I swear that this is a real-live conversation I had with my insurance company, Blue Cross Blue Shield of Illinois:
• Company: “Ma’am, you are required to use mail order prescription services under your plan.”
• Me: “But you sent me a letter that says that you do not have the drug in stock.”
• Company: “Regardless of that, you are required to use mail order.”
• Me: “So I am required to use your services even though you cannot provide the drug I need.”
• Company: “Yes.”
• Me: “So how I am supposed to get the prescription filled if you do not have the medicine in stock.”
• Company : “Ma’am, I don’t have any control over that, you are just required to use mail order under your plan.”
• Me: “Even if that means that I go without my medication.”
• Company [Large sigh] “I don’t have any control over the availability of our medication, I just know you need to submit to mail order claim.”
I gave up.
Lest you think I am slamming the insurance companies, here is a conversation I then had with the surly receptionist in my son’s physician office—a fellow pediatric physician.
• Office: “The doctor wants to see your son before issuing a refill.”
• Me: “Well, he is away at sleep away camp for the next month. The doctor told us the last time that he saw us to come back in four months, before school starts.”
• Office: “Every patient under 18 years old needs to be seen every two months.”
[Aside: as a pediatrician, my professional opinion is that seeing at 14 year old every 2 months is just income guarantee]
• Me: “OK, the choice is to not see him or to have him go off his medication.”
• Office: “Most parents who are on top of their child’s treatment will schedule around their camp schedule.”
• Me: [screaming on the inside though not on the outside] “Well if you had told me about your stupid income-guaranteeing, lawsuit-hiding policies, I WOULD HAVE TAKEN CARE OF IT. Is he supposed to go off medication, since there is no way to get him into the office in the next two weeks? Perhaps I should talk to the doctor.”
• Office: [Super-Huge Sigh] “Well. that is our refill policy, but I SUPPOSE I could give the doctor a message to call you.”
How dare some 19-year-old receptionist insult my parental organizational pride?!! [And two days later, I am still waiting for that call-back.]
While I prefer to NOT do this, I can still write prescriptions to cover my kids in these silly bureaucratic situations. What are non-physicians to do in this situation?
So how is this relevant to HIT? Please, HEAVENS ABOVE—there has to be a better way. We must be able use technology to make all of our lives easier. If my son’s physician requires a certain number of “$240-dollars-for 6-minute appointments,” then shouldn’t I at least be able to get a text message about it? I would settle for an email or a robo-call, or really anything.
Honestly, if you relay on silly paper processes and difficult 19-year-old receptionists…shouldn’t I get a discount? Where is my app?
And in the absence of the app, where is the outrage? Where is the demand for better service and technology integration? Or even basic service?
After all, it's very difficult to be a patient these days!