DOCTOR AND INSURANCE RANT

[j_seph]

So my wife has been having a pain in her abdomen. Even showing possible signs of gallbladder issues. Her doctor scheduled her for a colonoscopy with her gastro doctor. Colonoscopy comes out fine yet he says, "The pain she is having and location of it is most common for gall bladder. We are going to schedule her for an ultrasound. Well they cannot get her in until August at one place so they schedule her 3 weeks out to another place.
1) Is there that many people getting that many ultrasounds and not that many places to get one done? I highly doubt this is the case

2) If you know that this is typical of gall bladder and you need the ultrasound then why the crap didn't you do that to cut the time frame down so someone doesn't have to go through the colonoscopy preparation and procedure and can get this fixed if surgery is needed and to lessen the time having to deal with it?

I honestly believe that doctors today only see $$$ and how they can get it from procedures not needed and could care less about their patients or others needs other than their own. Rant over

 

[Lilly001]

I know that my insurance puts requirements on doctors that seem insane.
For example I have messed up vertebrae in my neck that pinch nerves that cause pain in my shoulder and neck.
An injection clears it up for 12-18 months.
But every new cycle requires an MRI and the 3-4 week review process.
This is a normal occurrence with me, and my doctor knows what to do, but we have to jump through their hoops every time.
So to get back to your rant, you have company.......

 

[Crakajak]

My FIL has to wait 4 weeks to get test run. I had to schedule my phyisical 12 weeks to get an early morning appt. Hate that for your wife.Seems to be more more people needing medical attention than medical practices.
I know 2 of my Docs closed up when Boma care started. My primary care sold to Emory and left after her commitment was satisfied.

 

[Oldstick]

Tell me about it. I with you j_seph 100%. Been through heck the last 4 years with multiple family members dealing with cancers, leukemia, surgeries and the list is endless.

 

[j_seph]

Makes me think of a vehicle throwing a code for a bad fuel injector so lets check the fuel pump that it has power, check the fuel line for a leak, then check to make sure there is gas in the tank. When the computer done told you what the fuel injector was not working and you already seen that the fuel injector was not spraying gas.

 

[greg_n_clayton]

They are common and you can get in on short notice around here ! Just went through the same symptoms back in the winter !

 

[Hunter922]

Doctors have to get their friends in on the money grab as well... This one sends you to a specialist, who sends you to a second golfing buddy and finally to the one that they play at his course every Friday... It's a joke, in almost all cases I have to be dying of pain to even consider a trip to the ER or Doc... Rant away, hope your better half gets better soon in spite of the labs and doctors..

 

[NE GA Pappy]

Insurance companies now require the doctors to follow a specific protocol to be paid for their work. They may suspect that you have XXX but they can't just do the test for XXX. The insurance companies know that a percentage of those having symptoms of XXX will not have it, and and instead have JJJ. Testing for JJJ is cheaper, and may eliminate other diseases as well. So they won't pay for the XXX test until you have had a negative JJJ test.

 

[elfiii]

Insurance companies now require the doctors to follow a specific protocol to be paid for their work. They may suspect that you have XXX but they can't just do the test for XXX. The insurance companies know that a percentage of those having symptoms of XXX will not have it, and and instead have JJJ. Testing for JJJ is cheaper, and may eliminate other diseases as well. So they won't pay for the XXX test until you have had a negative JJJ test.

That's part of it but the biggie is lawyers and malpractice suits.

 

[NE GA Pappy]

I am a colon cancer survivor. I have a scan every 6 months to make sure everything is still ok. We have to go thru an insurance approval every 6 months to get a scan with contrast.

 

[EAGLE EYE 444]

Unfortunately, the Insurance Companies controls the majority of healthcare for several years now.

I surely don't agree with the path that our Healthcare has been going for many years now either as it is controlled for the most part in my opinion by the Insurance Companies and Pharmaceutical Companies. I see it first hand as I have dealt with these situations for man years now.

I have seen it first hand on hundreds of occasions with my late wife, then with my late Texas girlfriend and also in my case especially during the past 2 years with my ongoing leg, knee and foot problems.

Now for the really GOOD NEWS ABOUT THE OTHER SIDE OF HEALTHCARE...THE WAY THAT IS SHOULD WORK AND DID WORK FOR ME !!!!

I guess one of the very best things to happen for me is the fact that I took it upon myself last Wednesday to go down to the hospital to see my Primary Care Physician as I had some very important questions. It was all over the local news last week. The fact was that a local restaurant had been determined to have an employee that had a case of Hepatitis A involved. They were advising any people that might have eaten in this restaurant or had any contact with employees to be checked immediately. I believe that all of their employees were checked. Well I do eat at this restaurant frequently so I decided to see my doctor to be safe about it.

Of course, I had no appointment and my doctor was in clinic at the time BUT the staff personnel talked with the doctor and they came up with a quick game plan for me. They sent me to the lab to have the proper blood work done immediately and within 20 minutes after that, they also gave me a vaccine shot as a counter measure at the time. Within 2 hours, the Doctor sent me an email advising the test results were negative with no exposure involved which was great. I couldn't believe that all of this happened so fast. I will let Medicare and my supplemental insurance worry about paying first and I will be glad to pay any leftover balance just for my "peace of mind". THANKFULLY, NOBODY HAD TO SIT AROUND WAITING FOR ANY UP-FRONT APPROVAL FROM ANYBODY FOR THIS HAPPENING !!!!

The bottom line is that things NEVER WORK THIS FAST !!!!

PS: I was surely glad that they did though as I had a busy day scheduled.

 

[Jim Baker]

When I had gall bladder problems they started with an ultra sound, then an upper GI, then a CAT Scan, then a Hida Scan, then an MRI. None of the tests were conclusive until the MRI.

It came back showing gall stones and a dead gall bladder. 3 days later after a month of misery they took it out before it ruptured.

I as the surgeon why didn't they just send me through the MRI to start with. His Answer, more or less was, "because that is the way the system works"

In other words I had good insurance and they had to pick it clean.

 

[georgia357]

In other words I had good insurance and they had to pick it clean.

I believe that that one sentence says it all.

 

[Bigtimber]

If you had nothing in life, illegally in the country and/or never worked....just head out to the best local ER and stay there .....they would fix u up in awhile free. See that place packed full of folks getting whatever they need and not pay a dime....through insurance or otherwise.

 

[j_seph]

Sad thing is I have dealt with more doctors in my life time through my late wife then most should have to. I lost most all faith in doctors when I watched my late wife get worse and worse until she could not even stand up. All along while doctors said her MRI of her brain showed no significant changes. Yet as she went downhill, you could see the changes in her physically. MRI after MRI same reading each time. We finally got her refereed to Emory where the doctor went over all of her MRI's and said "I can see where the tumor has been growing for a year and a half". Her doctors said it had not changed yet she had lost use of hand and arm and mobility.

 

[DAVE]

If you want good service and quick, you have got to take responsibility for the charges and not throw an insurance card to the Dr. The payee calls the shots.

 

[Ruger#3]

The docs know how to milk a walk-in for every dime they can get out of it. Wife went to see an ortho doc with a fresh MRI in hand. First thing was go get an X-ray?!?!?!

We both just shook our heads knowing it was just fleecing the insurance.

 

[Fuzzy D Fellers]

Goto the ER they have ultra sound 24hr a day.

 

[Oldstick]

The ER will charge you a minimum of $1000 if you walk in with a skinned knee. That is if you have good insurance they can bill or else if you can prove you have no money, or are covered by Medicaid only, they might put a band-aid on and send you away. (They will send you the bill for $1500 anyway for the band-aid and you will have a fight on your hands unless you have already qualified for Medicaid).

Even the public Medicaid hospitals are under no legal obligation to do anything other than get you "stabilized" so that you probably won't die the same day they release you, no matter how serious your condition. That is if you don't have money to pay. Otherwise, you had better be a multi-millionaire, or have a good insurance plan if you expect them to further treat your condition. For most folks, your insurance plan is your friend. Most of them will pay exactly what their contract and brochure say's they will pay. They are the only protection most of us have, oversight of the necessity of the medical providers actions and protecting you from bankruptcy due to the excessive charges.

 

[NE GA Pappy]

I had chemo treatments at over 14,000 per treatment, every other week. Pretty near 30,000 a month. I don't what we would have done without good insurance.

I maxed out my yearly out of pocket on the first treatment