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Old 04-28-2014, 04:44 PM
 
1,107 posts, read 2,274,181 times
Reputation: 1579

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May I ask what they lied about? Trying to get a feel for what others have experienced. For the most part, I have had good doctors, except, of course, the one who had their license pulled for having sex with a patient!! Thought that one was great until that point!!
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Old 04-28-2014, 04:47 PM
 
Location: Area 51.5
13,887 posts, read 13,642,217 times
Reputation: 9171
Quote:
Originally Posted by jzeig104 View Post
Wow, may I ask what your insurance is? My insurance carrier that I have had for 12 years did not dictate this way, and I have had caths/angioplasty, stents, and a triple bypass. I can't imagine that my insurance company would have told my nationally known surgeon that they couldnt do a bypass right away when the angioplasty didnt work, and I know they didnt do such a thing when I had the stent placement the second time around. It would seem that there is more to this story than the doctor is telling you. Did you confirm this with the insurance company rep?
Medicare.

If the heart cath shows an emergency, then yes, they will do whatever is necessary. But if it's interventional, nope. They will pay for the fix but not the interventional procedure. They won't pay for both.

It's what I was told and I've talked to about a half dozen other people who have been told the same thing by their doctor's staff. I will quiz my doctor when I see him.
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Old 04-28-2014, 05:12 PM
 
Location: In the real world!
2,178 posts, read 9,563,767 times
Reputation: 2847
You sound like you had the same doctor I had! My problem was not with the doctor but his "staff" if you can call them that! I had a procedure scheduled but my insurance needed some information. The answering system just kept sending me in circles, I never did talk to his "staff" so I told the lady answering the call just to tell them I tried and tired to call and could not get anyone to answer in his office so just cancel my procedure and throw away my files. I WILL NOT BE BACK! Others, I have just got up and walked out after waiting in the office to see the doctor 2 and 3 hours after my appointment time.. That seems to be happening so much more these days!
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Old 04-28-2014, 06:33 PM
 
18,794 posts, read 8,420,430 times
Reputation: 4125
Quote:
Originally Posted by Dale Cooper View Post
Medicare.

If the heart cath shows an emergency, then yes, they will do whatever is necessary. But if it's interventional, nope. They will pay for the fix but not the interventional procedure. They won't pay for both.

It's what I was told and I've talked to about a half dozen other people who have been told the same thing by their doctor's staff. I will quiz my doctor when I see him.
All patients are different, and many docs are different. But the above sounds like either unbundling, or the cardiac doc is not credentialed to do interventions. One needs to know and ask all the right questions pre-cath. i.e. What happens if such and such is found with the cath? And do you do interventional work, or can do the work at the time of the cath?
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Old 04-28-2014, 06:53 PM
 
1,107 posts, read 2,274,181 times
Reputation: 1579
Quote:
Originally Posted by Dale Cooper View Post
Medicare.

If the heart cath shows an emergency, then yes, they will do whatever is necessary. But if it's interventional, nope. They will pay for the fix but not the interventional procedure. They won't pay for both.

It's what I was told and I've talked to about a half dozen other people who have been told the same thing by their doctor's staff. I will quiz my doctor when I see him.
I was afraid you were going to say that. I'm going on Medicare in June, and I am terrified. If you find out more I would be really interested in hearing about it. Thanks for replying.

PS Dale, I re-read your original post and you mentioned dislike of the insurance industry. Is your Medicare provider through an insurance company or do you have just straight Medicare. If a company, which company?
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Old 04-28-2014, 06:59 PM
 
692 posts, read 1,001,944 times
Reputation: 1914
I've had the worst luck with gynecologists all of whom were either highly recommended or made top 100 doctor lists.

"Fired" one that kept me waiting for over 3 hours for an appointment. Another patient who drove an hour for her appointment had also been waiting several hours finally got up and left.

"Fired" another when their billing admin called me and yelled, yes she yelled because she swore my insurance information was incorrect on my forms and turns out it wasn't.

"Fired" one when on my very first visit right after an exam out of the blue she told why she thought black p___s were different than white p____s. Ummm we were done.
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Old 04-28-2014, 07:02 PM
 
1,107 posts, read 2,274,181 times
Reputation: 1579
Quote:
Originally Posted by Lubina View Post
I've had the worst luck with gynecologists all of whom were either highly recommended or made top 100 doctor lists.

"Fired" one that kept me waiting for over 3 hours for an appointment. Another patient who drove an hour for her appointment had also been waiting several hours finally got up and left.

"Fired" another when their billing admin called me and yelled, yes she yelled because she swore my insurance information was incorrect on my forms and turns out it wasn't.

"Fired" one when on my very first visit right after an exam out of the blue she told why she thought black p___s were different than white p____s. Ummm we were done.
WoW, just WoW. Did they think they were G*d or something?
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Old 04-28-2014, 07:04 PM
 
Location: Wisconsin
25,591 posts, read 56,363,195 times
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Quote:
Originally Posted by jzeig104 View Post
I was afraid you were going to say that. I'm going on Medicare in June, and I am terrified. If you find out more I would be really interested in hearing about it. Thanks for replying.
You're also going on an Advantage plan where the gatekeeper issue can be even more problematic. One of the reasons I got off and went to an hd-F Medigap - which, btw, MN does offer. I posted on the Health Insurance forum thread where we were having that discussion. You may not have read it, yet.
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Old 04-28-2014, 07:12 PM
 
1,107 posts, read 2,274,181 times
Reputation: 1579
ya, Ariadne22, i realized last nite that I had misunderstood the post. Cant get high deductible though because I am in the hospital too much. I realize the gatekeeper issue can be more problematic and will switch back to BCBS under a supplement plan if my advantage plan provider makes life too difficult. It was a really hard decision to make, because the premiums are so much more for the supplement plans that are any good.
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Old 04-28-2014, 07:28 PM
 
Location: Wisconsin
25,591 posts, read 56,363,195 times
Reputation: 23297
Quote:
Originally Posted by jzeig104 View Post
ya, Ariadne22, i realized last nite that I had misunderstood the post. Cant get high deductible though because I am in the hospital too much.
That's may be exactly why you should probably get an hd-F and not be on an MA. Sending you a DM on this.
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