As a healthy, 63 year old I was convinced their severing of
ties would not directly affect me. That changed the morning of September 26
when I accidentally caught my short on fire while changing a light bulb over a
gas stove.
The Mission ER was initially very efficient as they were
told from urgent care I might have third degree burns. Once they determined no
third degree burns the nurse was called away and I was forgotten until she
returned to discharge me. She thought someone else would take care of me while
she was busy. No one did. I was at first told I would be healed in two weeks
and to see my family Dr. in two weeks and apply Vaseline twice a day with
sterile pads to the wounds. Prior to
being discharged, I was encouraged to visit the Mission wound center for
further evaluation and told they would call me to set up the appointment right
away.
No one called and it was impossible to speak directly with
the wound center to get an appointment. Some centralized call center handled
the appointments. After much persistence, I was able to get my appointment for
the next day. They spent an hour with me with an MD. popping my blisters,
nurses changing my wound, and evaluating my burn. Since I had no feeling under
my arm, it was possible I had third degree burns requiring skin grafting.
Rather than billed as specialist co-pay I was billed as outpatient hospital
care and a one hour visit cost over $1100 rather than the anticipated $70
co-pay.
The wound center said they would order supplies to be
delivered to my home paid through my insurance. No supplies and no call.
Impossible to speak directly to a nurse, rather call and leave a message and
hope they eventually return your call. I did not even have the name of the
supply store. Finally, I found out the name of the home health agency supply
store in South Carolina and learned when I called them they did not deliver my
supplies, as I had not yet met my deductible. Ended up at a local pharmacy to
get me through until a larger order could be made.
Mission gave me a form to request continuation of care
through the wound center and BCBS called me and approved the care within a few
days. Upon my return to the wound center three days later, I was seen by a physician
assistant who recommended a plastic surgeon consultation (in BCBS network) to
determine if I needed skin grafting. She spent way more time with me than the
MD. earlier in the week, changed my dressing, was exceptional in her care and
concern and took the time to inform me more about what to anticipate. Her
hour-long visit was billed at $67 and I felt was money well spent.
The plastic surgeon ordered a prescription for an antibiotic
crème to be applied every 4 hours around the clock. He initially ordered 1 jar
with 8 refills and BCBS determined the jar was a week’s supply. It was no more
than a two-day supply. When I called BCBS to tell them I needed a refill right
away to avoid infection and a costly hospital stay I was told I could leave my
number to call rather than stay on hold for over 1 hours’ time.
When no return call came, I called back and waited on hold
for quite some time. When I finally reached the live person who could deal with
my situation I was told there was nothing they could do and to pay out of
pocket and seek reimbursement later. Later in the day BCBS returned my initial
call and the woman who called me back had a severe burn from a car accident air
bag deployment so she knew the urgency of my need. She said she had the ability
to expedite my request and she would get back to me the next day. Still no word
from her and when I went to refill my prescription the next afternoon she had
been able to get the crème approved. When I returned home there was a message
from her saying my RX was approved. However, BCBS still said 2 and then 3 jars
were enough for 1 week. They were not.
Every few days I was hassling with BSBS to get my needed
crème and I had reached my limit of exceptions and was denied my refill. BCBC
rep said she’d expedite and return my call and never did. Next rep I spoke with
when I called them back told me RX was denied. He worked at a wound center in
Georgia previously so he too understood my urgency. He listened to my situation
and called the plastic surgeon’s office with me at 4:30 on a Friday afternoon.
They closed at 5. The nurse learned from the BCBS rep she could order more than
one crème at a time. “How about eight,” she said. The next morning I had my
refill and BCBS now says eight jars is a week’s supply.
When I received my Mission bill, I called the business
office to apply for financial assistance. Since I am self-employed, I was told
I needed to complete tax forms to verify my income. They were to be mailed to
me. I was told no need to worry about my bills until my financial assistance
was resolved. No letter came until I received bills in the mail and some third
party collection agency phone call. When I called the business office, they
said my request was ended when no papers were received. The rep apologized for
the harassing phone call and reinstated my application with a promise to send
me itemized bills and financial aid forms.
When two weeks later still no papers came I again called the
business office to learn somehow I had been approved for a partial rate
reduction. I immediately paid the revised bill and was quite relieved not to
have that hanging over my head anymore. I again requested an itemized bill.
To this day, I have never received an itemized bill. I did
however get a letter from Mission after I paid my bill in full telling me I had
been approved for partial financial assistance. My wife’s employer has switched
her health plan in January away from BCBS. I am grateful to be seeing one of
the few small practices not affiliated with Mission.
While many of the people within Mission and BCBS were
exceptionally caring, the large volume of patients and bureaucratic systems
limited them. If I never again have to interact with BCBS or Mission Health
systems then I will die a happy man.
