A Desperate Patient And Insurance Drama! | Random Chamber Talk | Aug 29, 2024

in #hive-14008418 days ago

A 52-year-old worker was sent to our clinic. He was treated at his workplace clinic by a general physician. He didn't get well. The doctor referred him to an orthopedic doctor. We don't have an orthopedic surgeon in our clinic. His company usually sends patients to our clinic. Hence, he was sent to us, even though his insurance would have been accepted in a nearby private hospital! That private hospital had an orthopedic surgeon.

I told the patient (and the driver who brought him) about it. It appeared that the patient's primary target was to get a paper from us so that he could go to his homeland for management. He was having severe pain all over his joints; small and large! He was also having stiffness in the joints, mostly at night and in the morning. His features were suggestive of an acute stage of rheumatoid arthritis.

As he didn't want to go to another clinic, I offered him what we had. I also asked for two blood tests that would confirm my diagnosis. But, we needed permission from the insurance (pre-approval!) first for the test. After one hour of request, the insurance coordinator informed me that the tests were rejected!
"Why"?

"Autoimmune disease management is not covered by his insurance!"

Weird, right? [Rheumatoid arthritis is an autoimmune condition].

We informed the patient. He talked with his foreman. The company managed to get approval from the insurance, which was rejected at first! This drama is not new for us either. Many times, the insurance company rejects it at first. Then they come to their senses (!) anyway and give permission!

We got the test results finally. Those were strongly positive for rheumatoid arthritis. I prescribed the required medicines. However, he was still insistent on getting a paper to go to his homeland. Management of rheumatoid arthritis is a lengthy procedure. The medicines given to an arthritis patient come with many side effects. A rheumatologist should handle the case!

Besides the paper, the patient also asked me to tell his foreman to arrange for his leave! I talked with his foreman over the phone. He seemed to understand the condition. He told me that he would facilitate the patient's leave! I gave a prescription and a referral letter. He left!

I hope that he gets the leave to go to his homeland for the proper management of his illness!


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May be insurance company want to same month lol
Hope he qu get leave and will get proper treatment of his illness.

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I hope so.

Thanks

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You are not only a doctor but an insurance handler. You are also a man with a big heart for the people you care for.

It's a bit of an exaggerated statement about me!

I am just trying to help them.

Thanks for your comment.

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Maybe the part about being an insurance handler is exaggerated. I feel you have a big heart regarding the people you are treating. In other words, I admire doctors who try to help, not all are like you. And you are welcome.

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Insurance... Yeah, sometimes it's troublesome if it's rejected. We always need a person on the back or a close agent to help us with that thing. It's good that your patient is still covered until the first rejection. I hope he's safe until reaches his homeland and continues the treatment🤗

We face problems most of the time. They aren't easygoing dudes sitting at the insurance offices.

Thanks for your comment

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