Guest guest Posted February 12, 2011 Report Share Posted February 12, 2011 Hi Rhonda Happy to be of service:) , You crack me up!!! To: Sent: Sat, February 12, 2011 5:51:52 AMSubject: Re: Customer Service Yeah I was stoopid enough to call an insurance co the other day to say I was being capitated for someone that wasn;t minedumb dumb What was I thinking??first I got the we have an excessive call volume message that my wait would be longer than 6 minutes I called back later and after 3 routings talked to someone who kept saying wait I don't know how to do this wait can you wait I have to learn how to do this THEN stopped dead after two syllables of my name with no polite way to ask how to pronounce it then proceeded to explain to me that he wasn;t my patietn Which I ah knew and said so She then told me I was rude. ME?? I told her frankly to cut that out no one called her names or abused her, that I had a c onsciecne to call and she had proceeded to keep me waiting becasue she did not know what to do and then to tell me what I had called about and already knew. BUt I am rude. Yep. PArdon me for expecting anything like competence. I ruined her day.Next time I keep the money. Where did I leave my haldol bottle?? I agree….horrible week ending with a horrible day. I am SOOOO looking forward to the weekend so that I can get my head out of it for 2 days. Wow! Did you remind the insurance rep that waiving a copay is INSURANCE FRAUD!?!?! I would’ve gotten the rep’s name, rank, serial #, whatever, and reported it to the insurance commissioner. I might anyways…the insurance companies should have it logged (if not recorded) who talked to you. Pratt Office Manager Oak Tree Internal Medicine P.C www.prattmd.info From: [mailto: ] On Behalf Of Sangeetha Murthy Sent: Friday, February 11, 2011 5:34 PMTo: Subject: Customer Service One representative even got upset that I wouldnt waive a patient's copay, as the patient was very irate, that he didnt get what he wanted... I invited the rep to encourage the patient to make A formal COMPLAINT.. ok horrible week, am feeling quite misanthropic -- MD ph fax impcenter.org -- MD ph fax impcenter.org Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 12, 2011 Report Share Posted February 12, 2011 Hi Rhonda Happy to be of service:) , You crack me up!!! To: Sent: Sat, February 12, 2011 5:51:52 AMSubject: Re: Customer Service Yeah I was stoopid enough to call an insurance co the other day to say I was being capitated for someone that wasn;t minedumb dumb What was I thinking??first I got the we have an excessive call volume message that my wait would be longer than 6 minutes I called back later and after 3 routings talked to someone who kept saying wait I don't know how to do this wait can you wait I have to learn how to do this THEN stopped dead after two syllables of my name with no polite way to ask how to pronounce it then proceeded to explain to me that he wasn;t my patietn Which I ah knew and said so She then told me I was rude. ME?? I told her frankly to cut that out no one called her names or abused her, that I had a c onsciecne to call and she had proceeded to keep me waiting becasue she did not know what to do and then to tell me what I had called about and already knew. BUt I am rude. Yep. PArdon me for expecting anything like competence. I ruined her day.Next time I keep the money. Where did I leave my haldol bottle?? I agree….horrible week ending with a horrible day. I am SOOOO looking forward to the weekend so that I can get my head out of it for 2 days. Wow! Did you remind the insurance rep that waiving a copay is INSURANCE FRAUD!?!?! I would’ve gotten the rep’s name, rank, serial #, whatever, and reported it to the insurance commissioner. I might anyways…the insurance companies should have it logged (if not recorded) who talked to you. Pratt Office Manager Oak Tree Internal Medicine P.C www.prattmd.info From: [mailto: ] On Behalf Of Sangeetha Murthy Sent: Friday, February 11, 2011 5:34 PMTo: Subject: Customer Service One representative even got upset that I wouldnt waive a patient's copay, as the patient was very irate, that he didnt get what he wanted... I invited the rep to encourage the patient to make A formal COMPLAINT.. ok horrible week, am feeling quite misanthropic -- MD ph fax impcenter.org -- MD ph fax impcenter.org Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 12, 2011 Report Share Posted February 12, 2011 Whenever I get frustrated with the insurance phone people, I generally say, " I am really sorry you have to work for these people. " A little sarcastic, but it is true. What an awful job.Re: California law. I wonder if he is referring to the requirement for HMO's to pay for a patient requested second opinion: Continuous Care, Second Opinions, Referrals and Information Typically, a relationship is established between a patient and his physician when the patient receives his first physical examination by the doctor. By California law, the patient has the right to receive care from his physician and should be referred to other providers and specialists when it is necessary. He may also discuss any treatments or care procedures during his visit. When a patient or his physician sees the need for a second opinion, California allows that right. If a patient requires a second opinion or care from another physician, the health insurance provider must provide authorization within three days. Read more: Health Care Laws in California | eHow.com http://www.ehow.com/list_7228244_health-care-laws-california.html#ixzz1DmoR5gqe Sharon Sharon McCoy MDRenaissance Family Medicine10 McClintock Court; Irvine, CA 92617PH: (949)387-5504 Fax: (949)281-2197 Toll free phone/fax: www.SharonMD.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 12, 2011 Report Share Posted February 12, 2011 Whenever I get frustrated with the insurance phone people, I generally say, " I am really sorry you have to work for these people. " A little sarcastic, but it is true. What an awful job.Re: California law. I wonder if he is referring to the requirement for HMO's to pay for a patient requested second opinion: Continuous Care, Second Opinions, Referrals and Information Typically, a relationship is established between a patient and his physician when the patient receives his first physical examination by the doctor. By California law, the patient has the right to receive care from his physician and should be referred to other providers and specialists when it is necessary. He may also discuss any treatments or care procedures during his visit. When a patient or his physician sees the need for a second opinion, California allows that right. If a patient requires a second opinion or care from another physician, the health insurance provider must provide authorization within three days. Read more: Health Care Laws in California | eHow.com http://www.ehow.com/list_7228244_health-care-laws-california.html#ixzz1DmoR5gqe Sharon Sharon McCoy MDRenaissance Family Medicine10 McClintock Court; Irvine, CA 92617PH: (949)387-5504 Fax: (949)281-2197 Toll free phone/fax: www.SharonMD.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 12, 2011 Report Share Posted February 12, 2011 Whenever I get frustrated with the insurance phone people, I generally say, " I am really sorry you have to work for these people. " A little sarcastic, but it is true. What an awful job.Re: California law. I wonder if he is referring to the requirement for HMO's to pay for a patient requested second opinion: Continuous Care, Second Opinions, Referrals and Information Typically, a relationship is established between a patient and his physician when the patient receives his first physical examination by the doctor. By California law, the patient has the right to receive care from his physician and should be referred to other providers and specialists when it is necessary. He may also discuss any treatments or care procedures during his visit. When a patient or his physician sees the need for a second opinion, California allows that right. If a patient requires a second opinion or care from another physician, the health insurance provider must provide authorization within three days. Read more: Health Care Laws in California | eHow.com http://www.ehow.com/list_7228244_health-care-laws-california.html#ixzz1DmoR5gqe Sharon Sharon McCoy MDRenaissance Family Medicine10 McClintock Court; Irvine, CA 92617PH: (949)387-5504 Fax: (949)281-2197 Toll free phone/fax: www.SharonMD.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 12, 2011 Report Share Posted February 12, 2011 maybe, problem was, it WAS authorised in one day.. but he didn't want to share his prior medical history with the specialist's office , so they could figure out the appropriate previsit work he might need.. maybe he mean the line preceding that? He may also discuss any treatments or care procedures during his visit. Whenever I get frustrated with the insurance phone people, I generally say, " I am really sorry you have to work for these people. " A little sarcastic, but it is true. What an awful job. Re: California law. I wonder if he is referring to the requirement for HMO's to pay for a patient requested second opinion: Continuous Care, Second Opinions, Referrals and Information Typically, a relationship is established between a patient and his physician when the patient receives his first physical examination by the doctor. By California law, the patient has the right to receive care from his physician and should be referred to other providers and specialists when it is necessary. He may also discuss any treatments or care procedures during his visit. When a patient or his physician sees the need for a second opinion, California allows that right. If a patient requires a second opinion or care from another physician, the health insurance provider must provide authorization within three days. Read more: Health Care Laws in California | eHow.com http://www.ehow.com/list_7228244_health-care-laws-california.html#ixzz1DmoR5gqe Sharon Sharon McCoy MDRenaissance Family Medicine10 McClintock Court; Irvine, CA 92617PH: (949)387-5504 Fax: (949)281-2197 Toll free phone/fax: www.SharonMD.com -- -- Sangeetha Murthy M.D7830 mont Mesa Blvd #287San Diego, CA 92111www.mypcponline.com The information contained in this message may be privileged and confidential. If you are NOT the intended recipient, please notify the sender immediately and destroy this message. Please be aware that email communication can be intercepted in transmission or misdirected. Your use of email to communicate protected health information to us indicates that you acknowledge and accept the possible risks associated with such communication. Please consider communicating any sensitive information by telephone, fax or mail. If you do not wish to have your information sent by email, please contact the sender immediately. Email replies can be expected within 24 hours-Please CALL if the matter is more urgent . Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 12, 2011 Report Share Posted February 12, 2011 maybe, problem was, it WAS authorised in one day.. but he didn't want to share his prior medical history with the specialist's office , so they could figure out the appropriate previsit work he might need.. maybe he mean the line preceding that? He may also discuss any treatments or care procedures during his visit. Whenever I get frustrated with the insurance phone people, I generally say, " I am really sorry you have to work for these people. " A little sarcastic, but it is true. What an awful job. Re: California law. I wonder if he is referring to the requirement for HMO's to pay for a patient requested second opinion: Continuous Care, Second Opinions, Referrals and Information Typically, a relationship is established between a patient and his physician when the patient receives his first physical examination by the doctor. By California law, the patient has the right to receive care from his physician and should be referred to other providers and specialists when it is necessary. He may also discuss any treatments or care procedures during his visit. When a patient or his physician sees the need for a second opinion, California allows that right. If a patient requires a second opinion or care from another physician, the health insurance provider must provide authorization within three days. Read more: Health Care Laws in California | eHow.com http://www.ehow.com/list_7228244_health-care-laws-california.html#ixzz1DmoR5gqe Sharon Sharon McCoy MDRenaissance Family Medicine10 McClintock Court; Irvine, CA 92617PH: (949)387-5504 Fax: (949)281-2197 Toll free phone/fax: www.SharonMD.com -- -- Sangeetha Murthy M.D7830 mont Mesa Blvd #287San Diego, CA 92111www.mypcponline.com The information contained in this message may be privileged and confidential. If you are NOT the intended recipient, please notify the sender immediately and destroy this message. Please be aware that email communication can be intercepted in transmission or misdirected. Your use of email to communicate protected health information to us indicates that you acknowledge and accept the possible risks associated with such communication. Please consider communicating any sensitive information by telephone, fax or mail. If you do not wish to have your information sent by email, please contact the sender immediately. Email replies can be expected within 24 hours-Please CALL if the matter is more urgent . Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 12, 2011 Report Share Posted February 12, 2011 maybe, problem was, it WAS authorised in one day.. but he didn't want to share his prior medical history with the specialist's office , so they could figure out the appropriate previsit work he might need.. maybe he mean the line preceding that? He may also discuss any treatments or care procedures during his visit. Whenever I get frustrated with the insurance phone people, I generally say, " I am really sorry you have to work for these people. " A little sarcastic, but it is true. What an awful job. Re: California law. I wonder if he is referring to the requirement for HMO's to pay for a patient requested second opinion: Continuous Care, Second Opinions, Referrals and Information Typically, a relationship is established between a patient and his physician when the patient receives his first physical examination by the doctor. By California law, the patient has the right to receive care from his physician and should be referred to other providers and specialists when it is necessary. He may also discuss any treatments or care procedures during his visit. When a patient or his physician sees the need for a second opinion, California allows that right. If a patient requires a second opinion or care from another physician, the health insurance provider must provide authorization within three days. Read more: Health Care Laws in California | eHow.com http://www.ehow.com/list_7228244_health-care-laws-california.html#ixzz1DmoR5gqe Sharon Sharon McCoy MDRenaissance Family Medicine10 McClintock Court; Irvine, CA 92617PH: (949)387-5504 Fax: (949)281-2197 Toll free phone/fax: www.SharonMD.com -- -- Sangeetha Murthy M.D7830 mont Mesa Blvd #287San Diego, CA 92111www.mypcponline.com The information contained in this message may be privileged and confidential. If you are NOT the intended recipient, please notify the sender immediately and destroy this message. Please be aware that email communication can be intercepted in transmission or misdirected. Your use of email to communicate protected health information to us indicates that you acknowledge and accept the possible risks associated with such communication. Please consider communicating any sensitive information by telephone, fax or mail. If you do not wish to have your information sent by email, please contact the sender immediately. Email replies can be expected within 24 hours-Please CALL if the matter is more urgent . Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 13, 2011 Report Share Posted February 13, 2011 I'm not arguing that he wasn't out of line, just trying to make a little sense of that statement. When I first moved from Seattle to Orange County almost 16 years ago, I found that patients here assumed an antagonist relationship with me as a doctor (expecting me to " deny " treatments, referrals, etc.). I realized then that the profession was changing. I am still sad about it. SharonSharon McCoy MDRenaissance Family Medicine10 McClintock Court; Irvine, CA 92617PH: (949)387-5504 Fax: (949)281-2197 Toll free phone/fax: www.SharonMD.com maybe, problem was, it WAS authorised in one day.. but he didn't want to share his prior medical history with the specialist's office , so they could figure out the appropriate previsit work he might need.. maybe he mean the line preceding that? He may also discuss any treatments or care procedures during his visit. Whenever I get frustrated with the insurance phone people, I generally say, " I am really sorry you have to work for these people. " A little sarcastic, but it is true. What an awful job. Re: California law. I wonder if he is referring to the requirement for HMO's to pay for a patient requested second opinion: Continuous Care, Second Opinions, Referrals and Information Typically, a relationship is established between a patient and his physician when the patient receives his first physical examination by the doctor. By California law, the patient has the right to receive care from his physician and should be referred to other providers and specialists when it is necessary. He may also discuss any treatments or care procedures during his visit. When a patient or his physician sees the need for a second opinion, California allows that right. If a patient requires a second opinion or care from another physician, the health insurance provider must provide authorization within three days. Read more: Health Care Laws in California | eHow.com http://www.ehow.com/list_7228244_health-care-laws-california.html#ixzz1DmoR5gqe Sharon Sharon McCoy MDRenaissance Family Medicine10 McClintock Court; Irvine, CA 92617PH: (949)387-5504 Fax: (949)281-2197 Toll free phone/fax: www.SharonMD.com -- -- Sangeetha Murthy M.D7830 mont Mesa Blvd #287 San Diego, CA 92111www.mypcponline.com The information contained in this message may be privileged and confidential. If you are NOT the intended recipient, please notify the sender immediately and destroy this message. Please be aware that email communication can be intercepted in transmission or misdirected. Your use of email to communicate protected health information to us indicates that you acknowledge and accept the possible risks associated with such communication. Please consider communicating any sensitive information by telephone, fax or mail. If you do not wish to have your information sent by email, please contact the sender immediately. Email replies can be expected within 24 hours-Please CALL if the matter is more urgent . Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 14, 2011 Report Share Posted February 14, 2011 Does the term " borderline personality " come to mind? From: [ ] On Behalf Of Sangeetha Murthy [sangeethamurthy@...] Sent: Friday, February 11, 2011 6:34 PM To: Subject: Customer Service Does this happen every year? This year I am running into insurance / customer service issues at least 3 patients new to hmos, with new insurances sign up for hmos, run into restrictions, promptly call their insurance company, have their complaint recorded by semiliterate customer service agents, and guess who they call the PCP - me.. The complaint makes no sense to me any more , much is lost in translation, it is the plan restrictions and the lack of specialists that is the problem and who do they call for help to soothe the patient's ruffled feathers.. ME1 One rep actually asked me for the patient's plan information, so I am to provide data gathering services now! So it seems to me, they are 3rd parties, , paid to man telephones, take complaints, make calls to pcp, log it all on paper, and not really show actual results I dont see any effort to actually resolve the issue.. just makework companies One representative even got upset that I wouldnt waive a patient's copay, as the patient was very irate, that he didnt get what he wanted... I invited the rep to encourage the patient to make A formal COMPLAINT.. ok horrible week, am feeling quite misanthropic Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 14, 2011 Report Share Posted February 14, 2011 thats what I concluded when I heard " JUSTICE DEPARTMENT'' " CALIFORNIA LAW " Does the term " borderline personality " come to mind? From: [ ] On Behalf Of Sangeetha Murthy [sangeethamurthy@...] Sent: Friday, February 11, 2011 6:34 PM To: Subject: Customer Service Does this happen every year? This year I am running into insurance / customer service issues at least 3 patients new to hmos, with new insurances sign up for hmos, run into restrictions, promptly call their insurance company, have their complaint recorded by semiliterate customer service agents, and guess who they call the PCP - me.. The complaint makes no sense to me any more , much is lost in translation, it is the plan restrictions and the lack of specialists that is the problem and who do they call for help to soothe the patient's ruffled feathers.. ME1 One rep actually asked me for the patient's plan information, so I am to provide data gathering services now! So it seems to me, they are 3rd parties, , paid to man telephones, take complaints, make calls to pcp, log it all on paper, and not really show actual results I dont see any effort to actually resolve the issue.. just makework companies One representative even got upset that I wouldnt waive a patient's copay, as the patient was very irate, that he didnt get what he wanted... I invited the rep to encourage the patient to make A formal COMPLAINT.. ok horrible week, am feeling quite misanthropic -- -- Sangeetha Murthy M.D7830 mont Mesa Blvd #287San Diego, CA 92111www.mypcponline.com The information contained in this message may be privileged and confidential. If you are NOT the intended recipient, please notify the sender immediately and destroy this message. Please be aware that email communication can be intercepted in transmission or misdirected. Your use of email to communicate protected health information to us indicates that you acknowledge and accept the possible risks associated with such communication. Please consider communicating any sensitive information by telephone, fax or mail. If you do not wish to have your information sent by email, please contact the sender immediately. Email replies can be expected within 24 hours-Please CALL if the matter is more urgent . Quote Link to comment Share on other sites More sharing options...
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