daisylu
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Post by daisylu on Jun 26, 2023 14:17:03 GMT -5
I remember my kids doctor had an after hours sick clinic, with an added fee for the convenience. It was like $60 each time. Insurance would pay for the visit but not that fee. What burned me about it was that if I took them to the emergency room, where we were guaranteed at least 4 hours and a bill at least triple of what the office visit cost, and insurance would have paid the entire bill. 😡
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TheOtherMe
Distinguished Associate
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Post by TheOtherMe on Jun 26, 2023 15:23:06 GMT -5
I will get answers on the maintenance prescriptions this afternoon. I don't think she will refill them without bloodwork, which she will order done. Since I'm going in on Friday, it's not much of a delay. Maintenance meds can not be refilled without the bloodwork, so that has been ordered. She was not happy it was not ordered when the appointment was made. She said that's standard procedure with a Medicare physical.
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movingforward
Junior Associate
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Post by movingforward on Jun 27, 2023 15:00:17 GMT -5
DH had this happen before. They said if he wants to ask questions he needs to make a separate appointment. WTF is the point of a yearly wellness check if you can't discuss your health? And people wonder why up until now I didn't bother I got all my wellness stuff done through work. Another fun thing they do now is if you only see your physician once a year you get slapped with a $250+ new patient fee every time even if it's someone you've used for years. The spin is they want to "encourage you to build a relationship with your doctor" Dude I'm not dating my doctor I'm not paying for an office visit just to chat over coffee. This is punishment for me being healthy and not being able to milk my insurance. My GP "broke up with me" because she said I wasn't coming in enough. I thought that was a good thing, but I guess she would rather make room for an unhealthy patient. I suppose I sort of get that, but if I am not a needy patient you seriously can't make room for me to come in once a year. Well, I guess it had been 2 years since I had been to my GP.
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Deleted
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Post by Deleted on Jun 27, 2023 15:51:21 GMT -5
What absolutely makes me wonder about the medical system is that every damn year the doctor order labs when I come in to see him. Then, after waiting and sending messages, I get some feedback (mostly over my paygrade to understand) on the results and what they might mean. Here's an idea - why doesn't the doctor put in the lab order so he has the results when he sees me and we can go over them and discuss any concerns or med changes in person? Rad, huh?
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pulmonarymd
Junior Associate
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Post by pulmonarymd on Jun 27, 2023 16:18:22 GMT -5
What absolutely makes me wonder about the medical system is that every damn year the doctor order labs when I come in to see him. Then, after waiting and sending messages, I get some feedback (mostly over my paygrade to understand) on the results and what they might mean. Here's an idea - why doesn't the doctor put in the lab order so he has the results when he sees me and we can go over them and discuss any concerns or med changes in person? Rad, huh? Do you have any idea about how many patient's "forget" to do their blood work when we do that. If I order no to be done in 6 months so we can discuss it at the next visit, it is a tossup as to whether it is done. People lose the slip, forget about it, do not have the time, etc. You people on this board have to remember that you do not represent the large majority of people in this country. Most of you are outliers-you plan, you think about consequences, you generally understand things. Having to deal with the general public can be very frustrating.
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Knee Deep in Water Chloe
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Post by Knee Deep in Water Chloe on Jun 27, 2023 16:21:06 GMT -5
DH had this happen before. They said if he wants to ask questions he needs to make a separate appointment. WTF is the point of a yearly wellness check if you can't discuss your health? And people wonder why up until now I didn't bother I got all my wellness stuff done through work. Another fun thing they do now is if you only see your physician once a year you get slapped with a $250+ new patient fee every time even if it's someone you've used for years. The spin is they want to "encourage you to build a relationship with your doctor" Dude I'm not dating my doctor I'm not paying for an office visit just to chat over coffee. This is punishment for me being healthy and not being able to milk my insurance. My GP "broke up with me" because she said I wasn't coming in enough. I thought that was a good thing, but I guess she would rather make room for an unhealthy patient. I suppose I sort of get that, but if I am not a needy patient you seriously can't make room for me to come in once a year. Well, I guess it had been 2 years since I had been to my GP.
Mine has a once-per-year minimum or she fires the patient.
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wvugurl26
Distinguished Associate
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Post by wvugurl26 on Jun 27, 2023 16:33:47 GMT -5
I guess DH and I might have been fired from our PCP. We didn't go during covid. The PCP was adequate. I love my specialists and travel to all of them. None of them are in my home county.
I see the ob/gyn yearly. I see the allergy and asthma specialists at least once a year depending on how I'm doing. The PCP well I just didn't feel he added much.
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weltschmerz
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Post by weltschmerz on Jun 27, 2023 16:38:56 GMT -5
What absolutely makes me wonder about the medical system is that every damn year the doctor order labs when I come in to see him. Then, after waiting and sending messages, I get some feedback (mostly over my paygrade to understand) on the results and what they might mean. Here's an idea - why doesn't the doctor put in the lab order so he has the results when he sees me and we can go over them and discuss any concerns or med changes in person? Rad, huh? Do you not have a patient portal where you can look up the results yourself? Most bloodwork comes back with a High or Low on the results if something is amiss.
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TheOtherMe
Distinguished Associate
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Post by TheOtherMe on Jun 27, 2023 16:44:39 GMT -5
What absolutely makes me wonder about the medical system is that every damn year the doctor order labs when I come in to see him. Then, after waiting and sending messages, I get some feedback (mostly over my paygrade to understand) on the results and what they might mean. Here's an idea - why doesn't the doctor put in the lab order so he has the results when he sees me and we can go over them and discuss any concerns or med changes in person? Rad, huh? Do you have any idea about how many patient's "forget" to do their blood work when we do that. If I order no to be done in 6 months so we can discuss it at the next visit, it is a tossup as to whether it is done. People lose the slip, forget about it, do not have the time, etc. You people on this board have to remember that you do not represent the large majority of people in this country. Most of you are outliers-you plan, you think about consequences, you generally understand things. Having to deal with the general public can be very frustrating. I made an appointment last week for a physical on Monday. No blood work was ordered. Doctor was not happy with that time frame. I am not given a slip. It is sent to the lab. All I have to remember is to do it, which I will do tomorrow.
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Deleted
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Post by Deleted on Jun 27, 2023 17:06:17 GMT -5
What absolutely makes me wonder about the medical system is that every damn year the doctor order labs when I come in to see him. Then, after waiting and sending messages, I get some feedback (mostly over my paygrade to understand) on the results and what they might mean. Here's an idea - why doesn't the doctor put in the lab order so he has the results when he sees me and we can go over them and discuss any concerns or med changes in person? Rad, huh? Do you have any idea about how many patient's "forget" to do their blood work when we do that. If I order no to be done in 6 months so we can discuss it at the next visit, it is a tossup as to whether it is done. People lose the slip, forget about it, do not have the time, etc. You people on this board have to remember that you do not represent the large majority of people in this country. Most of you are outliers-you plan, you think about consequences, you generally understand things. Having to deal with the general public can be very frustrating. So I'm screwed and have to waste my time because of the majority of people are idiots? All righty there
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Deleted
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Post by Deleted on Jun 27, 2023 17:10:11 GMT -5
What absolutely makes me wonder about the medical system is that every damn year the doctor order labs when I come in to see him. Then, after waiting and sending messages, I get some feedback (mostly over my paygrade to understand) on the results and what they might mean. Here's an idea - why doesn't the doctor put in the lab order so he has the results when he sees me and we can go over them and discuss any concerns or med changes in person? Rad, huh? Do you not have a patient portal were you can look up the results yourself? Most bloodwork comes back with a High or Low on the results if something is amiss. I have access to an online portal with test results without interpretation. Yes, it shows high or low values without any indication if this is a life-threatening or altering condition. That's how you get mammo results too. Lots of fun. "Your radiograph showed an anomaly in your left breast". Try seeing that on a Sunday morning and waiting a month to find out if it was some stray deodorant or Stage 4
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pulmonarymd
Junior Associate
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Post by pulmonarymd on Jun 27, 2023 17:47:54 GMT -5
Do you have any idea about how many patient's "forget" to do their blood work when we do that. If I order no to be done in 6 months so we can discuss it at the next visit, it is a tossup as to whether it is done. People lose the slip, forget about it, do not have the time, etc. You people on this board have to remember that you do not represent the large majority of people in this country. Most of you are outliers-you plan, you think about consequences, you generally understand things. Having to deal with the general public can be very frustrating. So I'm screwed and have to waste my time because of the majority of people are idiots? All righty there No, if a patient calls and wants blood work before a visit, I order it. If I want labs to be done before the next visit, I order them. If a patient needs labs to be done to monitor things for medications so I can continue to prescribe it, I will refill it if they forget, and remind them to get it done. I try to be respectful of patients time, and try to be efficient. Unfortunately, many people do not get things done as they are requested. There are frustrations on both sides. Doctors don’t always do as you would like, and patients many times are unreasonable or unreliable. It is the human condition. If you ask physicians about their frustrations with patients, you would have a bitch session like we are having here. Just pointing out that it isn’t all one sided
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saveinla
Junior Associate
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Post by saveinla on Jun 28, 2023 5:56:42 GMT -5
What absolutely makes me wonder about the medical system is that every damn year the doctor order labs when I come in to see him. Then, after waiting and sending messages, I get some feedback (mostly over my paygrade to understand) on the results and what they might mean. Here's an idea - why doesn't the doctor put in the lab order so he has the results when he sees me and we can go over them and discuss any concerns or med changes in person? Rad, huh? My doctor office asks me to schedule my appt after I do the labs. They remind me when I call. Sometimes they get my results late, so the doctor calls me with the results and tells me what is needed. Thats always been the case here.
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Post by The Walk of the Penguin Mich on Jun 28, 2023 9:25:54 GMT -5
So I'm screwed and have to waste my time because of the majority of people are idiots? All righty there No, if a patient calls and wants blood work before a visit, I order it. If I want labs to be done before the next visit, I order them. If a patient needs labs to be done to monitor things for medications so I can continue to prescribe it, I will refill it if they forget, and remind them to get it done. I try to be respectful of patients time, and try to be efficient. Unfortunately, many people do not get things done as they are requested. There are frustrations on both sides. Doctors don’t always do as you would like, and patients many times are unreasonable or unreliable. It is the human condition. If you ask physicians about their frustrations with patients, you would have a bitch session like we are having here. Just pointing out that it isn’t all one sided Then you have my situation, where I DID do my blood work in a timely manner after my visit. I kept being reminded to get my blood work done. I had. I called the lab and they sent my results over…..multiple times. As I explained earlier, my BP meds were held hostage for my 90 day script, I’d get 30 days. So for 6 freaking months I either called the lab, or hand delivered copies to the staff in reception. I finally made an appointment and hand delivered the results directly t9 the doctor. I told him that I didn’t know which party was more incompetent, the lab or his office staff but I didn’t know what else to do to get my 90 day script released. BTW…..the date on my blood work was 6 freaking months earlier, about 3 days after my appointment.
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pulmonarymd
Junior Associate
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Post by pulmonarymd on Jun 28, 2023 9:40:29 GMT -5
No, if a patient calls and wants blood work before a visit, I order it. If I want labs to be done before the next visit, I order them. If a patient needs labs to be done to monitor things for medications so I can continue to prescribe it, I will refill it if they forget, and remind them to get it done. I try to be respectful of patients time, and try to be efficient. Unfortunately, many people do not get things done as they are requested. There are frustrations on both sides. Doctors don’t always do as you would like, and patients many times are unreasonable or unreliable. It is the human condition. If you ask physicians about their frustrations with patients, you would have a bitch session like we are having here. Just pointing out that it isn’t all one sided Then you have my situation, where I DID do my blood work in a timely manner after my visit. I kept being reminded to get my blood work done. I had. I called the lab and they sent my results over…..multiple times. As I explained earlier, my BP meds were held hostage for my 90 day script, I’d get 30 days. So for 6 freaking months I either called the lab, or hand delivered copies to the staff in reception. I finally made an appointment and hand delivered the results directly t9 the doctor. I told him that I didn’t know which party was more incompetent, the lab or his office staff but I didn’t know what else to do to get my 90 day script released. BTW…..the date on my blood work was 6 freaking months earlier, about 3 days after my appointment. Lots of blame to go around. Technology makes it both better and worse. I have had situations where a lab swears it sent results, and when I personally look, I can't find them. Maybe they went to cyberspace. If we have access to their sites, I can look them up myself in that circumstance, but if I don't, I can't. I have had similar situations where the labs were done, but we did not get them. I do not know solution. As to the meds, it is also a sticky problem. Do you refuse to refill them and let the patient's BP be uncontrolled. Do you refill them without knowing if there is a problem you would only see on the labs. We can be sued if something bad happens with either decision. As I said, the people on this board are not representative of the average patient I deal with. I understand your frustration. I work in this system everyday.
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Post by minnesotapaintlady on Jun 28, 2023 9:48:47 GMT -5
I always have to go to do my lab work before my appointment. The one time I forgot I got yelled at by a particularly brutal nurse even though they don't call or send any reminder cards. The send reminders about the appointment, but not with any special instructions of what you should do beforehand. They're really quick and the results are all online within a couple hours so I know what they are before the doctor does as he doesn't look at them until we're in the exam room.
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Deleted
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Post by Deleted on Jun 28, 2023 9:52:20 GMT -5
Then you have my situation, where I DID do my blood work in a timely manner after my visit. I kept being reminded to get my blood work done. I had. I called the lab and they sent my results over…..multiple times. As I explained earlier, my BP meds were held hostage for my 90 day script, I’d get 30 days. So for 6 freaking months I either called the lab, or hand delivered copies to the staff in reception. I finally made an appointment and hand delivered the results directly t9 the doctor. I told him that I didn’t know which party was more incompetent, the lab or his office staff but I didn’t know what else to do to get my 90 day script released. BTW…..the date on my blood work was 6 freaking months earlier, about 3 days after my appointment. Lots of blame to go around. Technology makes it both better and worse. I have had situations where a lab swears it sent results, and when I personally look, I can't find them. Maybe they went to cyberspace. If we have access to their sites, I can look them up myself in that circumstance, but if I don't, I can't. I have had similar situations where the labs were done, but we did not get them. I do not know solution. As to the meds, it is also a sticky problem. Do you refuse to refill them and let the patient's BP be uncontrolled. Do you refill them without knowing if there is a problem you would only see on the labs. We can be sued if something bad happens with either decision. As I said, the people on this board are not representative of the average patient I deal with. I understand your frustration. I work in this system everyday. And, to be very clear, not all physicians are equally comfortable with the newer technologies such as video visits, online chat, messaging, patient portals etc. I love my GP but he simply never ever responds to online messaging and only to phone messages after major prodding by his staff. The staffers are limited in what they can do without his input
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pulmonarymd
Junior Associate
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Post by pulmonarymd on Jun 28, 2023 9:59:00 GMT -5
Lots of blame to go around. Technology makes it both better and worse. I have had situations where a lab swears it sent results, and when I personally look, I can't find them. Maybe they went to cyberspace. If we have access to their sites, I can look them up myself in that circumstance, but if I don't, I can't. I have had similar situations where the labs were done, but we did not get them. I do not know solution. As to the meds, it is also a sticky problem. Do you refuse to refill them and let the patient's BP be uncontrolled. Do you refill them without knowing if there is a problem you would only see on the labs. We can be sued if something bad happens with either decision. As I said, the people on this board are not representative of the average patient I deal with. I understand your frustration. I work in this system everyday. And, to be very clear, not all physicians are equally comfortable with the newer technologies such as video visits, online chat, messaging, patient portals etc. I love my GP but he simply never ever responds to online messaging and only to phone messages after major prodding by his staff. The staffers are limited in what they can do without his input There are all kinds of HIPAA requirements with al those platforms. In addition, answering all those messages and everything are going to be done in between patients or after hours. All of these newer technologies are also adding to physician burnout. Younger physicians may be able to manage all that, but is difficult for us older ones to figure out new work flows. I also hate most virtual visits. It is just not the same as a face to face visit. I guess I am a luddite.
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Post by The Walk of the Penguin Mich on Jun 28, 2023 10:21:56 GMT -5
Then you have my situation, where I DID do my blood work in a timely manner after my visit. I kept being reminded to get my blood work done. I had. I called the lab and they sent my results over…..multiple times. As I explained earlier, my BP meds were held hostage for my 90 day script, I’d get 30 days. So for 6 freaking months I either called the lab, or hand delivered copies to the staff in reception. I finally made an appointment and hand delivered the results directly t9 the doctor. I told him that I didn’t know which party was more incompetent, the lab or his office staff but I didn’t know what else to do to get my 90 day script released. BTW…..the date on my blood work was 6 freaking months earlier, about 3 days after my appointment. Lots of blame to go around. Technology makes it both better and worse. I have had situations where a lab swears it sent results, and when I personally look, I can't find them. Maybe they went to cyberspace. If we have access to their sites, I can look them up myself in that circumstance, but if I don't, I can't. I have had similar situations where the labs were done, but we did not get them. I do not know solution. As to the meds, it is also a sticky problem. Do you refuse to refill them and let the patient's BP be uncontrolled. Do you refill them without knowing if there is a problem you would only see on the labs. We can be sued if something bad happens with either decision. As I said, the people on this board are not representative of the average patient I deal with. I understand your frustration. I work in this system everyday. I hand delivered (multiple) paper copies to their receptionist, so if they can’t find them this is on THEM, not cyberspace. I didn’t get my 90 day script released until I made an appt and hand delivered the results directly to the doctor. Secondly, I have never NOT done the lab work in a timely manner after 10 years. Does that not carry any weight? If I tell them that the lab work is done, maybe they should look harder at themselves? The doctor knew I was pissed when I walked into that appointment. Lucky he didn’t take my BP because I’m sure my meds would have been overwhelmed!
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pulmonarymd
Junior Associate
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Post by pulmonarymd on Jun 28, 2023 10:42:56 GMT -5
Lots of blame to go around. Technology makes it both better and worse. I have had situations where a lab swears it sent results, and when I personally look, I can't find them. Maybe they went to cyberspace. If we have access to their sites, I can look them up myself in that circumstance, but if I don't, I can't. I have had similar situations where the labs were done, but we did not get them. I do not know solution. As to the meds, it is also a sticky problem. Do you refuse to refill them and let the patient's BP be uncontrolled. Do you refill them without knowing if there is a problem you would only see on the labs. We can be sued if something bad happens with either decision. As I said, the people on this board are not representative of the average patient I deal with. I understand your frustration. I work in this system everyday. I hand delivered (multiple) paper copies to their receptionist, so if they can’t find them this is on THEM, not cyberspace. I didn’t get my 90 day script released until I made an appt and hand delivered the results directly to the doctor. Secondly, I have never NOT done the lab work in a timely manner after 10 years. Does that not carry any weight? If I tell them that the lab work is done, maybe they should look harder at themselves? The doctor knew I was pissed when I walked into that appointment. Lucky he didn’t take my BP because I’m sure my meds would have been overwhelmed! Please don't shoot the messenger. My default is to believe what patient's tell me unless they have shown themselves unreliable. I have patient's who I know are reliable. If they tell me something, I believe them. If they miss an appointment, the first thing I think is something happened. If they forget, they get some leeway. But some are unreliable, they skip appointments, they no show, and the like. The first group get a good amount of consideration, the second do not. Do you give your doctor the same consideration. Most times people do not. We try to put processes in to not make mistakes. They are not foolproof, and depend on humans who are fallible. It should not happen, but it does, and there is no excuse for what you are describing. But you only see one side of the issue, you don't have the person who has not been seen in 2 years calling about a problem or a refill at 9PM on a Friday night, who is pissed when you do not do what they want done.
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Bonny
Junior Associate
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Post by Bonny on Jun 28, 2023 13:18:23 GMT -5
I so appreciate my GP at Kaiser!
Before my annual I send her an email with my concerns. Never get charged extra and the emails are not charged either.
She's also not charged me for freezing off skin tags.
They did want to charge $50 for a BP check up appt but I just sent an email. No charge.
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NastyWoman
Senior Associate
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Post by NastyWoman on Jun 29, 2023 14:30:16 GMT -5
I so appreciate my GP at Kaiser! Before my annual I send her an email with my concerns. Never get charged extra and the emails are not charged either. She's also not charged me for freezing off skin tags. They did want to charge $50 for a BP check up appt but I just sent an email. No charge. I am a little (and I do mean a little) south of you and I second your Kaiser comments. Love my GP, and it would be easy to change it I did not, and the few specialists I have dealt with. Any questions I have I just email her and I get prompt replies - including the "my assistant will call you tomorrow to set up an appointment. It is better I see you in person" messages.if needed but phrasing her responses such that I do not go into panic mode overdrive. I never thought of having her remove a skin tag -> that will happen on my next visit as I developed one on my neck and that irritates me (cosmetically only)
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zibazinski
Community Leader
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Post by zibazinski on Jun 29, 2023 18:25:32 GMT -5
What absolutely makes me wonder about the medical system is that every damn year the doctor order labs when I come in to see him. Then, after waiting and sending messages, I get some feedback (mostly over my paygrade to understand) on the results and what they might mean. Here's an idea - why doesn't the doctor put in the lab order so he has the results when he sees me and we can go over them and discuss any concerns or med changes in person? Rad, huh? I told mine that I wanted my bloodwork done a week before I see her. It’s been that way ever since.
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Post by The Walk of the Penguin Mich on Jun 30, 2023 11:56:29 GMT -5
I so appreciate my GP at Kaiser! Before my annual I send her an email with my concerns. Never get charged extra and the emails are not charged either. She's also not charged me for freezing off skin tags. They did want to charge $50 for a BP check up appt but I just sent an email. No charge. I am a little (and I do mean a little) south of you and I second your Kaiser comments. Love my GP, and it would be easy to change it I did not, and the few specialists I have dealt with. Any questions I have I just email her and I get prompt replies - including the "my assistant will call you tomorrow to set up an appointment. It is better I see you in person" messages.if needed but phrasing her responses such that I do not go into panic mode overdrive. I never thought of having her remove a skin tag -> that will happen on my next visit as I developed one on my neck and that irritates me (cosmetically only) Kaiser is a different beast. Isn’t it an HMO? Kaiser is trying to break into the local area, and they have a not so great reputation here.
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NastyWoman
Senior Associate
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Post by NastyWoman on Jun 30, 2023 14:22:17 GMT -5
Yes it is an HMO but around here their reputation is quite good. I selected them a number of years ago to "test drive" them for when I reached Medicare age. We had four or so different plans to choose from and I figured I could at least try some before I retired just to get a general idea. I stuck with Kaiser.
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Bonny
Junior Associate
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Post by Bonny on Jul 1, 2023 10:24:52 GMT -5
I am a little (and I do mean a little) south of you and I second your Kaiser comments. Love my GP, and it would be easy to change it I did not, and the few specialists I have dealt with. Any questions I have I just email her and I get prompt replies - including the "my assistant will call you tomorrow to set up an appointment. It is better I see you in person" messages.if needed but phrasing her responses such that I do not go into panic mode overdrive. I never thought of having her remove a skin tag -> that will happen on my next visit as I developed one on my neck and that irritates me (cosmetically only) Kaiser is a different beast. Isn’t it an HMO? Kaiser is trying to break into the local area, and they have a not so great reputation here. Yes, it's a non-profit HMO. It's Bay Area based and has been around for a very long time. So far we've been very happy and I think we've been with them cumlatively for over 25 years. I think one of the things I like is the doctors are disproportionately female and people of color. Like the old Avis commerical they seem to try harder.
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wvugurl26
Distinguished Associate
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Post by wvugurl26 on Jul 5, 2023 13:31:46 GMT -5
I just received a message from one of the big health groups in my area that they were going to start charging you and your insurance plan for medical advice messaging. I have a BCBS flavor and this has never been listed under covered items. They use My Chart and beginning mid month they will begin charging.
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Post by The Walk of the Penguin Mich on Jul 5, 2023 15:15:15 GMT -5
I just received a message from one of the big health groups in my area that they were going to start charging you and your insurance plan for medical advice messaging. I have a BCBS flavor and this has never been listed under covered items. They use My Chart and beginning mid month they will begin charging. Next we are going to get billed for refills.
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wvugurl26
Distinguished Associate
Joined: Dec 19, 2010 15:25:30 GMT -5
Posts: 21,698
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Post by wvugurl26 on Jul 5, 2023 16:05:08 GMT -5
Adjusting medications is mentioned as an example of what would be billed. I guess if you call and leave a phone message the old fashioned way it might not be billed?
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Deleted
Joined: Apr 29, 2024 3:57:59 GMT -5
Posts: 0
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Post by Deleted on Jul 5, 2023 18:38:33 GMT -5
Adjusting medications is mentioned as an example of what would be billed. I guess if you call and leave a phone message the old fashioned way it might not be billed? I have an appointment 7/26 for my annual "wellness" exam and we will be discussing two things. #1 the fact that the practice had someone call me and ask me to change to a cheaper statin and #2 the fact that the practice now recommends only having a mammo every other year while my doc said get one every year. If they try to bill me for a "medication adjustment" consultation, they can stuff it.
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