The healthcare IT minefield and their cabal/cartel behavior

[LVSteve]

For reasons that are unimportant, I recently changed health insurer and need to find a new primary care physician (PCP). My old PCP retired and the new regime at that practice does not take the new insurance. With typical good timing, a small health issue has appeared in the middle of this process.

What a goat rope. The amount of contradictory information is driving me nuts. The insurer has a list of doctors, PA-Cs, and NPs showing that they are in network and accepting new patients. Having called multiple offices, I am rapidly reaching the conclusion that this list is at best, out of date, or at worst a work of unadulterated fiction. Even more funny, I called an office my wife had visited and they say they do take our insurance, but that specialist is nowhere in the insurance company's list.

Oh, and because my little issue requires somebody classed as a specialist, I need a referral. Did I mention I don't have a PCP right now? So, I have to go to a quick care and pay the medical cartel another co-pay just so I can go see a specialist when I already know who I need to see. Isn't that special?

Just to add to my cup of fun, I had to deal the insurer's helpdesk to get my online registration to work. The problem? I'm reasonably computer security savvy, so I don't allow cross-scripting between websites. This is advice often given by IT professionals. So why are the digital dunces out there writing pages involving registration, personal info and passwords with cross-scripting in about nine dimensions and several alternative universes?

I suppose I have all this to come once again should I make it to Medicare age.

 

[lkabug]

Just because your doctors will accept your insurance, it does not mean they are participating and preferred.

 

[Rudi]

Yes, it is a big mess.

 

[Old 44 Guy]

My health care Insurance changed servers July 1st. Less coverage, more money.

 

[AJ]

It is how the game is played.......Did not say it was right, just how the game is played. I have been blessed in a way. Since I retired from the Corps, we have always had two medical insurances. Usually Blue Cross (because of employers)and TriCare (because of my Service). Now have Medicare and TriCare. Also an added bennie is the fact that I got a degree in Nursing after I retired. I worked as a Med Surg/Orthopedic Nurse for 20+ years in a hospital. Knew all the doctors and had an inside track into their offices. Got lucky in what I picked to do. Did not say it was fair, just how the game is played.

 

[twodog max]

Healthcare these days is indeed a mess and IMO not an accident. Just recently my wife ended up in a local ER needing fluid removed from a lung. The ER folks were very professional but we were told that she would have to either be admitted and wait or go home and wait as no doctor was available to do the procedure. We had been texting friend that were concerned about her and one happened to be a retired radiology tech from this very hospital. She contacted a former associate still working and bingo in about 30 minutes she and a doctors showed up in the ER and removed fluid from the lung and she could breath again.
Amazing how doctors that were not available suddenly appear when backdoor request get made.
Such is modern healthcare. It is an almost impenetrable maze of bureaucracy created by insurance companies, government regulations and providers hiding within.

 

[pawngal]

Had one experience with health insurance that was tied to a network, after that I vowed never again.