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  1. #1
    Join Date
    Apr. 24, 1999
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    New England
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    1,264

    Default Who do I send the bill to?

    Mom had an eye appointment (retina specialist) this morning at 8:30. We arrived at the office at 8:15. It is now 11:15 and she has yet to be seen (except for the tech who dialated her eyes at 8:20). The waiting room is packed (40 people and counting). This is 100% unacceptable and we will be finding another doctor. But in the meantime what are my options? Tell the insurance company to not pay? File a complaint with the state board? Options ? Advice?



  2. #2
    Join Date
    Apr. 15, 2008
    Posts
    2,759

    Default

    well, no advice, but the first time i saw my retina guy, i spent 45 mins in his exam room playing with the plastic eyeball and reading the entire "diseases of the retina" chart (blurrily) because both of his patients before me turned out to have retinal tears and he had to laser them both. (and this was after the usual hour or so of dilating and acuity and tonometry and sitting around.) whole app't took over three hours. at least they warned me it might take this long, and i scheduled accordingly...
    ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
    Gravity works, and the laws of physics are a bitch.

    Member: Rabid Garden Snail Clique



  3. #3
    Join Date
    Mar. 24, 2004
    Location
    Pottstown, PA (East Coventry)
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    3,050

    Default

    I walked out of the office at an infectious disease doctor office after 1.5 hours. I was a new patient that was going for Lyme. I told the staff sorry but I am not giving my money to somebody that values my time that little.
    She still had one more patient to see before she got to me. I was taking a long lunch but was not expecting one that long.

    You are way more patient than I was. For certain specialties I understand when they run really late due to emergencies- surgeons, OB/Gyn, family doctors during flu season. I am a lot more tolerant if the staff at least comes out and says "Hey, we are sorry. Doc is running behind. He as had a couple of emergencies we really had to squeeze in." I understand that and would like to think that if I had a true emergency Doc would squeeze me in if necessary. Communication is the key though.

    I think if your mom actually eventually sees the doctor that you have then agreed to be responsible for the fee for the service rendered.
    I would be inclined to find another doctor and when you request the records be transferred let the doctor know that it was due to the excessive wait time.

    You can go complain on websites like Yelp. Healthgrades, rateMDs, vitals etc... You won't get the money back but you may help another person decide to choose a different doctor. You could complain to the PPO network they are a member of but I doubt that will do much good.
    Oh, well, clearly you're not thoroughly indoctrinated to COTH yet, because finger pointing and drawing conclusions are the cornerstones of this great online community. (Tidy Rabbit)


    4 members found this post helpful.

  4. #4
    Join Date
    Feb. 20, 2010
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    All 'round Canadia
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    Default

    Quote Originally Posted by SonnysMom View Post
    For certain specialties I understand when they run really late due to emergencies- surgeons, OB/Gyn, family doctors during flu season.
    Eh, no. Unless the family doc's admitting (acting as a hospitalist), flu season shouldn't put them far behind. If the patient needs hospital, you tell them to go to ER or call an ambulance for them.
    The OBGYN yes, because they might actually have to deliver. Any of those on-call surgical specialists; even the retinal guy, if he has to do procedures right then and there. But totally agree on the staff communicating that to the patients.

    If he's just overbooked (no emergency procedures), that's completely disrespectful to the patient and I agree with finding a new doc.
    Proud Member Of The Lady Mafia


    2 members found this post helpful.

  5. #5
    Join Date
    Jun. 16, 2011
    Posts
    804

    Default

    A retina doctor might have had emergencies. I went once to have my cornea checked after a transplant. They found a retinal tear, sent me immediately to the retina person in their office who looked at in, had me sign paperwork, then lasered it.

    Of course if there are forty people in the office I am thinking they overbooked.


    1 members found this post helpful.

  6. #6
    Join Date
    Apr. 17, 2002
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    between the barn and the pond
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    14,269

    Default

    I work for a very large walk-in outpatient-clinic company. One of our busy clinics averages about 80 patients a day in the Summer, our slow time.

    That clinic saw over 180 patients last Monday. You can bet our wait times are through the roof. Flu happens.

    For the OP, the specialist in question may have had emergencies to repair. If you were a new patient, arriving at 8:00 for the 8:30 would have given you time to fill out forms, them time to key that data in and process it.

    You cannot just blithely instruct the insurance to just not pay for services rendered, you don't have that authority. You can talk to the Office Manager, and ask them to consider waiving the copay as a courtesy to you.



  7. #7
    Join Date
    Mar. 24, 2004
    Location
    Pottstown, PA (East Coventry)
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    3,050

    Default

    Quote Originally Posted by Coanteen View Post
    Eh, no. Unless the family doc's admitting (acting as a hospitalist), flu season shouldn't put them far behind. If the patient needs hospital, you tell them to go to ER or call an ambulance for them.
    No flu season should not put them 3 hours behind. But I do find that especially on Mondays my family doctors would run 30-60 minutes behind since they would squeeze in patient's that got sick over the weekend but aren't sick enough for the ER. We are just starting to get some urgent care places around here but many of them do not accept insurance. My doctors office does keep a few openings in the schedule especially on Monday and Tues for emergencies.
    Three hours late for a family doctor is not acceptable but I will be more forgiving of 30-45 minutes when the upper respiratory infection or stomach bug is going around the area.
    Oh, well, clearly you're not thoroughly indoctrinated to COTH yet, because finger pointing and drawing conclusions are the cornerstones of this great online community. (Tidy Rabbit)



  8. #8
    Join Date
    Oct. 12, 1999
    Location
    Belchertown, MA
    Posts
    692

    Default

    I hear ya...on a related note concerning time and wasting it, I had a flat tire and pumped it back up here at home and then called the tire place to see if I could come in and have it checked out. Yep - come on ahead right now they said. I get there and there is a PACKED waiting area - no seats left in fact. I get to the counter and they tell me 2 1/2 hours. Ok - there are some shops nearby - I will go amuse myself. 4 hours and 40 minutes later I walk out of there pissed on the one hand but happy I stuck it out and got my tires looked at as they had to scrape some corrosion off the rims and then reinflate and balance. No problems since then so I guess it was worth it. I asked them 3 hours in if they could at least update the crowd with an "ok - the Camry has two cars in front of it, the Buick is in now and will be done in 20 mins, the Honda is about an hour and half out." That kind of info is somehow comforting isn't it?


    1 members found this post helpful.

  9. #9
    Join Date
    Feb. 20, 2010
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    All 'round Canadia
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    Default

    Quote Originally Posted by katarine View Post

    That clinic saw over 180 patients last Monday. You can bet our wait times are through the roof. Flu happens.
    Of course, at a walk-in. Same as in an ER when you're there for a minor issue. You wait, and waiting for hours can be perfectly normal depending on what's happening.

    We're discussing appointments, not a walk-in. At a family doc's office flu season shouldn't put him behind; if the office takes walk-ins as well as appointments, they shouldn't interfere with patients who have appointments. They wait to be seen.

    Quote Originally Posted by SonnysMom View Post
    No flu season should not put them 3 hours behind. But I do find that especially on Mondays my family doctors would run 30-60 minutes behind since they would squeeze in patient's that got sick over the weekend but aren't sick enough for the ER.
    Sure, and you also get the psych emergencies - a patient in for a 10-min routine BP check suddenly reveals she's very depressed and potentially suicidal, or something. The interview and forming, if needed, takes time. But I agree, not 3 hours long unless you're having the worst day ever, and then you really should take 5 min and let your waiting pts know that something's up.
    Proud Member Of The Lady Mafia



  10. #10
    Join Date
    Jan. 26, 2006
    Location
    Fort Worth, Texas
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    4,236

    Default

    I believe most of you are in for a surprise as we enter into this new era of health care.


    10 members found this post helpful.

  11. #11
    Join Date
    Apr. 17, 2002
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    between the barn and the pond
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    Default

    Quote Originally Posted by Coanteen View Post
    Of course, at a walk-in. Same as in an ER when you're there for a minor issue. You wait, and waiting for hours can be perfectly normal depending on what's happening.

    We're discussing appointments, not a walk-in. At a family doc's office flu season shouldn't put him behind; if the office takes walk-ins as well as appointments, they shouldn't interfere with patients who have appointments. They wait to be seen.



    Sure, and you also get the psych emergencies - a patient in for a 10-min routine BP check suddenly reveals she's very depressed and potentially suicidal, or something. The interview and forming, if needed, takes time. But I agree, not 3 hours long unless you're having the worst day ever, and then you really should take 5 min and let your waiting pts know that something's up.
    Accessible primary care/urgent care is what we do. I wasn't make that distinction re: Family Docs because many of our patients use as as their 'family doc'. You pulled in the appointment aspect around the flu and family docs-my point is to clarify for many in the coth audience, family docs don't necessarily live and die by appointment books. Carry on.



  12. #12
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    Feb. 20, 2010
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    Default

    Yes, but my reply was to the post about "running late" - at a walk-in you don't "run late". You have shorter waits or longer waits depending on the patient load, but you don't "run late" because there's no set time (appointment) to be "late" for.
    Proud Member Of The Lady Mafia


    1 members found this post helpful.

  13. #13
    Join Date
    Sep. 8, 2012
    Posts
    117

    Default

    We walked out of one office when we found out that they booked 4 people to each 15 min. time slot! That was after waiting 30 mins.to even get into a room.

    We had been in the room for 30 mins. (remember we waited in the waiting room for 30 mins.) when I opened the door after I could hear the nurses talking/laughing outside the door. I asked them when we would be seen. They just laughed and waved their hands "Oh no one ever sees Dr. M. on time since he makes us schedule 4 appts per time slot as there is always one or two that are no shows per day.) WHAT?????

    We walked out and talked to the office manager to make sure she did NOT charge the ins. and to get our money back. We have never been back and make sure that others do not go there.

    Kim


    4 members found this post helpful.

  14. #14
    Join Date
    Jul. 29, 2006
    Location
    Colorado- Yee Haw!
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    2,806

    Default

    Quote Originally Posted by clanter View Post
    I believe most of you are in for a surprise as we enter into this new era of health care.
    My internist sold her practice to the local hospital. I called with bronchitis and they told me they could schedule me 3 weeks out. If I didn't like it I could call every morning at 7AM and try and get a cancellation. This is a doctor that ALWAYS fit me in same day when I was sick before. That experience made me scared. I guess they just want to fill their urgent care. I should have known when my favorite PA quit when they made the transition. Oh and now they can't even tell you what it will cost for different options.


    2 members found this post helpful.

  15. #15
    Join Date
    Sep. 2, 2005
    Location
    Upstate NY
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    11,960

    Default

    I had this experience at an oral surgeon. Scheduled first appointment of the day for an extraction. Showed up 20 minutes early (office was not even open yet). 45 minutes after scheduled time I was called back into the room and then sat in the room, alone, nothing going on around me, for another 45 minutes. The ladies at the front desk were aghasted when I walked out, opened the door and announced to the waiting room (ok, really just my husband but the whole waiting room heard me) that I had still not seen anyone and was sitting in a room with nothing to do this whole time.

    I will not be going back to the oral surgeon.


    2 members found this post helpful.

  16. #16
    Join Date
    Mar. 10, 2006
    Posts
    245

    Default

    I worked in an Eye Clinic at a hospital for many years. One of the doctors I worked for was a Retinal Specialist. Unfortunately she was one of two in a large city. No matter how hard we tried to keep a realistic schedule we were always overbooked. There were always urgent cases to be squeezed in, in-patient consults etc. Working there as a tech was a frustrating and thankless job. Patients always complained about waiting, the doctor was frustrated and angry about being overbooked and we the techs had to work like crazy to triage, perform tests etc. while everyone around us was complaining to us. Throughout all this we had to remain efficient, polite, pleasant, smiling etc.

    Fortunately I have been retired for several years now and do have a nice pension.



  17. #17
    Join Date
    Jul. 14, 2003
    Location
    MA
    Posts
    6,159

    Default

    What is unforgiveable is the customer service in this instance.

    I've seen a great example of how to handle these situations gracefully. At my orthopedic doctor's practice, there is a large sign saying if you are not seen in 15 minutes after your appointment time, come to the desk and tell them. When you do that, they find out what is going on, tell you and approximate your wait time, and either offer to have you seen by someone else, or offer to reschedule or tell you when to come back.

    Of course, in Boston there is a lot of competition among the hospitals for patients, so that probably explains the customer service. Where you have less choice, they may not bother.
    "Against stupidity the gods themselves contend in vain" ~Friedrich Schiller


    2 members found this post helpful.

  18. #18
    Join Date
    Nov. 2, 2006
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    Maine
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    1,826

    Default

    I did walk out of the optometrist once. It was a full half hour past my appointment time, there were still two people ahead of me and I wasn't going to screw over the patients that I had scheduled to see me. I chewed out the front desk for their obvious careless disregard for my time and explained how pissed I was at their obvious overbooking and then reminded them how pissed off they would be if they had to wait that long when they brought their pet in. I also relayed all of this to the optometrist when I saw him the following week.

    I've spent years running on time as a small animal general practitioner while seeing my own daytime emergencies. I did an emergency c-section on my own dog and still saw the rest of my patients on time. My own GP runs late, but goodness knows she spends more than the likely allotted time with me all the time. She's also leaving the group practice to be on her own and have more control.


    1 members found this post helpful.

  19. #19
    Join Date
    Feb. 1, 2001
    Location
    Finally...back in civilization, more or less
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    11,473

    Default

    Quote Originally Posted by CS View Post
    Mom had an eye appointment (retina specialist) this morning at 8:30. We arrived at the office at 8:15. It is now 11:15 and she has yet to be seen (except for the tech who dialated her eyes at 8:20). The waiting room is packed (40 people and counting). This is 100% unacceptable and we will be finding another doctor. But in the meantime what are my options? Tell the insurance company to not pay? File a complaint with the state board? Options ? Advice?
    You can share your experience on any number of web services - like Yelp - that people review before deciding which practice to schedule with. Many insurance companies also offer similar mechanisms to rate patient satisfaction with a doctor or practice that they have been to.

    Your insurance company will not refuse to pay for the visit, I'm afraid.

    What I would do is calmly/politely ask to speak to the practice administrator. The front desk staff generally do not have any control over the schedule and often, not much idea of when you might realistically be seen, but the practice manager *should.* If the practice routinely overbooks the schedule, they will probably not do much other than give you a generic apology, but I have found that when I politely indicate that I am not willing to wait any longer, I am often seen within a few minutes. Of course this means you are probably "cutting the line," so to speak…

    I am by no means defending the practice of overbooking a physician's time, but I will note that it is not a new practice, and will likely only become more common as there is increasing pressure on reimbursement in medicine.

    That is the reason so many people are paying extra to join concierge practices, where the patient pays an annual fee to receive a more personalized service from a doctor who limits their practice to x patients total (usually no more than 600.) In those practices, appointments are usually kept right on time, you get 24/7 access to a physician (cell phone) and instead of seeing the doc for a few minutes, you get a lot more time/attention and a physician who can take the time to do a thorough, comprehensive exam, work on wellness issues, and so forth.
    **********
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    -PaulaEdwina



  20. #20
    Join Date
    Sep. 7, 2006
    Location
    WNY
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    5,544

    Default

    Getting 3 hours behind is bull. I would expect any doctor to be running about 30 minutes behind. Dead on time is obviously ideal, but crap happens, and I can deal with half an hour. For the office to be so far behind, and for it to apparently be normal is unacceptable. Time for the doctor to get a partner or cut back on patients.

    Unfortunately you can't send a bill to anyone. You can let the doctor and staff know it's a problem. You can leave feedback online (Health Grades, Vitals). You can tell your friends and family to avoid that doctor.

    When you look for a new doctor, look at reviews, ask people you know. Call the office and ask if the doctor generally runs on time. Ask when they are most likely to be on time. First thing in the morning or, if they take a lunch break, right after lunch are your best bets.

    I work for a family practice doctor and we try so so so hard to stay on time. Reasons why we get behind:

    1. Doctor gets tied up at the hospital in the morning and starts late.
    2. Patient in the hospital has a lot going on, so doctor has to keep calling the hospital.
    3. Patient comes in for something, exam reveals something else that requires more time (for example, patient comes in thinking they have a UTI, they end up needing a rectal exam and to get set up with a gastroenterologist... yes, it has happened).
    4. Patient scheduled an appointment for something simple, ends up not being simple (oftentimes it's a pap that they didn't tell us they were planning on getting).
    5. Patient has appointment, patient's spouse along and hijacks the doctor for an unscheduled appointment.
    6. Patient shows up late and we have to work them in, even though we don't have time.
    7. We don't have any available appointments, but the patient has something that they need to be seen for.

    1-3 are our fault, but unfortunately unavoidable. 4-7 are not entirely our fault and we try to prevent them from happening, but it's not always successful.

    When patients complain about us running late (thankfully does not happen often--both the running late and the complaining), I tell them that we hate running late even more than they hate us running late, but sometimes it can't be helped, and they'll be grateful that we get patients in when they need it and they get all the time they need when they're the one with an urgent or unexpectedly complicated problem. And of course there's a sincere apology for the lateness!
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