Monday, February 10, 2020

Gratitude Monday: bad medicine

As I mentioned a while ago, I’m in the process of trying to reclaim my knees from decrepitude. When I saw the orthopod two weeks ago, he said that the process of getting the hyaluronate for injections could take four to six weeks.

Last week I found out why.

On Tuesday, I picked up a voicemail from a woman who identified herself as Kayla in the orthopod’s office. She wanted to talk with me “about your injections”. She gave me a callback number including an extension, which she said would be answered “by someone named Julie”, but I should ask for Kayla.

Well, I rang twice on Tuesday, getting voicemail both times. Wednesday morning, I called around 0845, went straight to voicemail again and left a message saying this was my third call and if I did not receive a callback by 0930, my next one would be to the office manager.

At 1000, I called and spoke to someone who said that Kayla only works Mondays and Fridays (not mentioned in her message to me), and that she doesn’t have a direct extension, so that’s why she gave me the Julie line. There was a note in my record that Julie had rung my (home) number at 0927 and left a message.

Well, I spoke with Julie, who said Kayla hadn’t left any notations in my record regarding what she needed from me. She said she’d text Kayla and see what was going on, and she’d call me.

Needless to say, there was no call. On Friday morning, I rang again and asked for the office manager. Naturally the person who picked up the line wanted to know why, and I gave her the 30,000-foot view. She danced around for a while trying to fob me off, and eventually said that Kayla was in the office and would I rather speak with her? I drew in a deep breath and said okay.

Well, Kayla was pretty bolshie—she claimed that she’d annotated my chart and Julie could have asked for the information, nothing to do with her. And it turns out that what she wanted was the exact name of the hyaluronate I had been given five years ago. She claimed that without that information, Cigna (my insurer) might well deny my treatment.

I was dumbfounded, so I asked if she meant that if I’d never been treated with hyaluronate before, Cigna wouldn’t let me start? She assured me that it was entirely probable. So either I dug out that information from my orthopod from five years ago, or live in pain. She was entirely indifferent to which I chose; nothing whatsoever to do with her.

Considering that my insurer at that time never had a problem with the treatment, I find this extraordinary. But whatever.

When I got home that afternoon from my first physical therapy session, I tracked down my PCP from 2015. Fortunately the practice is gigantic (including every possible specialty) and Tina in my old PCP’s office called me verified when I went through several addresses that might be on my records (I hit the jackpot with D.C.); she didn’t make me cough up a phone number that I hadn’t used in five years. She pinpointed the treatment, but had no info on the hyaluronate because that was done by the orthopod.

But Tina connected me with Cindy, in the orthopedist’s office, and Cindy came through with the name. (Orthovisc, if you’re asking.) I thanked her profusely.

I called Kayla back—calling the main number, waiting for a human and asking for Kayla, but do not put me through to an extension that only goes to voicemail. The human kind of sniffed, and then told me that Kayla’s extension is 1422. Interesting, as the Julie-never-answered line is 1411.

Well, I gave Kayla the information. And she thanked me. But it turns out that part of the reason that this process takes so long is that she doesn’t stir her stumps to set it in motion until days after you’ve seen the doctor. She described a future of back-and-forth with Cigna, that—if I’m extremely lucky—ends with the doctor’s office receiving the hyaluronate (for which I pay—again, unlike my previous experience with another insurer) and them graciously condescending to set up the multiple appointments for the injections.

Jeez Louise.

So here’s what I’m grateful for today: that Tina and Cindy, with Palo Alto Medical Foundation, were so on top of things; that Tina gave me the benefit of the doubt on my identity verification; that PAMF had the information I needed; and that I closed out the day at least knowing what’s ahead. I told Cindy that my convos with her and Tina were the best of the day, and I meant it. Would that the staff at OrthoVirginia were as good.



No comments:

Post a Comment