Furious with CFA

[Anonymous]

I realize there have been ample warnings from others, so I maybe shouldn't complain.

But I'm scheduled to start my first round of IVF soon. Based on others' warnings I called about 10 times trying to confirm my prescription order and get my calendar. I finally got a reaponse about my prescription, including some snark about why I was confirming all the order amounts when the pharmacy I was using always gets everything right. I was told that I should place the drug order and my calendar would be sent later that day. Welll, it came two days later and included a totally different protocol!! I got barely an apology when I pointed out the discrepency. So I need to order more meds and am stuck with sbout $3K worth of meds I don't need. Lucky for me, I guess, I have insurance so mostly njot out of my own pocket. But at thisb point I have no faith in any of the staff. Am considering cancelling, but I also don't want to wait months to find a new doctor. What to do???

Just needed to vent.

[Anonymous]

they are SO frustrating. I am getting ready for my first IVF and I can't believe how disorganized they are. At no point does anyone really ever go over the protocol with you. You know who is helpful? Grubbs pharmacy where my meds were ordered. They have been so helpful in getting me info on all the drugs I will taken (I never got a straight answer from CFA) etc. I am willing to give CFA at least this first round of IVF but then may switch to Shady Grove.

[Anonymous]

OP, what happened? Did your doctor suddenly change their mind about your protocol? Without discussing it with you? That's bizarre. How else to explain the disconnect between what you ordered first and what the second protocol ended up being? I think they owe you money for this screw up. That is just too much money to be messing around with. I think your doctor really owes you an explanation, as that is totally unacceptable. Which doctor are you seeing?

[Anonymous]

what are the best nurses to work with there?

[Anonymous]

OP here. Yes, I think that's essentially what happened 18:20. There are a couple of extenuating circumstances (some mine, some theirs) that caused me to shift dates. According to the nurse, this led to a change in protocol. What's particularly frustrating is that part of the reason I called so persistently before ordering was to confirm that my protocol hadn't changed due to the change in timing. Even now I had to google to figure out a possible reason for why the timing might have caused a change in the protocol.

I know I'm lucky that I have insurance so it's not coming directly out of pocket, but it is coming out of my lifetime coverage limit. And in the end, someone's paying the $3K...an error like this is really infuriating. And a curt "I'm sorry" doesn't come close to cutting it. I've been to autobody shops that are more attentive and personable...and that take more responsibility for their mistakes.

Like I said I'm still really angry and trying to figure out how to proceed. There is no other medical treatment I would get from a medical practice in which I had so little faith...so maybe that's my answer. It just makes me so sad to think it'll probably be months before we can proceed if we switch now. DH is anxious to be a dad, but doesn't feel like it's his place to make decisions since I'm the one who has to endure most of the physical aspects.

[Anonymous]

I agree with PP - that does seem weird. I've had lots of problems with the staff at CFA, but that seems egregious. I would highly recommend that you speak directly with your doctor about it - I'm not sure which doc you are seeing but Sacks is usually VERY responsive to complaints about the front desk.

By the way, I would also find it very hard to believe that the pharmacy wouldn't take them back and refund you, especially if the doctor called and explained what had happened... That being said, I've never done that with fertility meds so I can't be sure about that.

[Anonymous]

So sorry this happened to you! We are about to start initial testing and then will probably go on to IVF with CFA and Dr. Sacks this summer. So far Dr. Sacks has been great, but I'm VERY wary of CFA given all the negative feedback on the staff on this site and am considering going with Shady Grove instead. Does anyone have helpful tips about how OP and the rest of us can manage this process and the nursing/billing staff at CFA (even though it sounds like OP could not have done ANYTHING more than what she did!). Unfortunately, my insurance does not cover anything, so we definitely can't afford these kinds of mistakes. OP - all the best to you. Hope the rest of your treatment goes much, much more smoothly.

[Anonymous]

I am so sorry that this happened to you. The only thing I can suggest is that you bypass the nurses and communicate directly with your doctor. I was a patient of Dr. Sacks, and I always emailed him or called him with questions. I rarely talked to the nurses because I much preferred dealing with Dr. Sacks directly. I found him to be very responsive. Just screw dealing with the nurses and communicate with your doctor.

All the best to you, OP, no matter what you decide.

[Anonymous]

Anonymous wrote:By the way, I would also find it very hard to believe that the pharmacy wouldn't take them back and refund you, especially if the doctor called and explained what had happened... That being said, I've never done that with fertility meds so I can't be sure about that.

Unfortunately, I can see returns being a problem with the drugs that have to be refrigerated. The pharmacy may have concerns that they weren't stored at the right temperature after they were sent. Still, there is no harm in asking, and you definitely should. Are there no drugs that can be used between the protocol you thought you were going to have, and the protocol you've ended up with?

I am so sorry this happened to you, OP. I agree with everyone who says to deal directly with your doctor when you can, and tell him or her about this mistake. But I have to say that when I did IVF at another clinic, most of my interaction was with the nurses. They'd be the ones calling to let me know the results of my monitoring, what to change in my injections from day to day, etc. So it's really important for that relationship to be fairly solid. This one clearly is not getting off to a good start.

[Anonymous]

OP again. Thanks all. I was wondering if I was over-reacting. We have generally been trying to deal with our RE, but we often get responses from the nurses or he tells us things in broad terms and tells us the nurse will follow up. I don't feel like there's much more we can do to protect ourselves and get the care we need. I already spend hours of unnecessary time on the phone following up on things that are simply routine for any other doctor I've been to.

[Anonymous]

I would see if CFA has samples/extras of the drugs you do need to take that they could "exchange" for the drugs that were ordered, but you didn't use. It's also (unfortunately) possible that you may need thw drugs for a different protocol down the line.

I did have CFA switch protocols on me without telling me, though fortunately for me, it was the correct drugs that were ordered, but I did spend all weekend worrying that a particular drug hadn't been ordered when it should have.

[Anonymous]

Thanks PP. I'm wondering if they might be able to provide us samples, though I'm pretty sure it'd need to be a lot of samples.

Mostly, we're having a really hard time with the lack of information. Both of our parents are physicians, and we have high expectations of understanding and discussing our medical care. I'm generally a very involved patient. It feels weird to have so little information about what (I hope) will be a life changing medical procedure. It's just starting to feel a bit like there is an implication that we can't possibly understand things so we should just trust the doctor and don't need to be told what's going on. It's only my body after all.

[Anonymous]

OP, I think lots of fertility clinics, including CFA, get away with s*** that no other medical facility could, simply because the patients are so freaked out by their situations. Fertility treatments are so time-sensitive, and everyone feels so vulnerable and strange about even having to be at a fertility clinic, that I think sometimes patients take crap they otherwise would not. Maybe if you were to switch to another clinic, it would not take months and months... maybe one or two. I'd consult with another clinic, at least, and check. This really sucks... I would not accept that $3000 coming out of your insurance. I truly hope that you are successful your first cycle, but unfortunately you may have to try several times, and your insurance may have to really stretch. This is their mistake, and they should absorb it. What is scary to me is if the nurses are so mismanaged, then what is happening with the embryologists??

[Anonymous]

OP: I think part of the problem is that the doctors at CFA (and maybe elsewhere, too) do all their communication through their nurses, so everything is second-hand, without the chance to interact with the doctor on a regular basis to ask questions. That being, said, my dr. (Dr. Abbasi) did give me her e-mail address, and I have heard that the doctors are pretty responsive to e-mail, so you may try to communicate directly with the doctor if you have specific questions. I agree with the PP that the prevaling view is "Just trust us" -- which for many overwhelmed patients, is good enough.

[Anonymous]

I wouldn't be so quick to assume your insurance will cover a bungled order. Not to be a downer, but I would really fight this. Like you said, it's coming out of your lifetime maximum.