As you may know, I’ve been having off and on stomach cramps.
So I went to the gastro.
Gastro touched my stomach and said- “I’m pretty sure you have a hernia. We need to make sure the hernia isn’t blocking anything. Let’s go for a cat scan.”
The scheduler set up the cat scan for the following week. At a location within the NYU hospital system (five minute walk from my house FYI), where all my Doctor’s are located, and all the info goes into a portal so that every Doctor I see can look at every single test and scan that I go for. As well as me having access to every single test and scan that I go for.
Sounds great, right?
That afternoon I get a call from my insurance:
Petty Functionary with a clipboard: I see you have a cat scan scheduled.
Petty Functionary with a clipboard: Why?
Me: Because Doctor suspects a hernia and wants to make sure there isn’t anything serious causing my stomach cramps.
PFWAC: I see you’ve chosen XYZ radiology.
PFWAC: You are aware that just because your Doctor said to use this facility, you have other options available.
Me: Is XYZ not in my network?
PFWAC: XYZ is in network, however there are other places
At this point, once you’ve told me that the location recommended is in my network and therefore already established as a provider by my insurance company, the conversation is pretty much over. But as I’m a good sport and you’ve tracked me down for a conversation, I’ll play along.
Me: If it’s in network, my Doctor recommends it, and it’s down the block from my house, why wouldn’t I choose it?
PFWAC: There are less expensive options.
Me: It’s in network. You are paying 80% plus the discount for going to an IN NETWORK FACILITY
PFWAC: There are places where you’ll pay less money.
Me: Have you been to any of these facilities?
Me: So you want me to trust my health to someplace where I need to read a YELP review, instead of trusting my Doctor, and the Labs associated with one of the largest hospitals in NYC?
PFWAC: It would save you money
At this point I really wanted to say: You know what would save money? Eliminating this ridiculous job of yours…If it was out of network, you call. But if it’s an approved, in network provider, your issue is with THEM not ME
Me: Can you give me the name and location of one of these facilities?
You can hear the excitement over the phone- the guy is salivating…
PFWAC: ABC Labs is only ten miles away…
Now- to someone who has a car and doesn’t live in an urban environment, this is a win. Ten miles by car is probably nothing. However, when you live in a city, and technically on an island, getting to a facility that is NOT ON YOUR ISLAND can be a bit of a bother. If I were to take mass transit, assuming mass transit is available, it could take me 90 minutes each way to get to this place. If I were to take a cab, it might still take an hour and be about fifty bucks. Each way. HMMMMM…is this saving me money? But I don’t say this out loud to the guy because he hasn’t really done his homework…
ME: are you paying for my transpotation and factoring in the time it will take me to get there and back. You know, as opposed to WALKING DOWN THE BLOCK?
Me: And how about the fee to get my results to my Doctors? Are you paying that? And, how about the timeliness of results? Is this lab going to get the results within HOURS? Or will I have to wait?
PFWAC: I can’t answer any of that.
And now I’m just a teensy bit bothered
Me: So basically, you want me to not go to a conveniently located lab recommended by my Doctor that is easy for me to get to and affiliated with the system that all my Doctors are in and approved as an in network provider by this insurance company, where the results will be put into my portal within hours garnering me and my team of Doctors immediate access to the results, and I’m able to get the tests done within a week, so if there’s really an issue we’ll know right away, and perhaps save my life?
PFWAC: I’m just saying it’s an option. But you’re approved for the Cat Scan…
FYI- they sent me one of those cute 1-5 survey things afterwards…