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WellPoint health insurance buys into hotel-spa

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posted on Mar, 15 2006 @ 06:57 PM
WellPoint Hotel-Spa story

WellPoint happens to own Anthem Insurance, which is who our provider is, so my ears perked up this A.M. when I heard about this story.

I have numerous chronic health issues stemming from my time in the Gulf, so I have spent quite a bit of time on the phone with the Anthem individuals trying to get pre-certifications for testing approved, surgical procedures approved, etc. This has been a constant battle and I can little afford to have the procedures done or buy the meds on my own. That is one of the reasons I was a little angry when I read:

It's comprehensive care, for those who can afford it.

My Neurologist for the last two years has been working at an (un-named here) research hospital in Indianapolis. I see many indigent people pass through there and some that I have talked to while waiting have had to spend a whole day waiting to be seen by their particular doctor in the clinic. When I have heard them question the staff about "when do I get to see the doc?", the reply is "whenever the doctor wants to see you. You may have an appointment time, but that doesn't mean that you will see the doctor today."

My last appointment at the hospital, I was waiting from 10:00 A.M. until 4:00 P.M. to be seen. My appointment was for 10:00 A.M.

I also see quite a bit of "turfing" patients amongst the different departments of the hospital. "Turfing" refers to sending a patient from one department to another because the patient is not quite sick enough for the original department to keep the person overnight for treatment, so they send the person to a 2nd or 3rd department for "evaluation" of a suspected health problem so that the person can be admitted overnight, get treatment for their preliminary problem while being evaluated for the secondary (non-existant) problem. A way of cheating the system.

After the 6 hour wait on the last visit, I wrote a letter to my Neurologist detailing how I was unable to get billing statements from the hospital, they had lost my record 3 times and were even unable to find it in the computer because someone typed my name wrong the first visit, then my social security number the second visit and so on. I had surgery in January and there were massive problems with pre-operative and post-operative care. I wrote how his office was failing to update my record after my visits.

I laid it all out.

The legal department is still going over the letter because it was 4 pages long and covered several departments. The Neurologist says I really shook things up in the Administration building.

So, I got invited to the "other" office location for this research group. Boy, was it just a little different than the hospital!

"We're sort of developing a two- or three-tiered pricing in the United States," said Dr. Gary Ayres, an internist with Fishers Internal Medicine. "That's frustrating because from a primary-care standpoint we want everyone to be treated equally and fairly.

Where the hospital had craked tiles and peeling paint, this place had plush pile carpet, victorian drapes, overstuffed chairs... The receptionist, after we signed in, told us to have a seat for a moment. She then came out to the waiting area to collect my insurance card, my transfer paperwork and gave me a couple papers to fill out before my appointment.

I was in my exam room, blood pressure and medical history taken three minutes after my appointment time. Wow!

After the physical exam by the doc and talking over the status of my ailments, the doc felt I should have an updated MRI done. Normally, this takes 1-3 months to set up the appointment, get pre-approval from the insurance company and finally have the test completed.

I asked the doc if we could have the test run locally as I live about two hours away from Indianapolis and I didn't want to have to make a trip back there. He said "sure, or we can run it here."

I laughed and said, "Today?"

He said, "Sure."

I said, "Right now?"

He said, "Sure, if we get the pre-approval from the insurance company."

I was in the MRI tube 45 minutes later.

So, I have seen both sides of this issue - the seamy side where patient care seems low on the totem pole and the brighter side where I was treated much better because I have decent insurance (my opinion).

Won't this hotel-spa be a similar situation for most of us middle/low income patients? And the article said that WellPoint will not subsidize financially the visits to the hotel-spa. Should my insurance company be a part of a pure money-making venture?

On a lighter note, it does remind me of the movie "The Road to Wellville."

Give me your thoughts please.



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