Wednesday, September 10, 2014

Your new, improved insurance company has now become That Person!

Dear [patient name],

To help you get safe, high-quality medical care, we review your health records -- your doctor visits, prescriptions, lab results, and tests and procedures. We compare your records to the highest standards of care as recommended by the medical community. If we find a way to improve your care -- or find a possible drug interaction -- we contact you. Your doctor may also be notified.

Call your doctor about this health issue
Talk to your doctor about the health message(s) on the following page.

(etc).

To Aetna:

I was motivated to write to you and let you know that I received one of your lovely new letters from your lovely new initiative to offer aid and advice that has neither been solicited nor desired.

I have a health care provider, in case you were not entirely aware. My provider has gone through years of medical school, and has many more years of experience in her field. Most importantly, my provider has actually seen me in person, listened to my concerns, and watched me for every single sign that cannot be possibly conveyed by diagnosis code, like body language, tone of voice, and nonverbal gesticulation, such as Pointing To The Part Where It Hurts.

You are my insurance company. I give you money because the government says that I have to. In return, you are supposed to pay my claims. You do not do this. Failing that, you should at least be able to negotiate a lower rate on my medical bills. You do not do this either. You managed, according to my paperwork, to bravely and skillfully talk down a $500 claim to $200, but what you did not realize was that I had already talked to the secretary and was assured that, if I had no medical insurance at all, I would not be charged more than $170. (Soon, more and more people will realize firsthand that this little game of bureaucratic footsie costs us more than it saves.)

You are not my provider. It is not your job to go peeking through my codes so that you can provide the same service that I can obtain from any harried hypochondriac who knows how to Google their way through WebMD.

My provider entered a variety of codes and information about my claim. For some bizarre reason, you decided to jump upon the least of these, and offer your utterly useless and outdated advice. The specific test that you recommended (via Harvard, alma mater of George W Bush and Barack H Obama, yippity skippity!) is based on information that has not been current for over a decade. My provider has already performed the correct, up-to-date test (as well as doing your recommended check, for different reasons involving my other, more serious health issues) and eliminated both factors as a cause.

In fact, my provider has already found the real cause for this particular issue, and we are already treating the problem properly. This is because she is, as I iterated above, my provider. She has stepped out of the bureaucratic current and actually bothered to see the patient. This has helped her to handle a case which is not (as the case often is for me) kind enough to follow the standard textbook models for your benefit.

I suggest you let my provider do her job. She's really very good at it.

Please save your money so that you can do yours.

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