June 23, 2019
Data, data everywhere, Not a drop to drink. Thank you for the nice description Coleridge.
So, I’m not writing this article to complain. I just figured writing my experience down would have provide some cathartic relief and of course shine the light on the desperate need for #HealthcareDataIntegration which @MarkLogic does so well. In that effort, I’m just going to lay out my minor run-in with our $3.5 trillion reasonably broken healthcare system today “As Is”.
- 8 am: So this morning I got stung by something, I don’t know what, on the back of my hand between my thumb and my wrist. It hurt a bit. I went ahead and got some pain relieving cream from one of my pharmaceutical customers, J&J, and applied it to the affected area.
- 8:30 am – 9:30 am Continued to apply cream multiple times as the pain was subsiding very slowly.
- 9:30 am Took a over-the-counter anti-histamine Claritin from another of my customers Bayer.
- 3:30 pm Before the start of a meeting several colleagues of mine mentioned spider stings could have serious emergency-room / life-threatening consequences.
- 4:05 pm I called my primary doctor to see if he would take a quick look, but got the answering machine indicating that they close at 4pm daily.
- 4:25 pm I log into healthcare insurance provider A’s website and click a link to find a local urgent care clinic. I get a website error indicating the single sign-on to CastLight Health is broken:
- 4:30 pm I briefly thought about downloading the A company’s app. BUT decide against it since the app has a 1.5 star rating. Realizing that I won’t be able to find an “In network” urgent care clinic and remembering that CVS was in network a year ago. I decided to go down to my neighborhood CVS minute clinic just to make sure the sting wasn’t of a serious nature. I mean a minute clinic should take a few minutes right?
- 4:35 pm As I got into my car, I decided to put on my nice bluetooth headset and give A company a call because I needed to talk to them about another procedure whose bill I had just received that they had rejected even though it was pre-authorized and approved in November of 2017, as well as confirm which “In network” urgent care clinics I could visit and what their relative cost would be.
- 5 pm Still on hold on the A company’s call, I walk up to the minute clinic and put my information into the minute clinic kiosk only to be informed that the wait was 93 minutes! Yikes! I take a seat anyways since I’m still on hold with A.
- 5:15 pm After forty minutes on hold, I get on the phone with a support member at A company and give him the pre-authorization number for the previous procedure from last November. He was quite nice and cordial. He promises to take care of it by calling the procedure vendor. I sure hope so. He then (takes a deep breath and) states the we site is having challenges and they are getting ready for their October registration period and emails me a PDF list of urgent care clinics. When I ask him if he can give me a relative cost for each of the clinics, the most I can get him to commit to is “An urgent care clinic visit will cost about $200 and you will be responsible for 20% based on your current deductible levels and for anything more accurate you will have to ask the clinic.”
- 5:20 pm The PDF file just has addresses and phone numbers. No relative cost information. No customer satisfaction ratings. No doctor ratings. No outcome ratings. I call the first one Right Time Urgent Care and find out they don’t have much of a wait and it is only a mile from where I’m at. Again, the person on the other end could not even give me a price range of what to expect from a cost perspective. At this point I’m more interested in investigating price transparency than actually having a provider look at my sting, which is not hurting as much as it was anyways.
- 5:30 pm I get to the clinic and provide the person at the front desk my insurance card and ask for an accurate estimate of the cost of a general urgent care visit for my insurance plan. He tells me that he can’t provide me that and that I should call my insurance provider. #LOL I respond that they told me to present my card in person to the clinic to get an accurate estimate. I then politely state that “I’m a consumer who is interested in purchasing a service and would like to know how much the service will cost and that I’m willing to wait for an answer before getting the service.” He decides to call his billing office. Surprise, they could not provide him an answer either!
- 5:40 pm Given that I don’t know how much the visit will cost and that the pain had subsided, I decide to google my symptoms and look at images of bee stings swellings. I’m pretty sure that is what I have and that I’m not going into anaphylactic shock today. A little more googling confirms the right treatment was antihistamines.
- 5:45 pm I decide to go home without seeing the provider whose name and consumer rating, and service costs were not transparent to me. Here’s to not knowing how much a simple urgent care visit will cost and to hoping I’m still above ground tomorrow!
- 9:00 pm While writing this post, I decide to check the A’s website again on multiple browsers including Chrome and Firefox. Surprise, the CastLight link is still not working.
- Remind me again how much I pay company A and my healthcare providers?
- Remind me again why I don’t have a choice of insurance providers?
- We really need to fix this …
Editor’s Note: Views expressed by opinion writers do not necessarily reflect editorial policy of Views and News, and are entirely their own
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