Psycho-Babble Social Thread 5599

Shown: posts 1 to 8 of 8. This is the beginning of the thread.

 

*#$%@! HMO's

Posted by blackjack on April 10, 2001, at 16:18:16

Well, I've been looking for a new p-doc. My old one disappeared--really! He doesn't have a receptionist, so I always just leae a message and he calls back eventually (he has ADD :) Well, I've left him 4 messages and had him paged in the last month and heard nothing. When he's been out-of-town in the past, he always left an emergency referral number on the machine, but this time nothing. Weird...

Anyway, I managed to get the list of in-network doctors from the company that does mental health for my HMO (Magellan Behavioral Health for Aetna/US Heathcare) and discoverd that there are only 8 doctors in the entire immediate area, two of whom are not actually in private practice, two of whom are child/adolcecent only, one of whom is being sued by a nurse for shocking her when he was performing ECT, and one of whom is an osteopath. I've still got 1 more refill before I'm out of Wellbutrin, thank god...

So, is my care managed enough yet? I can switch insurence this summer, but theother plans I have at work are just as bad. Are there any group health plans out there that DON'T contract out there mental health to some evil company like Magellan or Valueoptions? I'm going to write the head of Human Resources and request that they look into some other plans.

 

Re: *#$%@! HMO's

Posted by Noa on April 10, 2001, at 18:25:43

In reply to *#$%@! HMO's, posted by blackjack on April 10, 2001, at 16:18:16

That stinks. They are not really giving you options at all. I encourage you to send your story to the folks at the coalition of mental health consumers and professionals, whose webpage is www.nomanagedcare.com

 

Re: *#$%@! HMO's » blackjack

Posted by Sulpicia on April 10, 2001, at 18:48:02

In reply to *#$%@! HMO's, posted by blackjack on April 10, 2001, at 16:18:16

> Hi--
Have dealt with the *people* at M., and given that my child would be dead if I had followed their
instructions, I have come to the conclusion that they are totally useless and possibly designed to dissuade
people from seeking care for mental health problems.
Once I realized this I simply found the best pdoc around for my kid's problem and paid for his help.
Which I might add has been worth every penny. Interestingly, I was told that in my area at least, no pdocs worth
consulting would have anything to do with M. because they were compensated about $12 per hour and had no control
over the patient's treatment. At some point I'll tell you about the FOUR times they made my acutely ill child spend
24 hours on the floor of the psych ER while their bed manager didn't answer the phone or never returned calls. But
I digress. Go and find the best pdoc you can and use him/her for your meds. If you are stable on the Wellbutrin, you
shouldn't need to be seen that often. Make sure your records get sent so the pdoc can look at your prior history etc.
If money is a real issue, say so upfront. Most will let you pay a bill over time, and many will lower their fee. Believe
me, they do understand.
Don't waste your time on M.
I've also complianed to our HR person and union rep. I've also used the L-word [lawyer] but this is rather easy when you
have a hallucinating kid.
Best of luck, and really, it's not worth the wear and tear on your soul to deal with these nitwits.
S.

 

Re: *#$%@! HMO's

Posted by Marie1 on April 10, 2001, at 23:55:31

In reply to *#$%@! HMO's, posted by blackjack on April 10, 2001, at 16:18:16

Blackjack-

I too have had to put up with the b.s. from Magellan. There was no one on their list within 20 miles or so from where I live. Besides which, none of those esteemed pdocs returned my calls. So I started seeing a local shrink and have been paying out of pocket (130.00/wk.) I finally got so angry with the situation that I called Magellan and demanded that they either find me a therapist close by or pay for the one I am seeing (his rates, not their's!) To my utter astonishment, they agreed! Of course all this has taken months and I haven't yet seen a dime, but I'm still hopeful. My advice to you is keep trying - call them daily if you have to. Demand to speak to a supervisor. I'm sure they work hard at being the most inept and disorganized they possibly can, but eventually they'll tire of your pleas. It worked for me (I think); it's probably worth a shot for you. Good luck!

 

Re: *#$%@! HMO's

Posted by blackjack on April 11, 2001, at 11:29:33

In reply to Re: *#$%@! HMO's » blackjack, posted by Sulpicia on April 10, 2001, at 18:48:02

> > Hi--
> Have dealt with the *people* at M., and given that my child would be dead if I had followed their
> instructions, I have come to the conclusion that they are totally useless and possibly designed to dissuade
> people from seeking care for mental health problems.

Oh, I'm sure of it. I suspect they have a formula worked out whereby they know exactly how much to drag thier feet and muddle things in order to cause an economical number of people to either give up or kill themselves, but not generate enough lawsuits to push costs up. The call it the point of effecient neglegence.

 

Re: *#$%@! HMO's

Posted by Noa on April 14, 2001, at 12:55:51

In reply to Re: *#$%@! HMO's, posted by blackjack on April 11, 2001, at 11:29:33

I encourage you to visit the following websites:

Coalition of Mental Health Professionals and Consumers:

http://www.nomanagedcare.org

They have lots of links about dealing with HMOs, etc.


Physicians Who Care:

http://www.hmopage.org

They have a page where you can register your complaint:

http://www.hmopage.org/patcomp.html

 

Re: *#$%@! HMO's » Noa

Posted by Dr. Bob on April 15, 2001, at 0:12:53

In reply to Re: *#$%@! HMO's, posted by Noa on April 14, 2001, at 12:55:51

> I encourage you to visit the following websites...

Hmm, are you up for doing another Tips folder? :-)

Bob

 

Re: *#$%@! HMO's

Posted by allisonm on April 15, 2001, at 18:57:05

In reply to *#$%@! HMO's, posted by blackjack on April 10, 2001, at 16:18:16

I see an osteopath psychiatrist. He's very good.


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