It’s hard to believe that it has been 6 months since I last posted an article in my blog. It is the longest writing hiatus since I started blogging well over a decade ago. Truth be told, as much as I have enjoyed writing, my business activities at WorkCompCollege.com seem to have taken up all of my creative energy. It has been a tremendous amount of work, but I’ve really enjoyed building a new education system for the industry. So much so, that I have struggled to find the motivation to commit additional time to writing here. I knew eventually that I would return to these pages. It would, like most missives I generate, just take something extraordinarily stupid to drive me here.
And of course, my health insurance provider has come through with flying colors on that.
I won’t name my health insurer, as I do sell products to the insurance industry. Wouldn’t want to unnecessarily make any enemies, don’t you know. However, I can tell you that I initially believed that my health insurer was named after a goddess from Greek lore, but I was incorrect in that assumption. My extensive research reveals that rather than a goddess she was a nymph, purported to be the daughter of Uranus.
So, when I tell you that that the insurance company that now dictates my health care has the same name as something that came out of Uranus, there is really nothing more I can add to that. It seems to say it all.
And if she had been a goddess, by the way, I am fairly certain she would have been the Goddess of Ridiculous Bureaucracy.
I suppose you’re wondering what has brought us to this point. I am so glad you asked.
I have seen the same allergy specialist, an Immunologist, for almost 20 years. I recently had an appointment with him for a routine annual check. This check includes a breathing test conducted by a nurse, where according to the doctor in consultation afterwards, I routinely “blow like a champ.” I believe he is referring to my physical condition, and not my personality.
I sincerely hope so, anyway.
This is not by the way the first time I’ve written about visiting this particular doctor. I wrote about him in 2017. If you are interested, my asthma seems to have completely abated, and I am no longer on any medication. But of course, I digress…
This particular visit, it turns out, was entirely different than those in past years, and the change was apparently determined by my health insurance provider. After the tests were complete and a brief wait, two nurses returned to the examination room. They apologized, and explained to me that my insurance plan would not authorize me to actually see the doctor on the same day this particular test was conducted. I would be required to set up another appointment to meet with the doctor on another day. One option I had was for a telemedicine appointment. Since his office is now 45 minutes from my house, that is the option I selected, setting it for 10AM the following Monday.
Now, I wanted to make this telemedicine experience as realistic as possible, and that was accomplished. It started when his office called that morning to collect a second $60 co-pay for this additional appointment. Then I logged into the meeting room, recorded and reported my own vitals, turned the air conditioning down to 62 degrees, stripped to my skivvies, and sat on the end of my desk waiting for the doctor, who arrived 15 minutes after our scheduled time.
We had a pleasant conversation for about 10 minutes or so, with some of it actually pertaining to my healthcare. The good news is that I’m still blowin’ like a champ, and I have been released from annual follow ups. I will only need to contact their office if the need arises. The bad news is that I could have learned all that several days earlier, without the lost time of a second appointment and the expense of an additional co-pay. And my insurer likely wouldn’t be getting bills for two visits instead of one.
But on that latter point, I suspect it doesn’t really matter. I am very interested in reviewing the EOB’s, or Explanation of Benefits, when they are available. I would lay good money – even another $60, that when network discounts are applied to his bills for the two visits, I with my multiple co-pays will still be the primary funding source for this activity.
It is fairly well known that many aspects of our healthcare have not been in the hands of our physicians for many years. This isn’t the first time I’ve been affected by insurance company decisions. My last health insurance company, who I also will not name but seemed to be united in my healthcare, was pretty good and never interfered with actual doctor visits. They just always seemed to know better than the doctor which medication I should actually receive, assigning different medications than that prescribed.
If you spend any time looking at your EOB’s, it doesn’t take long to figure out that with your insurance premiums you are really buying access to a discounted network. Barring a significant health event, your health insurance provider spends very little money on your routine care. My insurance company currently collects more than $24,000 a year insuring my wife and me. Collectively we’ve had just 3 routine doctor appointments in the last two years. We’ve been a good bet, insurance wise. Still, we need insurance – as one unexpected significant event can quickly turn the tables on them.
This is what makes “stupid is as stupid does” bureaucratic policies so frustrating. On the surface, it appears to be a waste of time, money, and resources, with no apparent justification for the rule. Admittedly, I am a simple person who at times needs things ‘splained to him. If you know the reason for the policy I outlined, use the comment sections here to educate me. Barring that, however, I learned one important thing. I’m not the only thing around here that blows like a champ.