September 17, 2008 - 6:49pm
I had my PM app September 9. I told my doc the meds were not cutting it. I asked for something else or a stronger dose. What I got was "Take the Epidural shots or stick with what your on" What would you do. I have told him over and over that I am NOT taking and Epidural Steroid injection. I have produced studies from know sources that discredit them. He blew all that off as fear mongering by skeptics. Should I move on? I really don't see what choice I have. I have one other doc to go to but he is 70 miles one way. I need a good PM doc in Orange County California. Please send suggestions.
September 17, 2008 - 9:16pm
#2
Bad2WD, I see what you mean.
Bad2WD, I see what you mean. Sounds like your doc is locked out and not giving you much of a choice since you already made it very clear to him that you don't want the Epidural Steroid injection, and the meds aren't cutting it. Might be best to move on and find another dr. at this point, but first maybe ask him again once more. Maybe put it like this: Couldn't we just try a little higher dose or another medication first? Tell him it could make all the difference and probably solve the problem and help a great deal....(or something along that line)...he may agree to it, especially if he gets the impression you will go to another dr. Sure seems like a fair request to me..logical too. If he is still stubborn and unhelpful about it, then I would look for someone else who sincerely wants to help you. Best of luck!
September 18, 2008 - 12:59am
#3
Yeah And I am sure he is charging you every time
I am sure every time you go oin there he sure as he bills you right?
(edited)
September 18, 2008 - 11:35am
#4
Bills me? Oh Yea.....
Thats another thing. They said they take my insurance. What they failed to tell me, and I did not check, is that they are "out of network" so now I owe them $562.50 for three visits and all they have done is brow beat me over these shots and then write a me an RX that's not cutting it. Most places that say "yes we take that insurance" are in network or they tell you that up front.
There is another thing about these people. They are a very professional looking group in an upscale medical facility in Orange County in California and seem like professional people. This is a very upscale area. However, they have never weighed me, taken my blood pressure or heart rate or any of the other standard things doctors do when you show up for an appointment. All they did was copy my medical records from Houston and start trying to push these shots on me. I have high blood pressure as well and they have never even brought this up. You would think they would want to monitor that at least since it is documented in the records I gave them.
So, they are basically selling me scripts for narcotics that are not cutting it and doing that begrudgingly while trying to guilt trip me into taking shots that I don't want.
That's it. I am looking elsewhere for treatment. I will drive the 70 miles to San Diego rather than go back there.
September 18, 2008 - 7:16pm
#5
out of network
OMG, I just had this happen to me from a surgery center, but I got slapped with a $11,000.00 bill! I can't believe it. They HAVE to inform you if they are out-of-network for your insurance, because then you are technically a self pay patient and they should know most people don't have lots of cash laying around to pay medical bills when they have medical insurance for that purpose and that the patient will go elsewhere to an IN-NETWORK provider.
If you want look at this forum of what Dr. Lois says on this topic about insurance:
September 19, 2008 - 7:35am
#6
I work for a municipality
I work for a municipality and I do all the insurance for about 600 employees, medical, dental, life, I tell you this because I deal with alot of unusual situations and you would be ASTONISHED at what these companies will accept. PLEASE FIGHT! IMO these bills will be taken care of if your ready to be on hold for a bit (again IMO, it would so be worth a few grand) They truly give in, they "make" so much money off the people that do just sit at home and pay the bills. When taking care of my grandparents (they had BC/BS and Medicare) they would get bill after bill, and my Grandpa being a hard working honest man he just sent in payment, no fuss. Well once I got involved I ended getting him a few grand back and he never received another bill the rest of his life (he lived to be 91) I was once told that they will try to bill everyone and see what happens, why should they pay it when alot of people will just send p[payments in?
September 19, 2008 - 11:14am
#7
I had this happen to me
I had this happen to me about 1 yr ago and I called my insurance company and they sent me an appeal form to fill out & told me to send in a copy of the bill from the doc and I filed the appeal and won. It took a good 2 months but I was soooo happy when I got the letter from my Insurance company saying it would be payed in full (except my co-pay.) The lady at Cigna told me that it is the office staff's responsibility to tell you that the doc is out of network! We are not mind readers! That's what you need to do....APPEAL IT & FIGHT!!
Good luck to you................KK
September 27, 2008 - 6:23pm
#8
INSURANCE
I feel for all of you, and this is what happened to me and it takes the cake. I had been seeing my PM/neurologist for 1 yr when I was working and had great ins.I had to stop work in April and am now on Disability. Because you have to wait 2 yrs for Medicare, I was put on State ins, which he does not take due to the low reimbursement.I went to see him for my appt 2 weeks ago Friday and he refused to see me unless I came up with the $250.00 he gets a visit.I am on Duragesic, oxy ir clonazepam and ambien, which I know you can"t just stop taking. He was sooooooooo rude and said I will give you enough meds for 5 days then you are on your own.Can you believe it?What kind of Health Care do we have in this country.Thank God I found a clinic that not only takes my ins. but also has PM docs GP's and spec. clinics such as neurosurgery as I am looking to have my 3rd spinal surgery.Sorry this is so long, but I can't believe what they do to us.We have worked all our lives and the minute we can't pay its GOOD BYE.I feel for all you folks that are going through this.Its a Shame. And,when I asked this so called Doc if it was dangerous to just stop taking these meds (I know it is I worked in Health Care) He said Either you find someone or I guess you will be in the ER a lot.There must be someplace I can report this type of treatment or lack of but who knows. THANKS for letting me vent I appreciate it, Nancie
September 28, 2008 - 12:40pm
#9
If you went to a
If you went to a psychiatrist he wouldn't check your weight or your blood pressure either. Most specialists assume that you have a primary care physician to take care of your primary care. If you don't, most insist that you get one. Sometimes epidural steroids or facet joint injections work. I have several patients who have clearly benefited from them. Although I do not have anyone on an epidural morphine pump, that may also be beneficial.
As you realize, but surprisingly many people do not, your doctor is an autonomous practioner who can choose what he will and will not do and can pick who he will or will not see. You to have the option of seeing someone else if you are not satisfied with the care you recieved.
As you also know there is no upper limit to the dosage of narcotics a person can recieve, but it creates a concern about addiction and diversion when people are on constantly escalating doses. I do not know your individual drug history or your current dose, but this is probably why your pain mgmt doctor wants to try a different treatment modality.
September 28, 2008 - 1:08pm
#10
Ha ha ha ha! It is
Ha ha ha ha! It is certainly NOT the office staff's responsibility to tell you if they are out of network. Often patients have already met their out of network deductable and then their out of network doctor is reimbursed as if they were in-network. It is not the responsibility of the doctor's office to check to see if you have coverage, a deductable, a co-pay or even to bill your insurance for you! All of this is done as a courtesy to the patient at great expense and great delay in payment to the office.
I am glad you won your appeal, because most people would have just skipped out on the bill. When patients call to ask if we accept their insurance, half the time they do not even know what insurance they have. All they know is "Blue Cross" or "Cigna" or "Aetna"! They do not know what their in-network deductable is or what their out-of-network deductable is and look confused when you tell them they have not met any of their deductable and owe for the entire office visit cost. Then you bill the insurance and find you cannot get reimbursed because the patient has not completed the coordination of benefits paperwork.
September 28, 2008 - 12:58pm
#11
So sorry did I miss
So sorry did I miss something? Is there some other profession that provides services for free? I am guessing that you did not come up with the money to pay for this visit.
Go ahead and report this guy but it will go no where. Doctors are not under any obligation to provide care for people who cannot afford it. This guy was very reasonable. Even though you knew you had lost your insurance, you went to him with no intention of paying for your office visit. He gave you a script that would allow you time to find alternate care which you should have started doing as soon as you knew you were loosing your insurance.
September 28, 2008 - 5:10pm
#12
No You Did not miss anything
First of all, I thought I had one more month of UHC left and did not realize that as soon as you are approved for disability you are put on State ins. (at least where I live) I had my co pay with me and was willing to go get the rest of his money, but he said he had other patients and I could drop it in the mail.I was not trying to not pay him if that is what you are saying, I just did not have it with me.He is now paid and I just was concerned that it was dangerous to come off these meds.He did not titrate me down just gave me 5 days worth.I just found that a bit short of time to find a new MD.When I worked for the hospital, when patients left for whatever reason be it insurance, moving etc, We gave them a month's supply just to make sure they found some one to take care of them.I am not the type of person who does not pay for the services I receive and truth be told, I found your post to be insulting. I realize you are a Doctor and know a lot more than most on this site, and I always respected your answers that helped people.So, all I am saying is I do not appreciate being judged because I told what had happened to me.As far as this is concerned, I am seeing a good MD and the neurologist that did help me is paid and I am moving on.If I took what you wrote the wrong way, then I apologize, but my feeling were a bit hurt.Take Care Doctor Lois.
September 28, 2008 - 9:15pm
#13
uncalled for
Although I agree with your 2nd paragraph Lois. your 1st was totally uncalled for. Your sarcasm was rude and goes to show the bitterness of your character. Most of your posts that I read have some sort of smart remark in them.
September 28, 2008 - 9:49pm
#14
If you agree with the second
If you agree with the second paragraph how can you object to the first paragraph? Can you walk out of Sears without paying for a lawnmower or get a free haircut at a local salon? If you eat at a restaurant without paying it is called dining and dashing, if you don't pay for your gas in Ohio you get your licence revoked!
Several week ago I was in the waiting room of my doctor when a new walk-in patient (she had to fill out the paperwork) refused to pay the office manager before being seen. When the doctor came out to call the next patient she then had the gall to ask the MD in the full waiting room if she could have an examination and get a prescription without paying. When she was again politely told no as she had been by the office manager she left in a huff saying she was going to go see a specialist. Good luck seeing a specialist for free!! There was a general titter of laughter after she left as everyone there loves that doctor. The doctor maintained a straight face.
If my doctor's office dosn't charge people they go out of business and all of the patients loose out
Dr. Lois's comments are not sarcastic to the realistic.
Thankfully the OP did later post arrangements had been made with her doctor and her health care was continued. Her doctor likely does many pro bono cases that no one is aware of.
~I have no medical knowledge, only life experience~
September 29, 2008 - 12:03pm
#15
I think my sarcasm was very
I think my sarcasm was very well directed. It is completely unreasonable for people to expect free service from doctors.
September 29, 2008 - 12:35pm
#16
It is impossible not to be
It is impossible not to be skeptical of patient's promises to pay, when it is a daily issue even in my little primary care one doctor office. When patients don't pay me, I can't pay my suppliers, my rent, my insurance, my staff, my bank, or myself. Most offices have a policy of payment in full at the time of service, unless prior arrangements are made.
I'm glad that in your case it was just a mistake about insurance, and that you have coverage and are able to get care. (Since your old doctor did not give you the benefit of a full office visit, which would normally include a script for 30 days, I would also not expect for you to send him $250. But if you did it certainly puts you on the moral high ground. If he finds out that you did pay the full cash fee he might treat the next patient differently.) If you are the type of person who would never dream of not paying for services that you have recieved, you would be astounded by how frequently it happens.
My purpose is not to judge your doctor or to judge you. People frequently have misconceptions about what should be done, what normal practice is, or how a doctor's office operates.
September 29, 2008 - 12:35pm
#17
I do not
recall the op expecting her visit to be free, that WOULD be unreasonable. It is not unreasonable to be treated with respect from drs. Although it might be if you are the doc.
September 29, 2008 - 12:50pm
#18
Thanks Dr Lois
Thank you for taking the time to answer me I appreciate it.It was just a mistake in ins coverage and believe it I do pay for services I receive. I know the cost of running and maintaining a Doctor's office has to be astronomical and I have the utmost respect to Doctors such as yourself who "tell it like it is".Thanks again for all the good you do here, I appreciate it.We need more MD's like you. All The Best, Nancie
October 4, 2008 - 9:45pm
#19
Last Visit, Got Laughed At!
I went in for a third appointment and it will be my last. The Doctor would not see me. He sent a PA in who refused to listen to my request and literally laughed out loud at me when I mentioned the reason I did not want the epidural shots. He asked me if "ARC was aspirin or something" and acted like I made it up. I had several printed resources with me and he would not look at them. He threw them down instead of handing them back to me.
Dr. Lois, I like your posts and comments and respect your opinions. However, I have been to numerous PM's and everyone of them recorded my weight, BP and other vitals. I have also NEVER had a PA (who almost got a fist in his teeth) laugh out loud at me! So, maybe you need to accept the fact that all Doctors, no matter how proffessional they seem, do not always have your interest at heart. There are some who are self serving and I have just found a few. The place is called Mission Hills Pain Clinic. It is in Mission Viejo, Orange County California. They want to give you an epidural steroid shot or they don't want to see you. Period! So, they will not see me anymore. I will pay their $500.00 bill sometime before I die unless I keep seeing that little PA laughing at me every time I try to write the check!
October 7, 2008 - 1:39pm
#20
Hey guys....I am new to
Hey guys....I am new to this. However, I need to find a new doc as well. I am in severe pain in my neck/back/left shoulder. I was going to a doc who was great. I was on percocet 10. He left the practice and I started going to a new doc and he brought me down to vicoprofen. It does not work and now he is saying he wants to take me off completely!!!! All bc he thinks I dont need them. I have been on them for 2 years (rx by a doc). I cant take it and need to find a new doc. However, how can I find one that is not an opiophobe? I live in the birmingham, al area. If anyone has any suggestions.......PLEASE HELP!!!!
October 7, 2008 - 2:23pm
#21
The only way to find a doc
The only way to find a doc who isnt an "opiophobe" as you say would be trial and error and going to see a different doc.
October 13, 2008 - 7:12pm
#22
New Doc
Hi and Welcome.What I would suggest is that you either use your search engine on your PC and type in pain management physicians in your area, or maybe the local hospital could help you out with names.I live in CT and we have something called info line that answers any question about anything and will guide you in the right direction.Also try looking under Physical Medicine and Rehabilitation Physicians.Hope this helps a bit and best of Luck, Nancie
Bad2wd I had -0- benefit from any facet injections-if any thing they speed up the degenerative disc problem full bloom. I had a surgeon tell me that he personally felt injections did more harm than good. I know regardless of the 'real' benefit of them -some clinics and institutions have pushed them on patients as often as their insurance companies or carrier would cover the procedure. It is a big money maker -bottom line-get them in and get them out. When I declined from having them anymore-and this was a huge neuro institute in the midwest the pm dr I was seeing told me that he would do injections and oral pain meds. That place conducted so many procedures on me that it was a joke. Then the surgeon I was seeing passed me on to another surgeon who told me surgery was not an option-1st surgeon gave my husband and I hope that I would be a very good candidate for surgery.-as it was declared on my chart not an option surgery-2nd guy-only to be sent to a pain Dr. he was fine at 1st like the 1st 6-8 months, then when I conveyed my feelings on the injections-my call in refill went from 1-2 vicodin every 4-6 hrs for pain-the script read 1 vicodin in the am 1 in the pm. I was insulted, felt violated as well as used. I trusted them for 1and a half yrs. the money they made off me was crazy-I have a real serious cervical spinal situation-pain managment doctors good ones that really care about the well being of the patients are few and far between. I feel if the doctor has good standards and do a thorough deal asking for the proper info and records on you and are in their own practice or work out of a hospital they are worth there weight in gold. Doctors need to listen to their patients and vice a versa. I hope you can speak with your p.m. -and he truly understands you. good luck !!!