StatCounter

It Ain't Gonna Get Better Under Obamacare


So, you're telling me, Doc, that waking up like a Stegosaurus monster from Andromeda is due to stress?

I waited till the dust settled to describe the hell I went through to see a specialist. Now, this may bore some of you, dear Readers, however, it may give you a sneak peek into what to expect when Obamacare rolls out.

As a recipient of rare neurological deafness diseases (they were upgraded by the National Institute of Health from conditions to rare diseases), I was mistreated at the hands of negligent and apathetic ENTs where I was told by the primary ENT that I was mentally ill, should be put on meds, in a strait jacket and institutionalized. That's because she didn't know what "SSNHL" and "Hyperacusis" meant, something her audiologist knew quite well. Instead of doing the right thing, like pulling out a medical dictionary, she got downright mean and personal and attacked me for having the audacity to come down with rare diseases that she didn't understand or even care to know.

She also deafened me permanently, but that's neither here nor there.

The second genius ENT wrote in my medical notes during the beginning of April that "Ms. Stone should go to a medical university and conduct research."

WHAT THE FUCK??? And you think this apathy and indifference will improve under Obamacare?

Through phoning around town, I got the name of an ENT who might know what I have. I phoned his office and spoke in great detail with his staff, in particular one guy, Nimrod, before setting up the appointment.

"I live out of town and need to know the protocol to see the doctor," I asked.

"Give me the name of your health insurance and we'll help you out," said Nimrod. "Oh, the next appointment is in June."

"That's nearly 3 months away! Say, you're out of my network. Do I need to get my primary involved?"

"Don't worry, we'll handle everything at this end," said Nimrod.

I was thrilled that finally I found someone who could at least correctly diagnose me. There's not much that can be done for me, but to get that peace of mind was worth the wait.


Then, I checked the doctor's website. "...delivers services in a caring, state of the art setting and delivers compassionate care and educates his patients and their families about their medical conditions." That should've sent up flares.


A month later, I phoned Nimrod. "Reconfirming my appointment."

"Yes, I see it here."

"Do I have to do anything? It's out of network."

"Oh no. My staff took care of it."

"They did? How cool!"

Another month goes by. I phoned Nimrod. "Are you sure it's okay? I never went out of network before."

"Yes. As I told you, we got everything in order."

A week before the appointment, I phoned. Some woman answered. "Is Nimrod there?"

"Who?"

"I've an appointment next week at 2pm."

"You're not on our schedule. Who are you again?"

I broke down, out of my mind. Turns out Nimrod was a nimrod. He never contacted the back office. Instead, they switched me to the office manager. I begged her, "Can't I see the doctor and we'll arrange insurance separately?"

"Sure, but we don't accept your insurance. Just bring $1600 in cash."

That's when I fell apart.

Hours later, like a possessed woman, I researched online. Over the past month while I waited earnestly to meet this purportedly savvy ENT with patient care foremost in his treatment for $1600, I noticed the web became populated with more information than the previous two years about my diseases. I found The American Board of Otolaryngology. 

I phoned and the operator told me I needed a neurotologist.

A neurotologist is a specialist in neurology with a dab of audiology and a high dosage of ENT. It's a relatively new field of medical science to treat people like me with neurological deafness. So new, in fact that my audiologist and two former ENTs never even knew that such a field of medicine existed!

Yet, an operator knew more so than an audiologist and 2 ENTs. Goes to show...

She gave me the names of five neurotologists in Manhattan. The others were out of state, far away.

I phoned the first two in the same practice. The receptionist said to me, "What the hell is your problem? You're shouting!"

I responded, "Is this the first time you interacted with someone who has a hearing disability?"

These momzers wanted $1200 up front in cash and didn't accept my insurance. Oh boy! Well, that was out. The remaining three worked in the same practice affiliated with a top-notch hospital.

This is where the fun and games come in. I then learned I needed my primary to contact my insurance company to make a case for me to leave the network. That was easy enough as I'm the only one in her practice to have these diseases. She had one of her staff to work closely with me, a lovely woman named Dee.

At first, my health insurance provider wanted me to see other ENTs.

"You really want me to visit the two hundred ENTs in your plan?" I asked. "As if any of them are qualified?" I laughed.

It took a week of my incessant nagging, plus that of Dee for them to relent. And, luckily, the hospital accepted monies from my insurance company.

I had approval from my primary AND my insurance company. The only difficulty lay in the fact that the doctors wanted their $1200 cash and not the paltry $200 my insurance company would give them.

Every morning, I phoned the neurotologist's office. "Has your billing department contacted the insurance company yet?"

"No, Ms. Stone. Let me get back to you," or "What? They didn't contact you? Let me get back to you."

Every afternoon, Dee phoned. "They won't return my phone calls. Have you heard from them?"

This went on for three and a half weeks. Finally, desperate, I phoned the insurance company. "Has the neurotologist contacted you?"

"No, Ms. Stone. What's going on?"

A light bulb lit over my head. "Oh, they don't want me as a patient because you're not going to pay them $1200. So, they'll play this game where the incompetent staff never gets around to contacting you.  And I'll get tired and frustrated from this game that I'll fade away."

The customer service rep at my insurance company went batshit crazy. "I know that's what they're doing. And this is what you can do: call the President of the hospital. If you don't get an appointment, I'll help you initiate a lawsuit. This is unconscionable."

"What a great idea!" I said. "Why didn't I think of that?"

I'd have clarity of thought if I didn't have rampant tinnitus deafening me 24/7, acute pain, vertigo, hearing loss and imbalance. I'm too busy trying to do simple things in life, I can't focus when it comes to the big things.

So, on Wednesday July 3 at 4:45pm, I phoned the president's office at the hospital and got his personal assistant. After a rapid introduction, I said, "Why do you want to condemn me to death?"

That got her attention. I knew I had to be heavy handed if I ever wanted to see a doctor.

"I've a popular blog with over 35,000 readers, I won book awards and go on radio quite frequently. I just want to know why your doctor doesn't want to treat me, someone with rare diseases simply because she won't get $1200 for the visit."

Flustered, she then went about appeasing me while googling my name. I added, "I want an appointment next week. I'm tired of being dicked around the past month."

Monday morning at 9am I got an apologetic phone call from the neurotologist's office and saw her the following week.

My only question: did I get the $1200 medical treatment or the $200 special?

------------------------------------------------------------------------------------------

Postscript:

Upon the advice of the specialist, I got a CT scan to eliminate the possibility of a brain lesion. It's 2 1/2 weeks and the neurotologist won't return my calls. Luckily, I got a copy of the CT scan so I know I'm ok.

Next week, I'll phone the hospital president to find out the next steps of my treatment.


AND YOU THINK IT'LL BE BETTER WITH OBAMACARE???




# # #




















No comments: