Tuesday, January 11, 2011

bad day at the office.

i had an appointment with my (relatively new) endo at 3:45 today. i scheduled it after the first time i met her, which was the beginning of november.

we got some snow this morning. maybe an inch-ish. schools were closed, so i thought maybe i'd call the office around lunch to make sure they were good to go, as scheduled.

i didn't have to wait to call, because they called me.
her: nancy, you have an appointment today with dr so and so, i'm calling to see if you can move the time up to 1.
me: is your office closing early because of the snow?
her: no, she's had a lot of cancellations today and now she has a big gap in the day and she's not going to wait.
me: [pick my jaw up off the floor] ...silence... in my head: she's not going to wait?
her: um, could you come at 3?
me: uh, yeah i guess that's fine.
her: ok see you then.

um, i'm sorry, so what you're saying is, the doctor, who i pay, who provides me a service, who i set up an appointment with three months ago, wants to go home early, so you want me to shuffle my day around and come in early to suit her schedule? are you SERIOUS? now, if the question worded something along the lines of her children were out of school, she was trying to see if any patients are available to change their appointment times if it was convenient for them, etc., then i might have been more flexible. but i was shocked by the way she spoke to me and the attitude that she had in her voice when she called.

i made a few notes of things to talk about with the endo: Rx, BG questions, the phone call. the time for the appointment came, i arrived 10 minutes early as usual, in case they needed me to fill out paperwork or anything.

'nancy? so-and-so in billing needs to see you because you have a balance on your account.'
billing? why would billing want to see me? my mind started racing, because i always pay my copay before i see the doctor, i've paid them at all my appointments.

me: is this for copays or something? i always pay them at my appointments. 
her: yes.
she goes through my appointments and explains the charges. the front desk was charging me $15 less than what they should have been charging me - for two appointments (endo, dietitian). oh yeah and the time that i came in for about 10 minutes to get the CGM put on, they didn't charge me a copay.
her explanation: we didn't know if your insurance was going to charge you for that appointment so we didn't charge you. and we didn't know if they would charge you the lower or higher amount on your appointments so we charged you the lower. if we charged you a higher amount, then you'd have a credit on your account.

um, i'd rather have a credit on my account than HAVE TO PAY YOU $100 at once, three months later.
so i paid the amount, and my blood was boiling. how could they NOT say ANYTHING for three months???
i went back with the really nice nurse who i love (thank goodness, seeing her was a relief) and she took my blood. when we got to the room, she checked my blood pressure and said it was a little high. she asked if i had ever heard that.
me: no, but i'm really irritated right now.
her: oh gosh, did i say something to upset you??
i said no and gave her a quick recap of the billing thing and she said that when i was done she was going to take me to talk to the office manager so maybe they could 'fix it.'

so i met with the endo, forgot about the phone call thing from earlier because i was so pissed about the money ... but - the doctor herself was lovely, i learned things, i feel good, i'm healthy, do these things and i bet your A1c will be even better, all that fabulousness. 

so after i met with her, i go back to the nurse. while i set up my next appointment she went to tell the office manager i was waiting to see her. i was glad, i was going to tell her about the phone call rudeness that i had forgotten about.
so the person who had set up my appointment calls the manager to let her know i'm ready to meet with her.
'should i bring nancy back?'
after she hangs up, she took me back TO THE SAME BILLING PERSON. who sighs, and says 'okay, i've got it all open here to show you.' i could feel myself getting hotter, irritated that i was not meeting with the person i was told i would see.
so she showed me the charges. she showed the ones they didn't charge for and should have. 
now, on top of reviewing the same thing we had already gone over, there are two nurses standing in the same room. no privacy screen, no cubicle, no keeping her voice down, nothing that would make me feel like this was a confidential discussion. just saying all my financial information out in front of staff.which pissed me off even more. PATIENT PRIVACY??
and so i said, 'i understand the charges. what i don't understand is why no one has told me since november when i started coming here. i've been here more than once, and it was never flagged or anything.'
'well we didn't know if your insurance would charge you.'
she said they didn't want to charge me a higher amount if it only ended up being the lower amount, because then i would have a credit to my account. as apposed to this balance?? um, i'd rather have a credit than owe you 100 DOLLARS.
so she asked, 'what can i do to make you feel better about this?'
so of course i said, 'take the 100 dollars off my card.'
and she said 'well that can't happen.'  [insert shocked face at the rudeness yet again]
she said, 'i understand you are angry but i'm showing you everything...'
i said, 'shouldn't the people who tell me my copay KNOW the copay amount?'
'well not really, your insurance is really messed up and we don't know how they will charge.' 
now, this is what i call placing blame instead of admitting the mistake and apologizing. not ONE TIME did she say 'i'm sorry it happened.' she said one time she understood i was angry and she would be too. (how does that fix my situation? it doesn't.)

at that point i was so angry i could no longer process my thoughts in a kind fashion and i had to leave because i was so worked up with anger that i was on the verge of tears. i was angrier when i was leaving because instead of meeting with me, when i asked to see her, the office manager sent me to billing because she assumed that was my only problem. guess what happens when you assume?
she didn't even take the time to talk to me. i stopped on the way out and asked if she had a card, or an email or how i could contact her. because i didn't get to see her and i was so mad that i knew i needed to leave and calm down before i talked to anyone else. 

i am still appalled. where did the patient care go? and i don't mean the care from the doctor. i mean the other people in the office. it's not all about the doctor. i fully expect to be treated as if they care about their patients.
is that too much to ask?


  1. As a mom, I learned many, many years ago to have any questions for the pediatrician written down ahead of time. A big bonus was if I remembered to bring the written list of questions with me - duh...
    Now I do that for myself - and it does help. It's so easy to get distracted.
    Let the doctor know about your office procedure concerns.

  2. Tough day at the office, indeed... It's really annoying when docs dont treat you like a customer because you are right - thats how they should look at you.

    That being said, I personally would rather owe my doc than the other way around. Fighting with insurance companies or docs to get reimbursed for credits is tough, in my experience. Much better off being the other way around.

  3. wow. yes, the dr needs to know how her staff is treating the patients. period. you are the only way she can know. my old ob used to ask me about her staff and their friendliness, care, service, etc bc she said she trusted me and asking upfront was the only way she could get a clear picture of the experiences her patients were having -- she made a comment about her staff representing her. so true.

  4. Sorry you went through that with the office, especially when the nurse and doc are people you like - that can make it even tougher if you ultimately make a decision to part ways. I've had some issues like that in the past, and have flat out refused to pay for their stupidity. Because that's what it is: THEIR stupidity. Regardless of how stupid insurance is, your doctor's office is required to communicate with your insurance company to check for co-pays and then inform you. Not pawn it off on you. While it may be more work for them up front, it prevents this exact scenario from playing out and them ultimately getting screwed. If you show up, with just enough in your account to pay the amount, and not any more to hand over, there's not much they can do but refuse service or keep the balance. I'd write a letter to your doc about it, since there's not much that can be done now that you paid. But again, sorry it played out that way!

  5. I'm pissed just reading about it! I have come to the conclusion that you can rarely have it both ways. You either love the office staff and hate the doctor, or love the doctor and hate the staff. Right now, I hate my dr's staff, but I love him. I had to reschedule my endo appt because of my pregnancy scare and I told her I'm under strict instructions to see him every 4 weeks. What does she do? She schedules me for the end of FEBRUARY! (And not without a serious -itchy attitude, mind you) That's 6 weeks from now! That will be 10 weeks since I saw him last and I'm SURE he won't be happy about it, but she will not reschedule sooner.
    I would definately call back (or go back and wait) and get the office manager's email or direct phone number. Staff shouldn't be allowed to treat their paitents that way.

  6. i have an appointment with the dietitian on monday (in the same office), and i plan on talking to the office manager then. and i'm not leaving until i get to see her, she is not blowing me off this time.
    i fully intend to switch doctors, i actually found one with great office and doctor reviews that i scheduled a consultation with. - i'm crossing my fingers - and she's young so hopefully that means i could see her for years to come.
    even though i'm switching, i feel like they need to know why i'm leaving. sigh. we'll see what happens :)