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Doctor’s Office Spends 2 Hours On Hold With Health Insurer For Patient’s Surgery Authorization
By Allison Martinez
Paperwork, lack of assistance, cost, and un-affordability all appears to be a major issue now that may be blocking medical procedures and coverage under the not-so-Affordable Care Act, or Obama Care. In Virginia, multiple patients walked out of the hospital and the ER when they could not confirm they had insurance.
For some, the insurance was irrelevant because they didn’t have the co-payment. Maria Galvez talked with the Daily MailOnline outside the Inova Healthplex facility in the town of Springfield. She has a plan with Carefirst, identified on healthcare.gov as BlueChoice Plus Bronze According to Galvez, she has to incur $5,500 in medical expenses before her insurance kicks in. The chest X-ray alone would cost over $500.
She couldn’t afford it. Her plan will cost $450 a month alone, without using any medical provisions.
Other patients talked to mail on-line under the provision that their name and face not be released. One person named who walked out of Inova Alexandria Hospital told the Daily Mail On Line,
‘I had chest pains last night, and they took me in the emergency room. They told me they were going to admit me, but when I told them I hadn’t heard from my insurance company since I signed up, they changed their tune.’
In Chicago, Obama Care created enormous difficulties for people to get needed medical care.
Sheri Zajcew’s surgery was scheduled for Thursday. Dr. John Venetos’s office spent nearly two hours on hold with Zajcew’s insurance company. They needed clarification on paperwork and pre-authorization information before they could proceed with the surgery.
The office manager finally gave up. The doctor performed the surgery anyway. Nate Zajcew, Sheri’s husband was not at all impressed with Obama Care. He signed up for the bronze plan offered through Blue Cross Blue Shield through healthcare.gov on December 16th.
“I’m not a happy camper. I understand it’s just a matter of paperwork and yesterday was a holiday. I can be an SOB, too, at times, but since they’re going on with the procedure, it’s OK.”
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Vento’s office said that many of his patience are calling because they don’t have insurance cards and don’t know if they have insurance or not. Governor Quinn had attempted to turn around the situation on cancelled policies, but there is still a tremendous amount of confusion for insurance companies, doctors, and patients.
Ventos decided to proceed with the surgery. He told CBS he was probably going to get stuck holding the bag.
“We feel it’s the right thing to do. We may end up stuck holding the bag and not getting paid on these claims.. ‘At some point, every practice is going to make a decision about how long can they continue to see these patients for free if they are not getting paid.’
In Oregon, a woman who wishes to remain anonymous told CBS affiliate KOIN that she can’t afford insurance.
“I’ve been a cheerleader for the Affordable Care Act since I heard about it and I assumed that it was designed for people in my situation. I was planning on using the Affordable Care Act and I had done the online calculator in advance to make sure I was going to be able to afford it. It wasn’t until I started the process and got an agent that I started hearing from them I wasn’t going to qualify for subsidies because I qualify on my husband’s insurance,”
They don’t know what they are going to do.
Hundreds of non-native homeowners who live a subsistence life-style in Alaska are in a similar quandary. Practically anyone who owns land in Alaska is automatically disqualified from the subsidy. With no cash income to pay health insurance companies and limited job opportunities, these families will lose homesteads and way of life in the name of government mandated health insurance coverage.
h/t CBS, Daily Mail On Line.
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