Monday, August 08, 2005

Missed Appointment Ambush

I called Dr. Jay’s office on 8/3/05 to get a new 90 day prescription since my previous one had no more refills. I was informed by the office manager that since I had missed my physical appointment on 5/12/05, they would not refill my prescription until I paid them $200 for the missed appointment. He also informed me that on 5/12, he tried to bill the $200 to my credit card but it came back invalid (due to the fact that I changed credit card companies).

I told him I had completely forgotten about the appointment since I do not take an appointment card because for the last 3 years I have relied on the "day before" phone call reminders. In fact, no phone call was made for the "week before" blood work appointment or the physical at which time Dr. Jay likes to have the blood work results. So, in a sense, they had notice through my missed blood work appointment, I was not on track for the physical. Even though this reminder phone call is the informal, precedent behavior of the office, I was told, they do not have to make the phone calls and sometimes do not, so I still need to pay before they would refill the prescription.

I asked him why he didn't call me when the card didn't go through 83 days earlier so we could have straightened it out then or why he hadn't already sent me a bill requesting payment for the missing appointment so I could have already had this issue resolved. He said he hadn't had time to send out bills yet.

I asked him once more to fulfill my request for prescription at which time he asked if I was ignoring him about the payment. I told him no I had heard him but that I thought it was unfair of him and the office to have:

1. Not called to remind of blood work appt.
2. Not called to remind of physical appt.
3. Not made the connection between the first miss and realizing there may have been a miscommunication in progress.
4. Suspended the precedent "day before" phone call appointment reminder on which I had come to rely as my way of ensuring appointment attendance.
5. Not to have called to inform me they were billing my credit card for missing an appointment.
6. Not to have called to inform me the card they were trying to use did not work.
7. Not to have sent me a bill in the ensuing 83 day period so I would have been able to resolve the issue with them as I had done once in the past when I missed a similar appointment and promptly made payment prior to rescheduling.
8. Squandered 83 days of potential communication days to resolve the billing issue.
9. Waited for me to call with a legitimate medical need and then used my request for a medical need as an opportunity to ambush me regarding the billing issue.
10. Denied me medical care in the form of refusing to fulfill a refill prescription request and holding that activity ransom until the missed appointment was paid.

He responded:
1, 2, 3, 4. The office did not have to make the reminder phone call.
5. Office policy to bill the credit card of record for missed appointments.
6. No reason given.
7. Too busy, didn’t have time.
8, 9, 10. No response other than to request payment.

I called the insurance company and was informed that I should file a written grievance for denial of care.

I spoke briefly face to face with Dr. Jay and he said he did not have 5 minutes for me to talk about this issue and that I needed to call his office manager back to resolve it.

My questions to Dr. Jay:
1. does he know his staff has apparently suspended reminder phone calls?
2. does he know there is an 83 day old, unbilled receivable on his books?
3. does he know his office manager is “too busy” to send out bills?
4. does he know his office manager is using patient generated phone calls for legitimate medical need as his opportunity to discuss billing issues and, if not instantly satisfied, he is denying medical care?
5. does he know that for someone I trust enough to check my prostate annually that I am now very concerned about the intelligence of my choice?

On the 2nd phone call on 8/5/05:
I told the office manager I understand my medical care is ultimately my responsibility and in the future will take full charge of my own appointments and no longer rely on the reminder phone call. I told him I’m willing to pay the $200, but would pay by check and would not provide them with my new credit card. I told him I felt he had squandered 83 days of potential communication time with me and that he was ignoring my legitimate phone call for medical assistance and was using my phone call as an opportunity to ambush me regarding the missed appointment bill. I was told if I pay, he would issue a 30 day prescription which should give me time to find a new Doctor.

My question: Since when is the office manager the Doctor?

Any suggestions??

1 Comments:

Anonymous Anonymous said...

man, $200 is pretty steep for a missed appointment!
you said: Waited for me to call with a legitimate medical need and then used my request for a medical need as an opportunity to ambush me
i don't think it was that personal, he probably just saw your chart for the first time since the missed appointment and this prompted the communication (no other internal chart reviews, etc). unfortunate situation...

9:06 PM  

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