I just have to voice this because as you all know I don't have the best attitude when it comes to doctors lately. And that my insurance has been an ongoing issue which is so frustrating.
I have an appointment tomorrow with a top notch hematologist out in Boston who takes my insurance. But because the hospital that doctor is affiliated with is different from the hospital my PCP is affiliated with, my insurance (not the hematologist) required a prior authorization from my PCP. My PCP sent it in and my insurance denied it. UGH!
The guy I've been speaking to from the hematologist's office was explaining to me yesterday that my insurance will likely deny the authorization because they (my insurance) require it 5 days prior to the appointment. He must have heard the desperation in my voice as he was giving me other options like rescheduling the appointment (next available is in MAY!) or receiving a bill for $1,000. Neither of those options work for me and I need to see this doctor!
This man on the phone became a superhero in my book! Again, after hearing the hopelessness in me, he put his job position aside and became human. He was extremely kind the entire time, but at this point he lowered his voice and said he was gonna let me in on a little secret just in case the authorization did get denied (at this point yesterday we were still waiting on the answer from my insurance).
He told me that I could call my insurance and change my PCP to someone who is affiliated with that hospital that I'm going to tomorrow. If my PCP is affiliated with their hospital, my insurance won't require a prior authorization. I would have never known any of this without his help! And would've ended up with a yuuuuuge bill!
Sure enough he calls a little while ago to tell me that my insurance denied the authorization. He then assisted in calling my insurance with me on the line to change my PCP, after he looked one up who is in my more immediate area and is affiliated with their hospital. All is said and done and I'll be covered for my appointment tomorrow. I just have to call my insurance next week and switch back to my real PCP lol!
He provided a loophole that SO many others could've helped me out with in past situations with insurance problems. We need more people like him in those job positions.
Sharing this in case anyone here ever faces a similar situation. Now you know about the loophole.
He also said that if I like this doctor and want to continue seeing him that he would help me find a real solution to the insurance problem. This was just a quick fix so that I could keep my appointment tomorrow. : )
~*Ride the Wave*~