CS1964's Journal

It has really been a long time since I have written in my journal here. 

I am not very happy that when I went to call the office of the only rheumatologist in network for my insurance plan to make an appointment I was told that my referral from my primary doctor was denied by a Dr. Middleton (the Dr. of the two in the practice I didn't want to see anyway since I heard he isn't that great with fibro patients).  The person at the rheumy's office said it said this was a routine follow up and none was needed.  I have never seen this doctor before.  I explained to her briefly this was not just a follow up there were other things going on.  She said if it wasn't a routine visit to contact my primary doctor's office and have them provide more information.  I left a message for the referral person.  I then called my insurance company to ask about if that is allowed that a specialist's office can deny a referral from a primary doc.  I didn't receive an answer, but then she proceeded to call the referral person while I was on the other line and actually got a hold of her.  The referral person told the insurance company person that the doctor's office said the routine follow up was not necessary Dr. Middleton felt and it was denied. That was it.   I called and left another message for that referral person and she has yet to call me back.  I will keep trying to get a hold of her I guess and I have a letter ready to go to the insurance company since I was told that the only way anything will be done about this if it is in writing.  I mean I could see an out of network rheumy but I don't think I should pay more to see one when I got a referral done by my primary.  I even had to get bloodwork done before the referral could be processed.  That is related to another story.  Wednesday June 24th in the afternoon I left a message politely inquiring about my referral to the rheumy since I had seen the doc on the sixteenth and hadn't heard anything.  The next morning I get a call from the nurse saying well it takes seven to ten business days and have you even had  the bloodwork done yet with the autoimmune panel.  I had no idea that that had to be done first before the referral was done.  Noone told me.  She said all this in a very snotty tone.  Then later that day the referral person calls and asks me if I had the bloodwork done yet in an accusing tone as well.  I told her I just found out earlier today.  She said well I sent you a letter earlier this week.  She sent it Tuesday.  I got the letter that afternoon.  There was also a comment made that I hadn't seen a rheumy for years so basically what was the rush for.  Well that wasn't true.  I had seen one last year.  I became a patient of theirs this year so not like they would know anyway when I saw one so I thought that comment was out of line as well.  Well anyway this primary doc is good, but I think I need to have a talk with him about his staff.  Later all.

Cheryl

Cheryl