Gifted Issues Discussion homepage Forums Twice Exceptional Vindicated and not happy (vision issues)

My earlier post was made in haste, I should have said putrid doctor's practice.

Please do share this because the front office staff make or break a practice. Doctor's that choose to hire the dumb/the arrogant/the lazy/the forgetful (or all of the above) are doing so for one reason - keeping costs down, i.e. maximizing profits at the expense of customer service. This isn't a five and dime, it's a medical practice and the service when delivered properly can be life changing.

Whenever I see a practice with (and I'll call it what it is) crap front office staff - warning bells go off in my head. I suspect that the office staff failed to get clearance in time so we're trying to cover up their mistake in your case. Who knows which samples are being mislabeled, reports misfiled in such a place.

I really think that you should try to speak with the doctor him/herself about this and if you do not get a degree of satisfaction then you really do have a moral obligation to prevent them from damaging other families like this by shaming them publicly.

Sorry for the rant (mods feel free to delete) but medicine for profit (to the detriment of patient care) really just gets my goat and this is an especially egregious example of it.

This was my thought, too. It seems suspicious and like the front office is playing CYA to avoid trouble with the DO.

I wouldn't be too quick to throw the baby out with the bathwater, if you believe the therapy has benefited your DD. I agree with the advice to speak directly with the DO. They have an ethical duty to your DD and if the office staff has made mistakes that compromise her treatment--a good practitioner will want to make that right.

I have a private practice myself and when I've made mistakes (failed to get prior authorization on time), my services aren't charged to the client. Health care providers *eat* charges all the time. I'd talk to the doc about the ethics of this situation.

Update: DH spoke to our insurance company and was told there should be no problem getting the eval covered. Looks like it wasn't submitted properly so he filed an appeal and we assume it will all be a non-issue. So yes apparently a CYA scenario that created unnecessary aggravation. That takes care of the money part but doesn't make me any more comfortable with the cavalier attitude...

VT seems to be helping so I do want DD to continue if we can. I think I will try to work out bringing her once every few weeks so the VT can monitor her progress, update excercises and continue to coordinate with school OT. If I'm lucky DH will agree to bring her so I won't have to deal with them and my now developed knee-jerk reaction looking for problems.

DO is about to go on maternity leave so is crazy busy as everyone tries to get needed appointments with her before she takes a month off. I don't think any conversation with her would be productive right now but will talk to her after she returns. Well assuming we are still with the practice at that point.

The really good news is DD hasn't complained of the nausea for a few days and is back to doing the VT exercises without too much grumbling. Crossing my fingers that she continues to improve and we can make this new plan work.

Thanks all!

Just as an FYI, in case you aren't aware: when an insurance claim is denied, there is an explanatory code referenced on the denial. The biller should have been able to see where they'd made an error (left off a critical piece, used the wrong dx code, etc.) That was just crummy treatment on behalf of the front office, but I wouldn't be at all surprised if the DO has no earthly idea how the insurance side works. It seems to be an art form in and of itself.

Glad your DD is doing well and hope your DH can take her! It's hard not to have these reactions, isn't it? I think it must be part of the PTSD thing that goes along with having a 2E child. It's hard to assume/trust that the world is a safe place when your experience points in the other direction.

Sending support.

I empathize with your frustration. I also have made myself known at the VT office for disliking such incompetence. The doctor had said directly during our evaluation that she wanted to have a checkup at a certain number of weeks for the children. Of course it was summer when the time came, and the front desk staff couldn't find a time slot for a month beyond the target date. She said that she checked the other office's calendar too, and that we should just keep coming every week until the eval appt. I have two children doing this simultaneously and our insurance does not cover a penny. So you can imagine that I did not take lightly the assumption that we would automatically pay for four extra weeks without the doctor confirming it to be necessary. Two days later, I called the other office, and sure enough, they had plenty of slots in the time window needed. When we did have the evaluation, I relayed the situation to the doctor, and she was glad to hear about it. They have had other issues with customer services, and she said the more specific info they had, the better for getting it resolved. It's a pain, but when the doctor is back from her maternity leave, I'd recommend letting her know about the issue. It may help prevent it from happening again to you or others.

Update part 2: just got a call from the vision therapy clinic. NOT from the vision therapist who was supposed to have called last Friday but from her assistant. I spelled out everything just as I did here. In the strongest possible terms. (I'm no shrinking violet in case you haven't noticed...) She went from snarky to professional to a bit scared to apologetic and trying to figure out "is there a way to make this right?" Billing person called DH a few minutes later and he explained that they had used the wrong code and what needed to be done to resubmit the claim. His call ended with "Dr. _____ is not in the office today" so we assume she will be informed of the problem tomorrow. I expect her to call, DH does not.

So onward. I am quite certain that I made my point. What I am not sure of is their willingness to alter their practice. I guess we will see what happens...

If the practice is still remiss after you talk with the DO, or if you get a sense that the behaviors come from tone at the top, I would file a notice to your insurance company of the clinic's unethical practice to remove the clinic entirely from the insurer's approved providers. I might also contact a few of the other major insurance providers with copies of my records and correspondence with my insurance company. Insurers want to minimize coverage of services by disreputable service providers. Speaking as someone with experience in healthcare, insurers take this very seriously. You'd potentially be doing many families a favour, as I'm sure the share of insured clients out of all clients is high.

This is very interesting becasue DD was going to a private psychiatric practice for therapy and lets just say there were some billing irregularities and it appeared they were grossly over-billing insurance for services. Insurance covered everything but Dh complained. It seemed like insurance blew him off, but a few months later we got a letter in the mail from insurance stating insurance was no longer considering that practice an in-network provider. I assume other people were reporting things as well, or they took a very close look at the billing and rates and saw how absurd it was. The practice was very unethical in how they treated us overall. In retrospect, everything was about business/money for them, although at the time I wanted to believe they were helping.