GRRRR. Aimed at the Docs.

susiestar

Roll With It
We see the top neurologist for kids in the state, possibly even the region. He is excellent. I have real beefs with the staff. They charge $25 per PAGE for any forms to be filled out. Just having them fax jessie's school to say she really has migraines and they do last a week or more at times cost me over $100. They even billed me for phone calls.

The staff does not even take all phone calls to the doctor. If they think you are being a PITA they just erase them. They admitted it to us.

Right now Jessie really needs this guy. But he is trying to get out of a contract with our insurance co. If we go on medicaid he will help us.

He is still under contract to our ins co so he has told his staff to refuse to schedule anyone with it until they have different insurance. He will not or can not even let us pay cash for the full cost of his services. Not even if we pay up front.

I am so angry today. we did the video EEG. I called the pediatrician's office that ordered it. She is in excruciating pain. Between the shaking episodes the muscles on her back,legs, arms, everywhere - even her scalp are just all knotted up. They gave ehr a few pain pills and muscle relaxers. They are not helping much.

At this point a new patient appointment with another child and adolescent neuro will be a 4 month wait.

It will be 4-6 weeks before she can get medicaid.

How do I get her help NOW?

I did tell the nurse that the pediatrician needed to call the neuro to get some help for us. I was insistent. It will be tomorrow before I get any help.

We did NOT need this insurance squabble on top of everything!
 

Mattsmom277

Active Member
I would call and get a fax number for his office.
I would then write a SUPER polite letter. I would fax said letter to the docs office and carbon copy the fax to the insurance company.
I would politely state that although the doctor is in process of extracting his dealings with this insurance company, he in fact is your daughters doctor and she is an ongoing patient with medical needs right NOW and that until the insurance agreement with the company and the docs is formally severed, you expect to be seen by this doctor as per usual, without being fluffed off while doctor boots out this insurance company.
At the least, the doctor will learn you are upset, you and your daughter enjoy his service as a doctor, and that she is also in need NOW. It can't hurt. And a fax that is copied to insurance company isn't going to be booted out by the receptionist as they do with calls. For sure the doctor will see it, especially if you say that you expect the doctor to personally recieve this letter, not just staff. If you do it politely it should just be showing your care for your daughter and not offend the doctor. Worth a try!

Sorry you are going through this all.
 

Josie

Active Member
I think Mattsmom has a good idea. Also getting the pedi's nurse to call might help.

I went through something similar with my daughter. Her migraines were so bad that she hadn't been to school for weeks. The neurologist's office wouldn't schedule her until his next appointment for 6 weeks. What is wrong with these doctors?

How far are you from Dallas? I was able to get my daughter an appointment with a neurologist there pretty quickly at the beginning of the summer as a new patient.
 

maril

New Member
Unbelievable. I am so sorry for your daughter and am crossing my fingers for a quick resolution.

Those fees are incredible; $100 to fax how many pages?

The doctor's employees sound pretty arrogant. I've worked around some like that and have thought they're probably in the wrong profession. :(
 

susiestar

Roll With It
I really think much of what the staff does he has no idea about. The two ladies who are "in charge" of the front office are terrors. They have NO empathy for anyone. The most adorable babies and the sweetest kids get the same reaction of annoyance and irritation and borderline anger that the kids who have outbursts have. Heck, they even tried to rush a mom with a very much affected infant (under 9 mos) to pay and get "out of the way while he does that" when the child went into a full seizure. the mom started yelling for help as she was standing at the counter to check out when the baby started seizing. The first person to come up to her was a nursing student and the office biddies chased her away. Then the doctor came out to see what was going on and they rushed to help and chastised the student for "walking away when it was clear she needed help".

He truly is an incredible doctor. Absolutely the best in the state and up there in the nation for his field. He makes every kid laugh and feel at home. None of them balk at seeing him.

But the staff is horrible. I don't even know if HE knows they are refusing to book patients. I will find out tomorrow though.

I did write a letter. I will have to edit it tomorrow but will send it after I call them.

I just wish a few steps could be taken out. I called the pediatrician. They said to call the neuro. The neuro will say to have the pediatrician call him. I will call the pediatrician. They will say to have the neuro call them. I will then make four or five MORE calls to get them to understand that the pediatrician must call the neuro.

I hate this nonsense but I will dance the dance until they help my kid.

I am about 6-8 hours from Dallas. I will probably try other docs here first and then possibly fly her to Children's in Cincy. I have family and friends we can stay with and they can probably even come get us and loan a car to us for getting to the doctor.

I really do NOT want to have to do it, but I will.

Sigh. At least we could go to Jungle Jim's - the absolute most awesome grocery in the world! Acres and acres of food from all over the world. My 18yo cousin works there so we would get extra samples. Look up their web page. It is mind-blowing.
 

flutterby

Fly away!
My thoughts:

He may be a wonderful doctor, but how great is he if you can't see him?

I would look up your state medical board and find their guidelines. This stuff doesn't seem ethical. You have a child that is suffering and needs medical attention and they are denying her that.

I would contact your insurance company about them refusing to schedule. I don't know if they can do that if they are under contract without getting penalized. I had a doctor refuse to perform a lapraoscopy because I hadn't paid for it prior to the procedure. In fact, he refused to see me as a patient anymore. My insurance company told me when they approved the procedure not to pay until after it was done and after the insurance had paid their portion. They stressed it. It was in their contract. The insurance company jumped all over them for that. The doctor's office ended up reimbursing me for co-pays for the pre-op appointments and I'm pretty sure the insurance company didn't pay for them either.

I'm so sorry that you are going through this and that Jessie is suffering. My heart aches for you both.

(((hugs)))
 

gcvmom

Here we go again!
What if you took her to the ER during her next seizure and claimed she had no neuro (seems like she doesn't anyway since you can never get in) and get one temporariliy assigned that way?

I'm so sorry you're going through this nightmare. It shouldn't be so hard to get care for her.
 

susiestar

Roll With It
I would have a 75 mile drive to an ER that could call a neuro. There are none in our town except for 2 hours one morning a month. Never the same day, like the 14th or the 3nd Wed. That is for an adult neuro, NOT a child and adolescent one.

I am on hold with the insurance co now. I will look up the state medical board and other neuros. Thanks for the ideas.

I was just shocked when they told me they wouldn't schedule her in spite of the problems.
 
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