Return-Path: Received: from nl.cs.cmu.edu by K.GP.CS.CMU.EDU id aa14133; 21 Jun 91 21:58:00 EDT Date: 21 Jun 1991 21:37-EST From: Monica.Cellio@NL.CS.CMU.EDU Subject: health care To: pghguide@K.GP.CS.CMU.EDU, bovik@K.GP.CS.CMU.EDU Message-Id: <677554665/mjc@NL.CS.CMU.EDU> I strongly recommend *against* dealing with HealthAmerica. They are extremely inefficient, somewhat incompetent (e.g. dispense misinformation), slow, and in general a hassle to deal with. Because you take what doctors they have available, you have little say in the quality of your care. (In fact, often times you have to settle for a phone consultation because they don't think it's serious enough to rate anything more, like seeing one of their nurse practitioners.) Here's my latest HA story: in November I contacted them about a piece of minor elective surgury that my policy (note: not through CMU) lists as covered modulo a small co-payment. I actually had the surgury last week. Quite a bit of time elapsed in the meantime; all but a month of the delay was their fault. Rough chronology: November: call asking for appointment for pre-surgury exam; get told first available is mid-January. Mid-January: have checkup, everything is fine, told to call them next day to schedule. (Note: doctor explained all the risks, etc. at this time, and I told her I wanted to have it done.) Next day: I call to schedule surgury; the person I talked to said "did you sign a consent form?". No I hadn't; I hadn't known. Can they mail it to me? No, it has to be done in person. Fine, can I stop in tomorrow and do it? No, it has to be done in front of my doctor, after a full explanation of the risks, etc. I tell them I've already had that conversation; they say that's not good enough and I have to schedule another appointment to sign the form. First available is late February. Late February: meet with doctor to sign form and attempt to schedule surgury. Get told that since I'm "so young" (I'm 27), I have to "pass" an exam with their mental health people first. This is absurd, I say. It's the rules, they say. I grumpily tell them to give me the first available slot, which is in early April. (Aside: this requirement is quite likely illegal, and I will be investigating that.) Early April: everything's fine as far as their pshrink is concerned. I wasted more time in transportation and waiting around than in actually talking to the person. The conversation could easily have been held over the phone. That day: I call my doctor's department to say that everything is fine, and can we schedule the damned surgury now? Did I have a full exam in January, they ask? How should I know? The appointment was scheduled with the intent of doing this surgury, so I assume so. The HA drone shuffles some paperwork and informs me that I certainly didn't have blood tests in January and that's part of the full exam, so I have to schedule one of those. For early May. Early May: Go back for exam and blood tests. Ask doctor and three other people if they're all *sure* I don't need anything further. No, I can call so-and-so to schedule now. Let's do this now, in person, I say, just in case any other hitches arise. They tell me where to find the person in question, and an hour later I have a surgury date. At this time I was told, by someone who had my chart in front of her, that: - My surgury was at 9am and I'd be out of the hospital by noon or 1 - I'd be sore for a couple days - if I had it done on a Friday I'd be able to go to work Monday - I'd have to refrain from certain other activities for a week. They offerred me a date in mid-May; I was planning to go out of town for a week, about a week and a half after that, and decided not to risk it. (I'd definitely be partaking of the restricted activities during that trip.) That's why my surgury was in mid-June. Last week, after the surgury, when I was still in the hospital at 9pm and finally seeing my doctor for the first time since before the cutting began, my doctor laughed at what I'd been told, said I'd be off work for a week, and that I couldn't partake of that particular activity for at least 4 weeks, when I'd have a followup exam with her. Good thing I trusted my instincts over what I'd been told by the drone! (It turns out that there are two ways to do what I had done; what I was told is true for one way, but it very clearly said on my chart that I was having the other (safer) procedure.) Seven months, a week of lost work at a very bad time, and quite a bit of lying, misinformation, and aggrivation later, it's almost over. I will not be renewing my HealthAmerica policy. Oh, what was the "extreme" surgury that required so much running around, a sanity check, and whatnot, because I couldn't possibly be trusted to make such a decision on my own no matter *how* much time had elapsed since my initial request? A tubal ligation. Why might the sanity check be illegal? Because they don't require it of men who want vasectomies. Cheers. Monica