I live literally 2 blocks from a hospital ER. But, it’s not in my network so I’d have to sell my first born child to go there! I’ll keep my child and travel 5 miles or so to the closest in network hospital, and all the associated medical offices there.
D3 called for a specialist appointment and the soonest one was in mid January! And we have “good” insurance.
I can’t wait to be free of this system. Hopefully it will happen before I hit 65. I relish the idea of free choice of providers and locations, and no night terrors caused by “surprise billing”.
Family member here is having surgery, I told that person to make sure the anesthesiologist is in network. Talk to the surgeon about this. There are plenty of anesthesiologists at this hospital. Find one IN Network.
It happens too often—happened to my son when he had emergency surgery for his appendix. Hospital took his insurance as did surgeon but not one of the ancillary doctors. Tempted to say “just too bad”, but it can hurt credit. It was an enormous pain to resolve and took about a year
You don’t talk to the surgeon about it. They will have no clue who is assigned to their room that day. You need to call the hospital directly and request that. Lots of times it’s a nurse anesthesia person and the doctor just checks on the rooms BTW.
Also a comment before. Your “good” insurance doesn’t dictate how long it takes to get an appointment. That is the doctor office issue. If you can’t wait there are other doctors that most likely can see her earlier. Remember that doctors are people too ?.. They go on vacation, go to multiple educational seminars yearly, take off for family time, take kids back to college, etc etc. You will just hear that they are so busy. There are other factors also.
For folks who would like to be seen sooner, you can ask your primary MD to call on your behalf, asking for a sooner appt. you can also ask to be put on a waitlist for any cancellations.
@Knowsstuff - the problem is my network is too small, and if I venture outside of it the penalty is too high. I wish I could look all over the city instead of just in my network. The doctors are great, but the 3-month waits are not (this is not the first time…) And they want you to keep the same doctor, so if D chose a doctor an hour away in a satellite clinic, she’d have to go back to that person for every future appointment.
My husband is a physician, and he tried to get an earlier appointment when he needed one. Nope, had to wait 3 months. We’ve done the wait list and sometimes it helps by a few days or a week, if you can jump on it.
If I had Medicare, I might find a sooner appointment somewhere else, but then again, maybe the waits are even longer in other places.
@greenwitch. That is horrible. Are you in a rural area? I am also a physician /surgeon and if someone calls my office in pain we take them. They will have 5o wait but we will still see them. My practice is NOT hospital owned.
It seems like they are treating you like the old HMO clinics. Delaying treatment for a medical condition doesn’t hold up well in court either but they can always say just go to the ER.
So what can you do…
Some hospitals have regular day clinics in them that insurance usually pays for. Same day appointments.
Call you insurance company and let them know it is taking 3 months and see if they can recommend another group or doctor.
Call the hospital that they are on staff with and talk to the clinic director or odsbusman person. Hospitals do not want bad reviews etc their accreditation is linked to it.
Write to the head of the hospital and let them know if this is a hospital owned group… Almost all are now a days and most likely the issue. They might need to hire more doctors.
This is not how medicine is supposed to work. It pisses me off to no end.
I had a patient in my office after another doctor did a small procedure and the problem got worse with an infection. She called the original office and they said they couldn’t take her for 3 weeks!! That is malpractice.
She called my office on a referral and I saw her that day and fixed the issue but had to do a bigger procedure to fix it. They messed up honestly.
Sorry for venting but this is not how it’s supposed to work.
There is an orthopedic world known knee, Shoulder dude that works with the Chicago Bears, Bulls etc . 3 month wait. But if I call and need to get one of my dancers or athletes in, his office gets them in that week. This is how it’s supposed to work. Agh
…
Or pay PCPs* better relative to other specialists to attract more physicians into PCP specialties. Aren’t the PCP specialties among the lowest paid, so that graduating medical students with $300k+ debt find them to be the least desirable to go into?
*PCP = primary care physician (internal, family, pediatrics)
@Knowsstuff - thank you for your kind words. We are in a city, lol, but the network is linked to a particular hospital and it’s affiliated clinics. They are big, but clearly they don’t have enough physicians for all the patients.
H waiting 3 months for a sleep doctor really bothered me. D3 made an earlier appointment with a NP so hopefully that will be enough. I waited about 2 1/2 months with a painful, but livable, foot problem before I could see an orthopedist. None of these things were emergencies, but still… I hadn’t thought of complaining or asking for an exemption to go out of the system. You’ve given me something to think about.
It’s because of the baby boomer population is on Medicare. Doctors, hospitals, drug companies, labs, and imaging companies know insurance covers the cost, so they jack-up the rates. An X-ray costs about $0.20 to do, but they charge the insurance $3,000. A pill costs a few cents to manufacture, but they charge the insurance $800 for a 30 day supply. You see the problem?
Insurance negotiates the rates also, not just Medicare and Medicaid (whose rates are so low that doctors have to limit the percentage of Medicaid patients they have or lose money).
My local ob-gyn now does botox, fillers and liposuction, all cash procedures. She is not living high by any means. I suppose the reimbursement for regular women’s health treatments isn’t enough to support her office.
@coolguy40… Uh… No… My prices are negotiated with and by the insurance companies. I could charge $1,000,000.00 and still will get paid $68.00 for a set of foot rays.
Why do patients think doctors set the pricing? I wish… I get paid pennies on the dollar. Just had a $989. Patient charge and the insurance company paid me $98.00… Seriously…
Primary physicians are starting to do procedures and testing that they never have done before. This is where it gets dangerous in my opinion. All out of charging mite5. Many young physicians tell what they are resorting to doing. It gets scary…
How big of a debt burden are those young physicians carrying from medical school?
What I do not understand is why PCP specialties are “less desirable” lower paid ones. PCPs could encounter patients with anything, so they need to be widely knowledgeable about whatever patients can come in with, in order to recommend the best treatment (including routing to the correct kind of specialist when applicable).
For some reason (known only to bureaucrats and administrators), procedures are paid at higher rates than examinations. So internists talking to and diagnosing a patient are valued less than lopping off a mole or doing a colonoscopy.
And many medical school graduates have debt in the$250,000 to $300,000 range. Monthly payments are more than many mortgages. Then, for example, Ob-Gyns and other high risk specialties have medical malpractice insurance rates of $100,000 or more per year. No wonder many are moving into cosmetic procedures with cash payments and low risk.