So it's about 11:20pm and I bet hardly anyone will ever read this partly because it will be way below plenty of other posts come tomorrow morning when people sit at their desk with their morning tea, coffee, or what ever.
Well I got a call today from the "wonderful" folks at a prevalent insurance company who wanted to make sure I understand and adhere to their guidelines since I am in their network. I happen to be in virtually every PPO/POS network and even most of the heavy-hitting HMOs, but I wouldn't say I want to be best friends with any of them.
So the ins. rep (another chiro) explains what I've heard, read, been inundated with for at least 3-4 years now. It's that the average patient (yeah, you must be average. you're certainly not an individual!) gets out of substantial pain within 2-4 weeks of care at which time I, the treating doctor have 3 choices.
1. Discharge the patient who may return if and when they have a "substantial flare up" of the problem.
2. Provide maintenance care for the patient on a cash basis...not using insurance.
3. Provide corrective care for the patient on a cash basis...not using insurance.
Just because I wanted to feel nauseous today I told him I wanted to be totally clear. I said, "so you only cover people in nearly severe or worse pain and as soon as their symptoms stabilize, you won't cover them any more, correct?" He says yes, that's exactly right. So I further clarify by asking, "and if the patient wants to try to correct the cause of their problem or prevent worsening, you will not cover that care and it is the patients responsibility to pay themselves?" I got the same response..."yes, that's exactly right." Does this just make you sick?
I don't know why I bothered to write this. It certainly won't make anyone reading it feel good. I'm sorry for being selfish and needing to blurt this out only so I won't suffer over this alone. You don't deserve it. Nor do I as a consumer and member of one of these all powerful insurance behemoths. Well, I think I can sleep now and hope you can too.
Harris Meyer, DC
Body Focus Health Center
San Francisco
415-956-3226
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