Healthcare in Delaware (Dover, New Castle: university, moving, bill)

[elizamary]

Originally Posted by Laural

The front desk holds the power and makes most of the decisions on who gets to be seen by the doctor, most times the doctor isn't even aware what's going on. One example my mom had an appt went to her appt on time, and was turned away, the front desk told her she had the wrong day and she argued with the girl but apparently the computer is never wrong *gag*and the girl was very snotty about it. When she got home she found her appt card and and faxed it directly to the doctor, with a note on how she didn't appreciated being inconvienced like that and didn't appreciate the attitude of the girl. The doctor called her personally an apologized, and they managed to "fit" her in the next day and the girl who told her she came on the wrong day apologized profusely, and they treated her like a queen apologizing all over the place. We think once the doctor found out heads rolled. So if you have a problem ask to speak to the doctor. On that note, my doctor actually told me once, that doctors always worry about their front desk people and the decisions or advice they give can kill people! Yikes! That completely opened my eyes on how things are ran at a doctors office!

This is one of the reasons we changed doctors. The front desk was nasty and certainly not managed well.
I go to my new doctor on Wed. I heard she is good and a lot of paramedics use her.
So we shall see. I have waited 3 to 4 months for this appointment.

[rockky]

Originally Posted by elizamary

This is one of the reasons we changed doctors. The front desk was nasty and certainly not managed well.
I go to my new doctor on Wed. I heard she is good and a lot of paramedics use her.
So we shall see. I have waited 3 to 4 months for this appointment.

Unfortunately this is what I have been posting about over the last year, and when I received much disagreement about my reality I felt rather lost. I thought maybe I was the only person in the area who encountered this sort of thing. I found this situation to be the norm rather than the exception with the Dover medical community. It was not only frustrating...it was down right scary with a couple of incidents.

I sincerely hope that all of you have better luck finding a satisfactory primary care provider. It's even tougher to find good specialists in the area.


Hummm? Does that sound like an "I told ya so!"? LOL! Yeah. I suppose it does. Hope the situation improves as more folks move to the area.

[movn2del]

I haven't been reading a lot of the threads lately because I'm busy packing. I have the need to post now and hope someone can help me. The healthcare that I have doesn't apply in DE and we are moving in less than 9 weeks. All providers will be out of network. I don't want to be in a situation where I can't afford the healthcare my family will need. Can someone tell me if providers are easy to join networks so all I will have to pay is the co-pay? I called Bay Health Center and they said they probably wouldn't for one family. Maybe there are individual Dr.s? Heeeeellllp

[elizamary]

Originally Posted by rockky

Unfortunately this is what I have been posting about over the last year, and when I received much disagreement about my reality I felt rather lost. I thought maybe I was the only person in the area who encountered this sort of thing. I found this situation to be the norm rather than the exception with the Dover medical community. It was not only frustrating...it was down right scary with a couple of incidents.

I sincerely hope that all of you have better luck finding a satisfactory primary care provider. It's even tougher to find good specialists in the area.


Hummm? Does that sound like an "I told ya so!"? LOL! Yeah. I suppose it does. Hope the situation improves as more folks move to the area.

Roccky,
We were new to the area but also realized this can happen anywhere. Being new, we had to go by trial and error.
Yes, it is frustrating until you find a doctor and staff that you are satisfied with.
Unfortunately, not all are satisfactory so some scouting is necessary. Sad but true

[from PA]

Hi movn

When we moved here 2 years ago, I was on COBRA from my previous job in PA. They switched me from Aetna or Keystone in PA, can't recall now which one, to Amerihealth of DE. After 18 months, when my cobra expired, Amerihealth offered us a conversion plan. We had to ask for it but the terms were very similar in coverage and cost minus the Precription plan. So far we're doing ok without the scripts thanks to generics.
I don't know if this will help you out, it sure helped us.

Did you check with your current provider to see if they can offer you a similar plan in DE?

[rockky]

That's my point. You can do all the 'homework' and research in the world, but it isn't always effective. When you have serious need of medical care...well, that isn't the time to try to work out the bugs, but there's no way around it.

movin', even though I'm BC/BS Traditional I was told all the docs were out of network. It was a mess. They did pay some, but it was almost impossible to make sense of the EOBs. The docs could charge whatever they wanted even if they were BC/BS participating. The EOBs made little sense. Some reimbursements were sent to the doctors. Most of the time the check came to me. Then the docs had no idea what to charge. Many of them were cooperative, but I had to give them my EOBs in order for them to figure out what to bill. Also, the insurance company combined multiple docs on one check. I couldn't just sign the check and hand it over to the billing department. The insurance company refused to talk to the medical providers. Yet the insurance company told me that the docs could not, by law, charge me for more than what I was reimbursed plus the 10% out of pocket I owed after I met my deductible. It didn't always work. Also, some of the billing was not local, and I had to get the stuff to Wilmington.

It's another one of those things that DE needs to look into. I really don't know where the responsibility lies. The insurance companies and the state need to work together I suppose. Yeah. I know. They are throwing out the red carpet, but there's a pile of you know what at the other end when it comes to medical insurance.

I sincerely hope you can get some answers before you have need to use your covrerage.

[sanddollar]

Yes, indeed, front desks can be a turn-off for new patients, too. I was recommended a particular doctor in Dover for my mom who just moved into assisted living. (PA, you remember who it was). Well, I went to set up the initial appointment and fill in paperwork ahead of time because she was in no condition to come with me just then.

Not having been there before, I didn't realize that they take a long long break around noon. They didn't lock the outer office door, so I went on in. Three women were up front behind the glass. One was doing paperwork, a second was speaking to a patient, and the third was on the phone. I went ahead and signed in. Thinking that the third one could help me with a couple questions, I waited a few minutes until she could get off the phone. While waiting, I couldn't help overhearing the conversation, and it was very obviously a private phone call. You would think that she would have at least looked up and smiled or acknowledged my presence in some way, but no, I was invisible. After a few more minutes, I gave up and sat down until the patient was finished at the window. Then I got up and said, pointing at receptionist #3, "Is she on her lunch break?" Receptionist #2 said yes, and can I help you, etc., etc. While I was filling out the paperwork for a new patient, I was sitting out of sight of chatty-Kathy who eventually finished her conversation. I wouldn't have paid any attention except that she got all huffy and said the the woman next to her, "Did she say, 'Was SHE on a lunch break?'" And I piped up and said, "Yes, I said that. I'm filling out new patient forms and I didn't know your schedule." Not an apology, not even a sheepish look, nothing, from chatty Kathy at that point.

If I didn't know that the doctor Mom would be seeing had a great reputation, I probably would have walked out and canceled the whole thing.

Yes, folks at the front desk and make or break first impressions.

[elizamary]

Originally Posted by sanddollar

Yes, indeed, front desks can be a turn-off for new patients, too. I was recommended a particular doctor in Dover for my mom who just moved into assisted living. (PA, you remember who it was). Well, I went to set up the initial appointment and fill in paperwork ahead of time because she was in no condition to come with me just then.

s.

Sanddollar....... Who was the doctor. Just wondering if it was the group we went to. You can PM me or send his/her name in an email if you feel more comfortable.
Just curious.

When I was looking for another doctor, my neighbor recommended her doctor.
Well on the phone it was chaos. They kept me hanging and I got transferred, still hanging and that did it. I called someone else. I figured if they were that unorganized then it was not for us.

[movn2del]

Originally Posted by from PA

Hi movn

When we moved here 2 years ago, I was on COBRA from my previous job in PA. They switched me from Aetna or Keystone in PA, can't recall now which one, to Amerihealth of DE. After 18 months, when my cobra expired, Amerihealth offered us a conversion plan. We had to ask for it but the terms were very similar in coverage and cost minus the Precription plan. So far we're doing ok without the scripts thanks to generics.
I don't know if this will help you out, it sure helped us.

Did you check with your current provider to see if they can offer you a similar plan in DE?

I will be calling and checking tomorrow, if I can get another plan that works in DE. I don't think there is another available. I will see. Thanks for the suggestion.

Originally Posted by rockky

That's my point. You can do all the 'homework' and research in the world, but it isn't always effective. When you have serious need of medical care...well, that isn't the time to try to work out the bugs, but there's no way around it.

movin', even though I'm BC/BS Traditional I was told all the docs were out of network. It was a mess. They did pay some, but it was almost impossible to make sense of the EOBs. The docs could charge whatever they wanted even if they were BC/BS participating. The EOBs made little sense. Some reimbursements were sent to the doctors. Most of the time the check came to me. Then the docs had no idea what to charge. Many of them were cooperative, but I had to give them my EOBs in order for them to figure out what to bill. Also, the insurance company combined multiple docs on one check. I couldn't just sign the check and hand it over to the billing department. The insurance company refused to talk to the medical providers. Yet the insurance company told me that the docs could not, by law, charge me for more than what I was reimbursed plus the 10% out of pocket I owed after I met my deductible. It didn't always work. Also, some of the billing was not local, and I had to get the stuff to Wilmington.

It's another one of those things that DE needs to look into. I really don't know where the responsibility lies. The insurance companies and the state need to work together I suppose. Yeah. I know. They are throwing out the red carpet, but there's a pile of you know what at the other end when it comes to medical insurance.

I sincerely hope you can get some answers before you have need to use your covrerage.

Are you trying to tell me that the Dr.s aren't allowed, in DE, to charge more than the insurance companies pay?

[elizamary]

We also know some people that had healthcare in another state which is NOT taken in DE.
I had to try and find a plan that doctors in DE would accept. It was not easy so I went with Blue Cross and Blue shield because they are universal. Now we are in BC of DE.
Last year we had a big problem with BC paying our doctors. Didn't get straightened out till July. A very frustrating situation.
Everytime I called, I got a different explanation.
Now I am having a problem with my dental plan. That is very frustrating knowing you do not owe the money and they say you do with some **** n bull story.