Would you change PCPs?

[Anonymous]

I recently started going to a new PCP. I have seen this PCP three times. Two out of the three times, they submitted the insurance claim incorrectly, and I was billed for a visit with them claiming my insurance had told them I was not insured. Both times, it has taken multiple phone calls to their billing company and me being quite insistent with them to get them to resubmit the claim correctly. The most recent call took 2 hours with them contradicting themselves multiple times until I finally sat on the line with them while they called the insurance to confirm what I had already told them. Lots of putting me on hold to "check with the supervisor" which starts to feel like them intentionally wasting my time. We have not had this issue with any other providers (and combined our family has multiple providers we see regularly, including ones that use the same billing company). I am hesitant to search for a new PCP as I have started getting to know this one, while not perfect I feel comfortable with them. But dealing with fixing the claims is extremely draining. I tried calling the practice to try to understand why this is happening but got sent to voicemail and never got a call back.

[Anonymous]

I had a similar experience with VHC billing for outpatient physical rehab last year. I want to get more but won't go there. The therapist was great but billing for that department is crazymaking.
Other departments seem fine.

[Anonymous]

A couple of comments.

First, I don't know if I'd want to continue with the PCP, but you like the doc you saw and that is valuable. You could "compromise" and see if the errors happen again.

Second, I suggest calling the practice again -- or at least finding out the name of the person you left a VM for -- to inquire. They may have forgotten to return the call. Or they may be trying to ignore the question. If it was an "i forgot", I'd be more willing to continue than an "I don't want to deal with this."

[Anonymous]

My pcp does nothing but order tests and stuff so would definitely switch. If my specialist that i just love had these issues I would stick around a little longer to see if it resolves.

Pro tip, have the insurance company do a three way call with you on the line, let them leave messages and so on. BCBS is good about this.

[Anonymous]

No way would I stay. I recently had an administratively chaotic experience with a health provider. I stuck with the provider because I liked her and thought her care was good and that the problem was just with one person.

In the end, the administrative chaos was a reflection of her capacity as a manager. The office staff weren't directly responsible for my care, but their actions/inactions had consequences that caused a negative health outcome as a result of the administrative chaos.

I am considering a malpractice claim, since what happened to me is not something that can be fixed.

I learned my lesson that a good doctor isn't just about the doctor him/herself, it's also about administrative staff. I was a fool for sticking with a practice that had a red flag.

[Anonymous]

Anonymous wrote:I recently started going to a new PCP. I have seen this PCP three times. Two out of the three times, they submitted the insurance claim incorrectly, and I was billed for a visit with them claiming my insurance had told them I was not insured. Both times, it has taken multiple phone calls to their billing company and me being quite insistent with them to get them to resubmit the claim correctly. The most recent call took 2 hours with them contradicting themselves multiple times until I finally sat on the line with them while they called the insurance to confirm what I had already told them. Lots of putting me on hold to "check with the supervisor" which starts to feel like them intentionally wasting my time. We have not had this issue with any other providers (and combined our family has multiple providers we see regularly, including ones that use the same billing company). I am hesitant to search for a new PCP as I have started getting to know this one, while not perfect I feel comfortable with them. But dealing with fixing the claims is extremely draining. I tried calling the practice to try to understand why this is happening but got sent to voicemail and never got a call back.

yes, I would switch My time is valuable and it should not take me 2-3 hours for each medical visit to get my insurance billed properly.

[Anonymous]

Anonymous wrote:I had a similar experience with VHC billing for outpatient physical rehab last year. I want to get more but won't go there. The therapist was great but billing for that department is crazymaking.
Other departments seem fine.

Op yes find a new doctor.

PP VHC charged me $1400.00 for a physical even though they were in network. NEVER AGAIN!!!

[Anonymous]

Yes, it’s very much a money grab for so many doctors these days. What is happening?

[Anonymous]

Medical billing/coding is a nightmare, and good help is hard to find. I'd give them one more chance.

[Anonymous]

Anonymous wrote:No way would I stay. I recently had an administratively chaotic experience with a health provider. I stuck with the provider because I liked her and thought her care was good and that the problem was just with one person.

In the end, the administrative chaos was a reflection of her capacity as a manager. The office staff weren't directly responsible for my care, but their actions/inactions had consequences that caused a negative health outcome as a result of the administrative chaos.

I am considering a malpractice claim, since what happened to me is not something that can be fixed.

I learned my lesson that a good doctor isn't just about the doctor him/herself, it's also about administrative staff. I was a fool for sticking with a practice that had a red flag.

OP here

Thank you for sharing this. Darn it, you are right. The admin capabilities absolutely impact care.

Not excited to find another PCP but you have convinced me.