Posted by jojo on November 8, 2000, at 16:46:36
I asked my Shrink for an hour-and-a-half appointment, as I think we've hit a rough spot, and
she has developed some counter transference problems (she's beginning to make mistakes
writing my prescriptions, and when I point them out to her, she re-writes it, and again makes
a mistake! My last Shrink used to do this 60-70% of the time). She said she only saw NEW
patients for more than 45 minutes, and didn't have a free appointment until Nov. 30. My
Internist said that she would only order the endocrinology tests that I requested (prolactin, growth hormone, testosterone, DHEA, melatonin….all of which effect sleep and sexual function) if the Shrink
asked her to. I have had severe insomnia for over six months and have taken various anti-depressants (and lived with their side effects) for 18 years, following 10-12 years of Psychoanalysis, sometimes as often as seven times per weekI wrote this in a letter to the Shrink, but don't know what her reaction will be
when she reads it. When I asked her for the tests the last time I saw her, she said I was talking
about possibly $600 in Lab. fees. Instead BC/BS paid $1800 for an apparently useless
sleep test, which revealed that I did not have "Sleep Apnea or "Restless Leg Syndrome", something I already knew. (Still haven't received a written report, but they wanted to schedule another test
for two days ago). So I said to myself, "Why should I give a shit about containing Health
Care costs, if no one else seems to care? I won't have to pay for it anyway", and I called my
Internist and asked her to set up an appointment with an Endocrinologist, whom I had
selected. The appointment is already set up.
Here's a good chuckle, I quote from the "Oklahoma Preferred and Point-of Service Directory of Providers, Service Benefit Plan, 2001:
"Neither the Service Benefit Plan's Point-of Service Program nor Blue Cross and Blue Shield of Oklahoma guarantees the services of health care providers. Whether or not a provider is included in this directory in no way reflects the qualifications or skills of the provider or the quality of care provided to patients."
Now compare this to the quote of BC/BS in the following letter:
Dear Sir/Madame:
I wonder if you could indulge me with some assistance in understanding your recent communication. Unfortunately, I have only had eight years of university training, so I find this communication perplexing.
"The approval for a referral does not guarantee payment.. It only establishes an approved level of care. Benefit availability is subject to the terms and provisions of the Service Benefit Plan Point of Service benefits."
I have no idea what this means. Possibly if you could explain it in French or German I might be better able to understand it.
Thank you for your assistance.Sincerely,
If "The approval for a referral…. only
establishes an approved level of care", how can they
say "Whether or not a provider is included in this
directory in no way reflects the qualifications or skills
of the provider or the quality of care provided to
patients?"Does anyone know what "an approved level of care" means?
Who are these people, and what language are they speaking?
What do really sick people, who can not ask for referrals
and do not have the energy to "make things happen" do?
poster:jojo
thread:2323
URL: http://www.dr-bob.org/babble/social/20001031/msgs/2323.html