Sunday, January 10, 2016

United Health (doesn't) Care...

If you read my post about having a tooth extracted on 10/19/15, let me explain the aftermath. Today is now 83 days later and ..... 

On 11/5/15 I went to the ER complaining of pain and the inability to open my mouth more than a 1/4 inch. They took a CT scan, charged my insurance company $4500 and told me to see a dentist, then referred me to a dentist in the ghetto. It felt like I'd gone full circle. Next was a visit to my cardiologist and he was good enough, after our scheduled visit to walk me next door to a friend of his in dentistry. He talked to me and explained that my dentist may have hit a nerve with her multiple injections and who I needed was an oral surgeon that specialized in the jaw. My next attempt was to contact my insurance company to locate for me, an oral surgeon that knew about the human jaw. They personally contact a Dr. Mavadi, but the earliest appointment that I could get was 2 weeks into the future. I agreed to waiting that long and keep in mind that the appointment was made with me on the phone in a conference call. A lady friend said she wanted to go with me and I was all for that. Time went by slowly as it does when you are in pain, but the ER supplied me with 20 Percocet pills to assist in sleeping, being careful not to take too many realizing they are addictive. Eventually 12/15 came around and my friend came to pick me up. We drove to my appointment and the office was completely empty of patients. I approached the counter and introduced myself to the Hispanic girl behind and said, "Hi, I'm Mel Fisher, your next victim." She laughed and that was my ice breaker. I pulled out my insurance card and and her face fell, explaining that they don't accept my insurance! Flabbergasted and not knowing what to say, I ask her to check with her superior. Timidly the doctor came out, a short Middle Eastern woman and told the girl to call the insurance company. While the girl was double checking, the doctor explained that the only way she would see me was on a cash basis. The Hispanic girl returned from her call and confirmed they didn't accept United Health Care. Embarrassed, head down, I took my friend by the arm and explained we had to leave, but her coffee wasn't yet brewed, so we had to stand there while it finished, feeling awkward.

Upon finally leaving, a million thoughts went through my head about what had just transpired when my lady friend, who we will call Karen, because that's her name, explains that she needs a bowl of chicken soup with a matzo ball and to pull into Chompies. I do as she asks and we are seated shoulder to shoulder with all of the other dining people devouring corned beef sandwiches. That's when Karen dicided to start screaming at me! Although she probably thought she was keeping her voice down, the man next to us removed his hearing aid! She was yelling at me, when you go to a doctor's office you don't make jokes! You act like you're in pain, that way the doctor will see you! I determine all of this to be insane and try to determine why she's really yelling, but at the same time I need to diffuse her. I simply look at her and ask if she thinks we're married and smile? That seemed to work, because my response confused her. I realized that she only knew how to express herself in a parent/child relationship and I refused to be the child! She finally shut up and people stopped looking at us with the corner of their eyes. She asked me for the telephone number of the insurance company and began her salvation of my jaw and also trying to show me her power. 

At some point she was able to schedule an appointment but not for about 3 hours later. We ran her errands for that amount of time and arrived at the doctor's office about 90 minutes early. Time dragged on, as we read magazines silently when suddenly a man enters wearing sweat pants. He's an obese fellow and 5' 7" with a huge belly and younger than me, but with skinny legs, I'd guess about 60. While he was schmoozing with the receptionist, his pants fell down and I couldn't believe my eyes! In almost 70 years, I'd never seen that happen to anyone! All I could do was gently nudge Karen with my elbow and watch her mouth fall open and whip out her iPhone! Now I was embarrassed that she wanted to film the event. The funny thing was, the man was making no immediate attempt to pick them back up! As I watched him, he slowly bent over, continuing to to flirt with the young girl, and then picked them up. That's when the girl came out and called my name or attempted to. Mel is not that difficult to announce but the African-American assistant pronounced it in 2 syllables and another man approached her saying he was Bill. I was the only other person there, except for pants-less, so I approached saying I'm MEL. She took me back and weighed and measured my height, telling me I was 73 inches tall and I looked at my 1 inch heels and realized I'd shrunk and inch. I waited for the doctor. As he finally came in, I realized that poor Karen had waited alone for quite a long time and with her lack of patience, I should probably ask if she could attend my exam. It wasn't like I was getting a prostate exam! The doctor, wearing light grey suede shoes went to look for her himself and kind of swished out the door returning and telling me there no one waiting for me, but he asked one of the nurses to watch for her. Eventually there was knock at the door and it was she. I explained to the little doctor why I was there and he explained to me that he was a family doctor and that he knew nothing about the jaw! He too offered me drugs and gave me a list of oral surgeons, that I promptly threw away, because I need one within my insurance network. We left with Karen explaining that I never told her I needed an oral surgeon. I said, nothing!

The following day, Karen had asked me to drive her to the airport and was exceedingly rude to me for the entire morning, when I finally screaming at her in the car to SHUT THE FUCK UP! She did and never said another word to me and thankfully didn't call me for a ride to pick her up from the airport, which was good because I would have decline Back to flying solo, I called my irresponsible, United Health Care, but this time I asked for a supervisor. You would have thought that I'd asked for a pint of blood. They ask what it is about. I explain, that what I want to talk to a supervisor about. Finally they attempt to connect me and get a voice mailbox. I leave a message and try again, no luck, Shanicia is not picking up. About 4 hours later, Shanicia returns my call and I explain my dilemma for about 30 minutes. she's a good listener (I think) but when her return call comes, it's from a subordinate and she's schedule an appointment with an oral surgeon, finally. The appointment that I actually called and arranged was quite a distance and it turned out to be in a rather poor neighborhood and few of the people waiting used English as their first language. After waiting for about 30 minutes, I was called in and x-rayed and escorted to a dentist's chair. In walks this dude that looks like he just came from the gym about 40 years old. I explain why I'm there and he laughs. He puts his fingers in my mouth and tries to pry it opened. I'm in pain, so I grab his arm and stop him. He laughs again and asks, how can you eat? I immediately know I'm in the wrong place again and tell him so. He says, he doesn't know anything about the jaw, that what I need is an ENT surgeon and leaves. Disgusted and frustrated, I go home and call Shanicia and naturally get voicemail. I leave a message and then 2 more in the following days, but nothing. Now another 10 days go by as I get pisster and pisster and I leave a message that says I'm giving her until the close of business tomorrow to return my call or I'm going to go over her head to explain what United Health Care and Shanicia have put me through. The return call comes the next afternoon with her explaining that she's been out for 10 days, that absolutely don't believe and ask why she didn't say that on her voicemail message. She explained it was expected, (uh huh). I then get a call from one of her subordinates and she has a doctor's office on the line and again we have a conference call. I specifically ask if they treat TMJ and have knowledge of the jaw. The nice lady explains in detail, everything they do there and it sounds perfect. I schedule an appointment for this past Thursday at 4 PM and it's 5 minutes from where I live, in the same office complex as Dr. Madavi. I fill out the new patient application online and I'm ready to go. Then on Thursday, just to make sure, I call there again and confirm that they accept my insurance because I've been this far before and she says, yes but let me call with your ID number. She calls me back 3 minutes later and the system says I haven't been a member since 2011! What??? I just got this card 3 weeks ago. Now the "nice lady" starts acting like I'm some kind of crook and I realize that I'm not going to be able to convince her when she insists on cash in advance or forget it. I choose, forget it and hang up frustrated as usual. I call United Health Care and explain what happened and the girl I speak with explains that the provider needs to speak with a person, not the automated system, because that can't be changed! Then this new representative needs two or three more days to look for a provider. Would you like to be with United Health Care?

1 comment:

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