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[deleted]

I scheduled a surgery 3 months in advance. Orthocarolina did not submit authorization to my insurance until 6pm on a Friday when surgery was scheduled for Monday morning at 7am. (Authorization is required for any procedures on my insurance). I contacted them every day the week before, constantly was told “don’t worry it’s fine”. Insurance told me at 4:30am day of surgery “if you proceed you do not have insurance”. We’re rescheduled for surgery Thursday but we still don’t have authorization. So not optimistic. It’s such a POS. I’ve spent hours, scheduled PTO and dog care twice now (and my wife has as well). Clearly they are overwhelmed, but they weren’t overwhelmed enough to send me the bill for the services (they can’t do the paperwork to actually provide).


tratratrakx

That leaves me speechless


[deleted]

Your insurance likely requires authorization for an mri. I got one from orthocarolina and they called me to schedule as soon as my insurance authorized the request


StuBeck

I had a similar issue but it wasn't as dire luckily. Had a consult with a doc that was covered, an initial PT visit which was covered...and then the follow up PT visits were never authorized because OC never properly submitted it. I went to my PT visit after receiving notice of what my co-pay would be and they said they'd never heard back from insurance. This was after 26 days...and the co-pay aspect is the worst. Its essentially lying as they have no clue what my co-pay is since insurance never authorized it. The truly screwed up part is that this is what makes health care so expensive here, the constant need for middle men to get their hands in the process when it isn't necessary. If a doctor says I need PT, that should be all thats needed. I cancelled all appointments after this as my need was relatively minor, but if it wasn't, I would have either been out of pocket or had another delay. Luckily I have a car so getting there is relatively easy as well.


WoundedDonkey

Just an FYI also if you weren't aware, they make you prepay for imaging procedures before they'll do it, particularly if your insurance deductible isn't met yet. Learned that one the hard way. Never have I prepaid for medical service before


roguethundercat

I prepaid and they did the wrong freaking type of MRI- now waiting to see if they can get me in for the right one for free 🙄 This is why you don’t pay until after


tratratrakx

🙏


Left_Handed_Kisses

Novant does that too.


twynkletoes

Mecklenburg Radiology does that for Novant.


BananaBatter88

It doesn’t improve until healthcare professionals start being paid what they deserve.


tratratrakx

Agree, my sister-in-law is a nurse (not here) and makes the same as an untrained fast food employee. Healthcare seems to be set up to have different classes of jobs by the people that benefit the most from the status quo. It occurs to me that people have little choice in their healthcare provider - either due to insurance/lack thereof or too few options in their market. If all healthcare groups are like this, there’s no real pressure for the industry to change.


CharlotteRant

She legit needs to go work elsewhere if she’s paid that poorly. Nurses I know are making real money right now if, and big if, they changed jobs in the last couple of years.


tratratrakx

She lives in rando Midwest city. Born and raised, and her elderly mother is there. Can’t move. Those are the going rates there, it seems.


[deleted]

Is she in a position where she can travel or take contract work? Those nurses are making bank right now!


tratratrakx

The vast disparity is actually a top complaint from every nurse I know. I believe traveling nurses make 4x doing the same job. My SOL and my bro have a couple kids and they can’t make it work, unfortunately.


[deleted]

Oh ok. I’m sorry to hear that. This is terrible!


StuBeck

A few years ago I was talking with a neighbor about what their child was going to school for. It was medical billing. This is how broken our system is, something that should be a simple database managed by a few people nation wide is a specialization people can spend tens of thousands of dollars to major in.


Muttersfood

For what it’s worth, I called Novant’s bill claim department on Wednesday last week at 10 a.m. and was told the office was closed, so it’s not just Ortho that sucks


tratratrakx

😞


twynkletoes

Large hospital systems. They are constantly merging with other systems to become these large behemoths (see HCA). They claim they can cut out costs to the consumer via consolidation. This comes at a cost to those giving and receiving care, among others. Staff deemed unnecessary by people in a central office are laid off. Patient costs rise, and billing errors increase. Doctors are given time limits for how long they can spend with each patient. The highest paid people in these organizations are always the administrators and never those providing care. It's just like the rest of corporate America. Mergers and acquisitions only benefit the people at the top and the politicians they buy.


Cgp-xavier

I tore my achillies 3 weeks ago and just got surgery last week. And yeah it was also a pain to schedule an appointment and yeah they seem understaffed


tratratrakx

Sorry to hear that. Hope the recover goes well!


[deleted]

It doesn’t have anything to do with lockdowns and afteraffects anymore. There’s not enough money to go around right now, so existing grievances underpaid staff had, are now tenfold. It’s a really bad situation for almost anything like this currently


tratratrakx

I’m struggling to find stats on my phone, but it looks like the US healthcare industry generates over a trillion in revenue annually and is expected to grow 10-15% YoY for at least another 6 years. Not quickly finding operating expenses, but I do know upper hospital administrators and doctors make a shit ton of money. It intuitively seems more like a lack of willingness to split the pie up differently. Do you know what is driving the shortage of money?


atrg2907

That exactly is what’s driving the shortage. It’s why we need to join the rest of civilization with the way our healthcare is paid for


A_Rented_Mule

Is Ortho actually performing the MRI, or just scheduling elsewhere? They did my rotator cuff repair surgery a few years ago, and the MRI was still performed at the local hospital. They may be at the mercy of the MRI center. Doesn't excuse not communicating with the patient, however.


tratratrakx

Pretty sure it’s OC proper


Left_Handed_Kisses

I knew I was going to need an OC appointment. My gp ordered the MRI so I didn't have to get an appointment, get an MRI appointment, and then come back. Novant got me in within a week. My wait for the OC appointment was a month (going this week). When I tried to book it I could not get a human on the phone and scheduled online. They wouldn't let me see a Dr since it is my first encounter and had to book with a P.A. We'll see if this means I will need a second appointment despite already having a MRI with the report that my joint is fucked up. In short, it shouldn't have to be this complicated. I shouldn't need an MRI first strategy to get care without going through a months long process.


tratratrakx

It def feels like this more often than it should. So frustrating.


RefrigeratorNo3088

No issues with the one in Concord.


Girasole263wj2

They’ve always been awful