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Frustrated by PM Dr's admin staff

anjuanaanjuan Posts: 236
edited 06/11/2012 - 8:36 AM in Pain Management
I am so frustrated by my pain management Dr's admin staff at this point, that I don't know what to do. They still haven't sent the documentation to get the preauthorization for the SCS to my insurance company! As a result, I may not be able to have my trial on October 8.

I have said how I like my PM Dr., but his admin staff is a whole different story. There have been so many times where they put my appointment time or day down incorrectly, not sent back my refil requests to the pharmacy, etc. It drives me nuts!

Well, this time my Dr. had told his staff directly in my presence to get my PT records on August 28. I had my therapist eval on September 15 and passed w/ no problems. The therapist sent the report to them the next day. I called the PM office up and they had the therapist report, but they hadn't even asked for the PT records. I called the PT office on September 22, and they still hadn't requested my records so I asked them to send them over and they did within an hour. So the PM office had everything they needed to send to my insurance. I called my PM office yesterday and they still hadn't sent it yet. I asked if they could do so yesterday and call me afterwords and they said they would. Still no call today. I also e-mailed my PM Dr. since I believe he reads his e-mail personally and no response. I have never had this type of problem with other Dr. offices!

Any advice on what I should do? Should I call them back again, or just wait longer? I really want to get the trial scheduled because I am so tired of this pain!! I read the stories of success on here and I just don't want to wait any longer. On the other hand, I don't want to make them too upset with me because I am afraid the staff would delay my pain med refills, etc.

Sorry about the long book on this. I really would love any advice.


  • Years ago I had a knee doctor that his staff was the same way. On one of my office visits, I asked the doctor if I could share some concerns with him. He was shocked and had no idea his patients were being treated this way.

    This is just me...but I would call the office and remind them you are scheduled for the 8th...only takes 10 days to get answer back from insurance company so they still have time. Politely ask them if you could speak to the doctor...if they ask what for just tell them it is a private matter and you would really like to talk to the doctor...be prepared for them to put you off and say he will call you back. If they put you through or he calls you just tell him your concerns and how frustrated you are and that you felt he should know his office staff is making patients feel uncomfortable. Let him know of the mistakes with appointment dates and the return refills. He needs to know. For all you know he is losing patients due to there inability to do their job in a timely manner. Honestly they ask for two weeks but it takes less than 10 days to get the authorization. Hang in there.
  • I had a problem with my neurosurgeon's office filing my request for disability authorization in her bottom drawer. After you do as Locklynn suggests, call the office every day to check on your insurance preapproval.

    BTW, I am not so far along as you. I am surprised that PT records are required for SCS trial preapproval. How far back do they want records? In my case, that could require contacting several PT places.
  • I dont know what to tell you. Im more of the sit back and wait til i think i cant wait any longer. Im always afraid of making them angry like you. My pm seems to have a good relationship with his employess therefore i dont feel that i could say anything about them for fear of losing my pm.

    since you are on a limited amount of time I would probably go ahead and call and be very polite and just tell them the date of the trial and the 10 to 14 days of insurance approval and that if everything gets into this place asap you can begin your treatment. Other than that i dont know. sorry

    good luck
  • I didn't have to have pt records or phych evaluation either. I think that is just for the doctor not for the insurance. I have BC insurance and they seem to go on what the doctor said. I don't know if it had anything to do with my primary doctor referring me for this procedure or what...but it seems that many people have to jump through unnecessary hoops. After my trial...it took 5 days for insurance to approve the perm. system. There were no questions asked. Of course they put their statement in there that it might be preexisting but I have been with same insurance for 15 years so there was no way it could be considered preexisting. Even if he/she gets along with office staff they need to be aware of what hoops you are jumping through and you are not getting the respect you deserve. Don't get upset with him just calmly state your concerns. I am sure if he hears how you feel, less of a person because of the office staff, they will change their policy or proceedures. I am not a confrontational person by any means...will do anything not to cause a problem...but you are paying them good money to take care of you and if you are not getting the level of care you feel you deserve than your doctor needs to know. He may have an explaination for all that is going on...but he will understand your frustration and do something to help or you will find that he/she isn't the doctor for you. I know that sound cold but I feel that if you are paying for a service and not getting it you would find someone that would give you the level of service you are paying for...same is true of doctors. I have fired doctors in the past and told them...I maybe just a number or dollar figure to you...but I am not going to waste my money on someone who doesn't work for me. I found that after I said that...they do anything they can to keep your business and one doctor gave me his personal cell number and told me to call that number if I had any further problems. You will ultimately know what is right when you are face to face with it.
  • Well, I talked to the Dr. office today. Apparently they had to send in some paperwork to Boston Scientific and Medtronics prior to sending the preauth in to my insurance company. (My Dr. is going to use the Boston Scientific, but if that doesn't help me the Medtronic is the back-up.) They said that they still had me scheduled for Thursday, October 8. So, at this point I am going to try to just sit back and plan for the procedure on October 8 unless they tell me differently. I am going to tell my Dr. about the problems that I have been having the next time I am in his office.

    As far as your questions about the PT, they just wanted to know that I had tried it somewhat recently. I did PT after my fusion so that is the only records they needed. They didn't need the records for all of the PT I have ever done.

  • At least you are one step closer. Sometimes i think just the stress of all the waiting and not hearing anything is too much. hopefully you will get it done oct 8 and your right you just have to wait and see what happens.
    good luck with your procedure and talking with your doc.
  • If you want to hear a real horror story, wait until October 31 and then look up what happened to me under the headline PUT OFF and PUT OFF Part Two. That was really something! Susan
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