Blue Cross Blue Shield of Texas drops Kelsey-Seybold Clinic from most plans (house, office)

[Augiec]

Anyone here have a preference regarding alternatives to Kelsey Seybold in Houston?

Pros of KS -
Being able to call in 24/7 and schedule appointments with relative ease and short notice
Not being tied to one doctor (thank goodness for electronic medical records).
Multiple offices in different parts of town.

I noticed Memorial Herman and TCH seem to be going in a similar route, but not sure if they are quite as customer service oriented.

[Spartacus713]

Originally Posted by Augiec

Anyone here have a preference regarding alternatives to Kelsey Seybold in Houston?

Pros of KS -
Being able to call in 24/7 and schedule appointments with relative ease and short notice
Not being tied to one doctor (thank goodness for electronic medical records).
Multiple offices in different parts of town.

I noticed Memorial Herman and TCH seem to be going in a similar route, but not sure if they are quite as customer service oriented.

How is it that Memorial Herman is going a similar route? Perhaps I am just not very familiar with how they are organized. Can you please explain this a little more?

Thanks.

[marksmu]

Originally Posted by Augiec

Anyone here have a preference regarding alternatives to Kelsey Seybold in Houston?

Pros of KS -
Being able to call in 24/7 and schedule appointments with relative ease and short notice
Not being tied to one doctor (thank goodness for electronic medical records).
Multiple offices in different parts of town.

I noticed Memorial Herman and TCH seem to be going in a similar route, but not sure if they are quite as customer service oriented.

Just went to TCH...could not have been easier. Seamless integration of medical records. Surgeons saw everything the primary care physicians had done. Insurance and payment cards, etc all on file.

[Spartacus713]

Originally Posted by marksmu

Just went to TCH...could not have been easier. Seamless integration of medical records. Surgeons saw everything the primary care physicians had done. Insurance and payment cards, etc all on file.

Anyone have any similar observations about Memorial Herman? Kelsey customers are used to having everything all integrated and coordinated. Specialists, doctors, everything.

If someone was interested in finding a similar arrangement at Memorial Herman, is that possible? How do you get that? As far as I can tell, the doctors have admitting privileges at Memorial Herman and it is all quite a patchwork after that.

[Texas Ag 93]

Originally Posted by Spartacus713

Anyone have any similar observations about Memorial Herman? Kelsey customers are used to having everything all integrated and coordinated. Specialists, doctors, everything.

If someone was interested in finding a similar arrangement at Memorial Herman, is that possible? How do you get that? As far as I can tell, the doctors have admitting privileges at Memorial Herman and it is all quite a patchwork after that.

Even in large systems, credentialing is done at the individual facility level. My husband has practiced in more than one large hospital system, and we (meaning mostly I) do credentialing paperwork only for the specific facilities where he will be working. The paperwork is a PITA and takes forever, so nobody is going to do more than they need to. Moreover, most hospitals will only credential someone who is actively working in the facility and doing a certain minimal amount of patient care, so there is no point in obtaining credentials where you won't be working. It sure would be nice if there was reciprocity between facilities though.

[Spartacus713]

Originally Posted by Texas Ag 93

Even in large systems, credentialing is done at the individual facility level. My husband has practiced in more than one large hospital system, and we (meaning mostly I) do credentialing paperwork only for the specific facilities where he will be working. The paperwork is a PITA and takes forever, so nobody is going to do more than they need to. Moreover, most hospitals will only credential someone who is actively working in the facility and doing a certain minimal amount of patient care, so there is no point in obtaining credentials where you won't be working. It sure would be nice if there was reciprocity between facilities though.

Thanks for your reply. I guess I am trying to determine how close to Kelsey that Memorial Herman would be as far as the integration of their specialists with a primary care physician. I get the impression that there is a very loose "network" of doctors and specialists, but that it is largely every person for themselves and everything is all over the place.

I have enjoyed the integrated approach that Kelsey has, with primary care physicians and specialists all under one roof, all sharing the same information systems, etc. But I guess that is over with now, thanks to system destroying effects of Obamacare.

It is really frustrating the way this Obamacare scam has worked out, with everyone losing their doctors, or their healthcare, or both. But I guess we all have to just deal with it somehow and try to move on.

[Texas Ag 93]

Originally Posted by Spartacus713

Thanks for your reply. I guess I am trying to determine how close to Kelsey that Memorial Herman would be as far as the integration of their specialists with a primary care physician. I get the impression that there is a very loose "network" of doctors and specialists, but that it is largely every person for themselves and everything is all over the place.

I think that all probably depends on the system. What you describe above is the ideal, which all systems should be striving for.

[Spartacus713]

Originally Posted by Texas Ag 93

I think that all probably depends on the system. What you describe above is the ideal, which all systems should be striving for.

That is what Kelsey has provided, but my BCBS insurance no longer covers them. Who else in Houston does this? If Memorial Herman somehow did, that would be great news and I would probably try to switch over to them. But I am not getting the impression that they do.

[Texas Ag 93]

Originally Posted by Spartacus713

That is what Kelsey has provided, but my BCBS insurance no longer covers them. Who else in Houston does this? If Memorial Herman somehow did, that would be great news and I would probably try to switch over to them. But I am not getting the impression that they do.

This integration and consistency is something that should be done across systems, but often isn't, and yes, it can be frustrating. Sometimes, it's not as easy as it appears, for example, if one hospital is purchased and then rolled into the new system. They often have legacy IT, Lab, Radiology systems etc, and the transition is slow. The same thing happens when hospital systems purchase individual physician practices that had previously been private- they have to slowly introduce the new systems. I've even had services done at a smaller hospital that was part of a large system where both the Internist and Specialist were on separate systems that could not talk to each other. Really, guys?

I don't honestly know who does it well, but maybe someone can make some suggestions. I do know that my daughter has needed some pediatric sub speciality appointments recently, and I chose to go to some UTMB clinics near where I live in League City. I have been very pleasantly surprised with them in terms of appointment availability, skill of practitioners and clinic location and efficiency. I'll admit I've always thought of UTMB as an "also ran" compared to any of the systems in the Medical Center, but I have changed my tune on that, at least as it pertains to clinics.

[Augiec]

I guess there are no comparable networks/systems to the one Kelsey built. That's really unfortunate. I still don't blame the ACA. BCBS didn't want to pay KS what KS wanted to charge. Nothing to do with the ACA really.