the front and back office of a drs office is high, and this may lead to more turnover. There was a thread about this issue a while back, when someone may have inadvertently breached confidentiality about a bill or something. Some thought the staff person was trying to be helpful, and others were outraged. Lots of opinions about this stuff, but the provider always seems to get the blame. Some Drs have gone to starting concierge practices. They charge a fee but guarantee quicker appointments, response time to calls, etc. I guess its like first class vs coach, yet I understand. Things were different back when most insurance companies paid 80% and patients paid 20%. Things are different now, and, sadly, in some cases, people get what they pay for. </p>

<p>Not meaning to launch into a diatribe about the mess the healthcare industry is in. Just saying there are 2 sides to every story. </p>

<p>I went to a hairdresser once who kept me waiting for way too long each time. So, I found another hairdresser. But, I spoke to him about it first, so he was aware of the issue.</p>

<p>I had an appointment scheduled two weeks ago with my son's guidance counselor at school. I showed up and was told that she had not come to work that day because her child was sick. Yes, they knew about her appointment with me, yes they had my phone number and thought about calling, but just didn't. No excuse and no apology. More of a shoulder shrug, oh well, we're telling you now so what's the big deal.</p>

<p>They didn't want to reschedule on her behalf, so I left my phone number and asked her to call me when she got back in. Two weeks later--nada. I am now waiting for SAT scores to be posted and then I will call to reschedule, but I was disgusted. Luckily, I'm not working now. If I had to miss several hours of work to be stood up that way, I would have been apoplectic, but it's not worth saying anything. We need this woman. I guess they know the power they have, so don't feel the need to act professionally.</p>

<p>northeastmom, I would also be steaming mad.</p>

<p>There was my treatment by the ob/gyn while I was expecting. Patients were routinely kept waiting 45 minutes or more. Once I bent over the receptionist's desk and saw that patients were scheduled for 10 minute appointments -- no wonder everyone was running late. </p>

<p>The absolute worse case was when we were waiting while the ob/gyn was delivering a baby. That day the doctor was running almost two hours late. (I did not use this same practice for baby number two.)</p>

<p>I can also remember working full time, having to leave to take my child into the pediatrician's for an appointment, then having to wait up to an hour to see the doctor.</p>

<p>The ONE TIME I was late -- did they wait to see me -- NO!!!!</p>

<p>I think you should call and complain.</p>

<p>Why is it we put up with repair people saying they will come "between 8 and 12"? It is a royal pain, but it is hard to predict how long a repair will take or how bad traffic will be. The nice service is when they call to say they are on their way- with, say 20-30 minutes heads up, so you dont have to sit around all day. That way you only have to get there ahead of them. This is, however, the exception rather than the rule. In most cases we are expected to sit around for hours waiting for them. Yet we get incensed when a Dr is running 30 minutes behind. It seems to be a sociological shift. Maybe these days the plumber or the cable repair guy gets paid more by the hour than the Dr does :)</p>

<p>jym-I think it's more that if you miss the cable guy, they just come back the next day (or that Monday, if you had a Friday appointment). Whereas with a doctor, they can be as late as they want, but should YOU be late, it can take MONTHS to get back in. (This seems to occur an awful lot with my doctor...she's always very booked.)</p>

<p>fendrock, I and TheAnalyst, I can sympathize. I understand how you feel. Frankly, the TheAnalyst, I think that school has a lot of nerve! Your right though, you do need them. </p>

<p>To clarify, with my first appt., the person who schedules made several appts. for my son prior to the precert. They knew that they needed it. My mistake was not calling in advance to make sure that they had completed it. I used to be more on top of things like that, but I got busy and just showed up for the scheduled appt. The insurance carrier was not late, had no questions, and they were not at fault. Tha's right, the insurance carrier was not at fault. The medical provider scheduled a two days too soon. They did get the precert. and called to let me know. They also told me that if that if the medical personnel had known about the situation they would have treated my son without that precert. since I made the trip. Frankly, I would not have gone for that one. They blocked an hour for my kid, so I guess it was their loss too. Oh, well.</p>

<p>I'll take the blinders off on the second visit. That one was not for medical treatment. It was for standardized test tutoring! I prepaid for the month, since they made such a big deal about needing their money up front. They originally wanted me to pay for thousands of dollars worth of tutoring without even having met the first tutor. I refused, and now I am very glad. I can easily walk away from this place any time. I do want to give them a chance, since my son was fine with the tutor. The people who were there felt awful, and did call to apologize. My son had only gone once, and on the second visit his tutor did not show up because she was given the day off. It was not her fault, but someone messed up. This place makes such a big deal about not missing, having the money paid in advance, etc, and then they did not value our time. They actually had the nerve to tell me, that I won't pay for that slot! No kidding!</p>

I wish I had YOUR cable company. I cannot tell you the number of times I waited and waited- something supposedly happened and they didn't get to our house, but they had to reschedule for another time (not necessarily the next day) which was fine because I work fulltime and cant just take another half day off to wait for them again. Or, I'd schedule a repair several days down the road so I could get the first appt, yet they'd still show up hours late.</p>

The medical provider scheduled a two days too soon. They did get the precert. and called to let me know. They also told me that if that if the medical personnel had known about the situation they would have treated my son without that precert. since I made the trip

is a little confusing. Can't quite tell who did what. Did the staff make a scheduling error and the Doctor offered to see your son without the precert (meaning they'd eat the fee and do it for free) because of your inconvenience? If this is what you are saying , thats pretty nice of them to do that.</p>

<p>As for the second situation, it might have been helpful to be clearer up front that this was not a doctors office, but a tutor. They screwed up, but they did apologize. I had a similar situation with a tutor who showed up late, but still charged the full hour. I called, spoke to them about it, and they credited me a portion of the fee towards another session. It worked out fine. I called and courteously addressed the situation, and it was addressed. </p>

<p>Ironically there is a thread running about whether Drs are happy with their profession. <a href=""&gt;;/a> It is an interesting read.</p>

<p>The staff scheduled knowing there needed to be a precert., but without paying attention to the length of time it takes. No, they were not offering to eat the bill, so I don't know how they were going to handle it. If they really meant to see him without the precert. they would have offered it while I was there. Their office manager, who did not have the guts to call me, had some underling call me to let me know that if she knew the situation they would have seen my son without the precert., and "somehow worked it out." The point is that since I was no longer there, it was not a real offer.</p>

<p>jym, I did not say that the second situation was a doctor. I said that it was another professional. Frankly, I think that since they insisted that I prepay, and I drove at 3.65/gallon and wasted all kinds of time, and changed things around for that appt. that I am due something more than an apology. I won't get it, but I feel an extra 30 minutes of free tutoring should be offered by them to show good will. It won't happen, and I won't ask, but it would be good business.</p>

<p>Just adding, I recently had a plumber in. He gave me the 9-12 line. I asked him to just call 15 minutes before he was going to arrive, and I gave him a mobile number. That way I was free to run local errands.</p>

I don't know how big the practice is where your Dr precert snafoo occurred, but sometimes a front office person really doesn't know how long it takes to get an authorization with a particular insurance company for a particular procedure, and it can't always be predicted with great accuracy. Did you happen to have a preference for a follow up appt for the procedure at a certain time or on a certain day? Sometimes offices try to accomodate that when they schedule the appointment and then do their best to get the authorization fast-tracked to accomodate the patient. Please understand, I am not blaming you- but I am distressed at the incredulity I hear sometimes. There are lots of sides to these situations. </p>

<p>And it may be their procedure to have a staff person handle phonecalls. It may not mean that the office manager "didn't have the guts" to call you. Did you ask about what options could have been explored for your son to be seen before you left the office? Perhaps it could have been worked out, or the insu verification people could have tried again (though its a challenge to get answeres quickly from insurance companies). </p>

<p>By the same token, if the tutor doesn't "offer" to give you a free session to make up for their screw up, ask for it and see if they will work with you. The worst that could happen would be that they say no. But, why not give them a chance?</p>