Should I complain?

[jamrobmic]

The clinic where difficult child was receiving treatment had a rule that if you were on medication, you were required to see one of their therapists monthly. difficult child's therapist didn't think he needed to be in therapy (I disagreed, but difficult child never really said much in therapy, and the therapist wasn't helpful to me or difficult child). So he recommended we find a psychiatrist who didn't require therapy, and gave us a couple of recommendations.

I made an appointment with one of those psychiatrists, and it was a disaster. I went in with difficult child, which I think immediately ticked off the psychiatrist. When the psychiatrist asked why we were there, I started to explain, and the doctor cut me off and told me he wanted to hear it from difficult child. He asked difficult child why he was there, and difficult child told him he guessed so he could keep taking the medication. When asked why he was taking the medication, difficult child said he didn't really know. The psychiatrist told him he thought difficult child DID know. Then the psychiatrist told me to wait in the waiting room. He came back to get me after about five minutes and said difficult child wasn't being cooperative.

Then the psychiatrist asked me if I knew what was going on. Even though I was tempted to tell him yes, but he wanted to hear it from difficult child, I held my tongue. I told him difficult child had been diagnosis with bipolar disorder. The psychiatrist asked me what made me think difficult child was bipolar. He was very belligerent the whole time. He acted like we were trying to get rx for something we could sell on the street (he never said anything like that, but he acted like we were trying to con him into giving difficult child a rx). I tried to tell him I didn't THINK difficult child was bipolar, his previous psychiatrist had diagnosis him bipolar.

It went on like this for a few minutes, and finally difficult child said, "This is a waste of time." I told him I agreed, and we both walked out. The whole time, the psychiatrist was saying he agreed, too, that Lamictal was a very strong medication, and he couldn't rx it if difficult child couldn't answer some simple questions.

We didn't hear anything else from this psychiatrist, so I assumed he at least had enough integrity not to file an insurance claim when he really hadn't done anything. WRONG. I just received a statement (the first one I've received) from his office that they did file an insurance claim back in July, but it hasn't been paid yet, which is strange, because the insurance company is pretty quick. I have't received anything from the insurance company at all.

So my question is, should I complain to the psychiatrist, the insurance company, the board of insurance, or all of the above? in my humble opinion, this guy shouldn't have charged us at all, and he sure shouldn't have charged $225.00 for a psychiatric evaluation (that is what it says on the statement) that never took place. I would appreciate any input anyone has.

 

[Fran]

I would. No evaluation took place.
Maybe he should bill for a 15 min medication check/office visit. He sure didn't evaluate anything.

 

[jamrobmic]

Thanks, Fran. To me this seems like insurance fraud, but I didn't know if I was overreacting because the psychiatrist was such a jerk. The whole thing felt more like a police interrogation than a doctor's visit.

I think I'll give him the benefit of the doubt and start by contacting his office and go from there.

 

[OTE]

Were you handed a fee schedule when you went in? I'd check that. If it says that there's a flat rate for an evaluation, a first appointment, then that's what it is. Any part of that time counts as the flat fee. It's not an hourly rate for the intial evaluation. They often set up a fee schedule that way because they book a couple of hours for an initial evaluation... depending on the dr. So if they don't take any patients for those two hours they don't want to lose 2 hours of billing time. I can tell you that the psychiatrist I work for..the receptionist calls any new appointment 2 days before the appointment to confirm that they're going to show. Not much more than 60% confirm. Of that 60%, probably 10% doesn't show 2 days later. In fairness, the waiting list to get an evaluation is about 3 mo. So often people make the appointment and then in the 3 mo find another psychiatrist. But in an 8 hour day if you lose 2 hours it affects the budget! Particularly if it happens a couple of times a week. So we have a fixed fee of which 50% will be billed if they don't show up without 24 hours notice. Patients are told this when they make the appointment. It's also in the packet that is sent to them to bring with them for the appointment.

It's not insurance fraud. It's a verbal contract between you and the dr if you were told in advance. Written if/when you sign the contract.

There's no excuse for a psychiatrist to be rude. Also no excuse for a psychiatrist to assume that you are trying to push medication into difficult child's throat. But also illegal for a doctor to prescribe medication against the patient's wishes or without informed consent. A psychiatrist should foster open communicastion. But you weren't the patient and your difficult child is an adult. I still would have told difficult child to wait in the hall and had a word with the psychiatrist about his/her attitude. But the line can be blurry when the patient is an adult and the family member is perceived by the doctor to be overly controlling. Not that you are, just that it would seem that that was what the psychiatrist was thinking. psychiatrist should have been more tactful.

 

[jamrobmic]

No, there weren't any fees mentioned anywhere. The psychiatrist was just as rude to difficult child as he was to me (maybe more so-he pretty much called difficult child a liar), so if his problem was that he thought I was controlling difficult child, I would think he would have been civil to him, at least. And difficult child had only legally been an adult for about two weeks; I find it hard to believe this psychiatrist had never dealt with an 18 year old who couldn't discuss his condition/medication in depth. Especially an 18 year old who has a condition that can affect his thoughts/perceptions (I offered to have difficult child's records from his previous psychiatrist transferred to this guy's office, but they didn't want them). I still plan to call the psychiatrist's office tomorrow; nothing may come of it, but at least I won't be sitting back accepting being charged for work that wasn't done.

 

[jamrobmic]

I called the psychiatrist's office, and told the person who answered the phone that we had been charged for an evaluation that didn't take place. She asked what happened, I told her, and she told me if there was a problem removing the charge, she would give me a call. I haven't heard from them again, so hopefully that's the end of that.

 

[JJJ]

We had a similiar "appointment". The psychiatrist told me that my 5-year old (now 11) was a hopeless case and recommended we disrupt the adoption so that DCS could place him in an institution. That was his learned opinion after almost 3 whole minutes spent with us! ( /ubbthreads/images/graemlins/919Mad.gifInsert bad word here! /ubbthreads/images/graemlins/919Mad.gif )

 

[jamrobmic]

JJJ, something similar happened to my sister. Her son's pediatrician told her if she (my sister) didn't get a handle on her son's behavior (he was two), that he was going to be a juvenile delinquent. My sister found out not long after that that her son's ears were so full of fluid that it was like trying to hear underwater, which was why he wasn't obeying-he couldn't hear. This same pediatrician didn't catch the hearing problem, another doctor did. You have to wonder why some of these insensitive morons even became doctors.

 

[guest3]

Your are totally in the RIGHT