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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by JennyR on December 30, 2000, at 10:11:27
Mid-year my pdoc said he was dropping my insurance at the end of the year. I choose to hang on with him even though there were some weird prior incidents.
One prior incident was he was lying about what he was submitting to the insurance company - my statements showed he was putting down "psychotherapy" instead of medication management. The insurance company was refusing to pay for my therapy with my therapist (MSW) and my therapist thought that by the pdoc submitting therapy instead of med management the insuranc company may feel why pay for it in two places, hence denying my therapy. I brought this up to the pdoc who said he is submitting medical management and someone at the insurance company is submitting the wrong code. I called the insurance company to ask them to correct the code and they said the pdoc submits the code and this is what he is submitting. I then asked him about it on the next visit and he got very flustered and said he had a memo from the insurance company saying he is allowed to submit a particular code which covers both med. management and therapy. He showed me the code and it was a therapy code. He said he gets more money by doing it this way. But he had lied the first time, saying he was submitting medical management and someone there was putting a code on. He thought I was naive or wouldn't check.
Incident number two was when he saw my husband who was also seeing him, when he told him he was dropping the insurance at the end of the year, he said our insurance pays him about $50 for the 15 minutes and privately he can get $125, but he'll continue to see us for the $50 if we want. I thought it was very tacky for him to say the part about he can make the $125.
In terms of med, however, he knows his stuff. I was on Serzone. At first the 300 mg was good, then it wasn't doing much, he raised it to 400 and eventually to 600. After a while, recently that pooped out. I really was going to phase him out and hoped to just be off the stuff altogether, but then when the 600 of serzone stopped working, and a lot of personal stresses and strains were going on, it was clear I still needed meds. So at a time when I wanted to disengage from Dr. Moneygrubber (name changed to protect the guilty) I had to continue to avail myself of his services. He put me on Wellbutrin which was hell for a while. He gave me ambien to sleep, which only lasted a few hours and then I was up. Then he changed the ambien to klonopin which was great. This combination is working for me. Usually when I see him, I get a 3-month mail in prescription, or if it's something new, a one month for the pharmacy plus a 3 month mail in prescription. So I went for my last visit of the year and forever, and he gave me the mail in on the Wellbutrin, but said the Klonipin could only be one month at a time. That's NY law. He asked where the mail order company was, and it is PA. He said to call them and see if they would accept it. I called and explained and they said it's fine as long as he puts an appropriate diagnosis. I called him back the next morning and told him they said it was fine. He said the only appropriate diagnosis is seizure disorder so he can't do it. I said I had explained to them what it was for and they had said it was okay, and that I know from my reading (this board particularly, thanks folks)that it is common to use it the way we are. He asked for the number and said he'd call. I didn't hear back so I called him at the end of the day. He said he called and they told him it can only be filled for seizure disorders. It didn't make sense to me that they were telling us two different things and then I realized he's lied before, so maybe I should call again and check. I called and explained exactly what it was for and they said it is fine, he should just put Dx: anxiety or Dx: anxiety disorder. I left him a message that night saying this is what they say, so can I please usse my mail order benefit, and can he write it out and give it to my husband who was coming the next day for his final visit. I called the next morning to see if he got the message and if he was going to do it. He said, in a really nasty tone "fine, just to stop these phone calls, I'll give it to you." This was upsetting because he's the one who told me to check. I said to him "I only called because they told me one thing and you another so I wanted to see which was right." Then he says in a really nasty tone "you know what, now I'm not going to give it to you. The more I talk to you, I don't think I'm going to give it to you." I was shocked. I said "but you just said you would. I don't understand." I said I have the 3 months of Wellbutrin, and I'd like the klonipin to go with it. They said it's fine. He said "yes, the more I talk to you, I don't think I should give it to you. You should see someone else sooner rather than later. I said but with just the one month supply, I'd have to see someone in less than a month and I never saw you that often. He said "I'm not going to put anxiety down when that's not what we're using it for - we're using it for sleep. I said the mail order place knows that and they said it's fine and that that's what you should put." I didn't understand. He was very willing to lie and be sneaky about codes to the insurance company, but here, when I'm not asking anything unethical, just what the pharmacy is saying, he's acting nasty, with a mean tone, reversing himself in a punitive way when I didn't do anything. He said that's how it is, I'm not giving it to you, and you might not like it but that's how it is and you should see someone else very soon. He was acting like I was some desperate drug addict or crazy person.
I called my therapist, really upset and shocked at how I had been treated, so he, equally shocked, called him. The jerk told him the reason he wouldn't do it is since I'm ending with him, he doesn't feel comfortable giving me the 3 month supply of a controlled substance when I'm no longer his care (even though I had assured him I would start soon with someone else). But this is not the reason he gave me, and even later when my husband did come by for his final prescriptions, Dr. Lying-Moneygrubber said to him it was because I want him to put down anxiety which he in good conscience (as though he even had one) can't do.
My husband said he was quite upset about the way he Dr. No-Social-Skills-Nasty-Moneygrubber had spoken to me - my husband referred to it as "snotty and snippy." He then went really nuts with my husband, and that ended on bad terms too.
I was really upset about all of this.
Nowhere in any of this did he ever say to me (like on the final visit or any of the phone calls that it's been nice working with you or good luck, or anything like that - just told me to look into if PA would accept it, then me calling to say they would, him lying and saying they told him they wouldn't (doubt he ever called) then being angry that I called again (probably since I'm not supposed to ever doubt Dr. High-and-Mighty-Because-I-have-an-MD-Moneygrubber. And then the jerk gets mean and nasty on the phone, like his punishing me for the calls, saying he'll give it to me "to stop these calls" then saying no, now you can't have it (simply because I've called PA to clear up the confusion of the conflicting stories). I would appeciate any feedback.
Posted by JennyR on December 30, 2000, at 10:19:45
In reply to Nasty, painful termination with pdoc (long), posted by JennyR on December 30, 2000, at 10:11:27
I left this out - when he said he'd still see us for $50, our co-pay had been $10. That's why we decided we were going to switch at the end of the year. Also, I think maybe why he never said anything nice at the end and never tried to terminate in any kind of professional manner was that maybe he was mad that we were leaving him (though in my mind he was dropping us). I had been a model patient - kept all appointments, paid, followed instructions precisely. I feel like he dropped me, then kicked me in the behind on the way out.
Posted by judy1 on December 30, 2000, at 14:36:06
In reply to Re: Nasty, painful termination with pdoc (long), posted by JennyR on December 30, 2000, at 10:19:45
Dear Jenny,
The law in California is that a shrink has to give 1 month notice of his/her intent to terminate a professional relationship with you. This is done by letter. In that time there is usually a transition phase while you establish yourself with another doctor. Since I am not familiar with the law in your area, I think a call to the local branch of the APA would be a good place to start. Also, my insurance company was willing to cover fees if I needed time to adjust to another shrink when they no longer covered the shrink I was seeing- this took a couple of phone calls to speak to the right person. Basically this person sounds like an asshole though, and since you were seeing him for just med management, I'm wondering how much of a personal investment you have in this. I was terminated by my psychiatrist whom I was seeing for therapy and meds- there were boundary issues and a very painful period of time where things were eventually sorted out. In all honesty, I still hurt. Hope some of this helps- Judy
Posted by S. Howard on December 30, 2000, at 19:27:28
In reply to Nasty, painful termination with pdoc (long), posted by JennyR on December 30, 2000, at 10:11:27
For what this is worth....when I worked at an orthopedic office, the doctors did not do the actual coding...the nurse or the billing person did. Of course, the doctors had to give a diagnosis, but office staff would take it from there. If the particular diagnosis given was not printed up on the "superbill", (which is submitted to insurance) the staff member would have to look up an appropriate CPT code in a very large book. Even in a profession as straightforward as orthopedics, it sometimes got confusing and there was some guessing as to the best code to submit.Of course, this may not be the case with your psychiatrist. I feel he got defensive because he believed you were questioning his ethics and/or his competence, or the competence of his staff, depending on who does the coding. However, his defensive remarks do sound suspicious. If he was truely not at fault, he should have assigned someone to look into the matter and have it corrected.
Better luck with your next pdoc...
Gracie
Posted by Noa on December 30, 2000, at 19:37:13
In reply to Re: Nasty, painful termination with pdoc (long), posted by S. Howard on December 30, 2000, at 19:27:28
That is nasty and painful. It sounds like the right decision to go elsewhere. I find his responses about the miscoding suspicious, too, especially since he had a chance to correct it but didn't. And it directly affected your access to your ACTUAL therapy. 15 minute meetings are not therapy. And, I highly doubt that if he were using the correct coding, the going rate would be 125 for 15 minutes. That sounds like 30 minutes to me, at least. 125 for 15 minutes is what, 500 per hour? Give me a break.
I am sorry you had to have this experience. Ethically, by the way, he should provide you with several names of colleagues who do work with your insurance company.
This is the end of the thread.
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