For those of you unfamiliar, your pediatrician gives you a referral to see a specialist. That referral goes to both the insurance company and the specialist's office so everyone is on the same page. You get a certain number of office visits with the specialist under each referral. If, for some reason, you don't have the necessary referral or for certain procedures for which a referral is not enough, you need an authorization from the insurance company. There are always snafus with this much paperwork circulating, but most specialist offices work it out before the visit and call to let me know if I need to make any calls or track anything down.
Two days after Christmas, I took the afternoon off of work to drag S to the ENT for a check-up on her tubes and a hearing test. Aunt E was in town and came with. The appointment was riding right up against S' afternoon naptime, but I figured we'd be in and out, We checked in, and for about 5 minutes, kept S entertained by spinning her stroller around. I then get called to the front desk, never a good sign. Aunt E starts bouncing S.
"We need you to call United because we need an authorization. We tried to call your pediatrician, but no one answered" (((it is a super tiny pediatrician office, they were probably at lunch or still gone for the holiday)))
"I'm sorry, why do you need this?"
"We don't have a referral on file"
"I would have really appreciated being informed of this three weeks ago when I made the appointment"
"Well, when they made the appointment, they were looking at her chart and it says she's on a PPO, but really she's on Health Select"
"Well, yes, I know she's on Health Select, why does her chart say she's on a PPO? She's never been on a PPO."
*Shrug*"It's an error."
I calmly walk away from the desk, you can't scream at these people. I tried to consider that this was probably just an honest mistake, plus, we will continue to deal with them for years to come. I call United, the guy who answers is super confused. He says that we don't need an authorization because she's still under a valid referral with several more doctors visits. He gives me the referral number.
"United says that she doesn't need an authorization. There's still a referral on file. Here's the number"
"Huh, well, um, I don't see it. I can't do anything with the number. Can you call them back and ask blah, blah, blah [a bunch of questions I have a hard time remembering]"
"ooooooooooookkkkkkkkkkkkkk"
Call United back, the lady is confused about why the referral number is't enough. While I'm on the phone, with my anxiety ratcheting up, E is carrying S around letting her touch and pull on the fake plants. It's very cute even if she shouldn't be messing with it. I'm just trying to keep everyone calm. Me calm, I was trying to keep me calm. E and S were fine.The front desk woman, the United lady, and I agree that faxing the referral should work. Get off the phone. Go back to waiting. Wait, wait, wait. At least a half hour.
We're at naptime, I know she's going to need a bottle because if she doesn't nap until after the appointment, it will have been too long since her last bottle. (I could write a whole post about my insanity regarding naps and feeds) I'm about to go check to see what's up, when there is a fire alarm. Like, a real one. We have to leave the stroller in the office and head outside. I see her doctor and seriously consider just asking her to take a quick peek into her ears so we can go home. We're outside for so long, S has to eat, so I sit down on the sidewalk like a hobo and feed S. A fire truck rushes by, and the resulting wind gust almost blows S over. That was funny at least.
Finally we can go back and and I decide that I've had enough and tell the front desk woman that I have to go. Aunt E is doing a great job of entertaining S and keeping me from committing mass murder. United still hasn't faxed the referral and the front desk woman just didn't think to tell me ever. She checks with the nurse who says we can reschedule for next week and I demand a first thing Monday morning appointment because frankly, I have already taken too much time off of work. We leave without killing anyone.
As soon as we get home, I put S in her crib hoping against hope that she'll just go to sleep already because it's 3 p.m. Friday and I have to make a bunch of calls to get this nonsense straightened out by the end of the day. Call United, the woman who answers is, well, an idiot and is confused by every single word that I am saying, and puts me on hold so she can check with her manager or something. After ten minutes, I hang up figuring that the likelihood of the next operator who picks up being even stupider is pretty slim.
"I need her referral faxed to the doctor's office."
"Ma'am, we don't do that sort of thing, we don't interact with the doctors' offices that way."
"Really? Then why was I told earlier today that it was possible?"
"One moment. Ok, ma'am? We will fax it, would you like to stay on the line until the delivery is confirmed?"
"YES"
I am crying this entire time, by the way. S has in fact not gone to sleep and is also crying. The dogs are barking at me because they're jerks. I usually don't take the customer survey at United because who has the time, but I did that day, and went on a 5 minute rant detailing the depths of my dissatisfaction.
I call the ENT to make sure they got the referral. The woman who answers the phone doesn't see it, but tells me she'll check and get back to me either way. I tell her that if they don't have it, I will lose my mind. She laughs and thinks I'm joking. I am not.
Well, it's almost 5 p.m. and I haven't heard back. I am full of rage. So, so, so full of rage. I call them and of course no one answers so I leave an impassioned message articulating how outrageous it is that we didn't get to see the doctor that day and that no one is helping me or even calling me back. I didn't curse once. I research other pediatric ENTs in town and plan to email the craniofacial nurse coordinator to see if they deal with other ENTs. This is the most egregious bout of nonsense from this office, but not the first. I also begged them to call me first thing Monday morning about the referral so that I wouldn't waste yet another chunk of sick time on a fruitless appointment. Nada. We show up there and they all act like nothing happened. No one at the front desk says anything to me. The doctor makes small talk about the fire alarm. Only her nurse apologizes, and it is not even her fault! I do really like the nurse and the doctor, so we won't be switching, but jesus, that front office needs to get it together.
In actual news, the tubes are fine. They did the hearing test where S had to be perfectly still and quiet while they stuck probes in her ears. She passed on the first try. S was a crab apple that day, but always performs well in front of randos.
