Thursday, December 27, 2007

ONE v/s FWO - My Opinion FWO!!!

To All,

Thank you all for the moral support. I hope everyone is having a good holiday season.

Yesterday I accomplished the following:

#1) Got copy of accident report - $12 (will be charged to Allstate)
#2) Took copy of report to my insurance (so they can file proof of insurance to state)
#3) Ordered replacement of glasses (will be charged to Allstate)
#4) Rented replacement vehicle & picked up (will be charged to Allstate)
#5) Replaced my cell phone (will NOT be charged to Allstate - it had been having issues)
#6) Stopped by work to show them my condition & discuss my situation (Loss of work will be charged to Allstate)
#7) Set up appointment w/ Orthopedic Doctor - THIS IS THE ONE TO DISCUSS!!! :(

I first called Orthopedics North East. I called them because: A - They are nearby, B - They were recommended by Parkview as being a partner & thus having access to my medical information.

The first thing I did when calling them was to explain that I was just involved in an accident Christmas Eve and this was the soonest I could call. I need to see a Doctor right away so that my hand doesn't start to heal in an incorrect manner and thus need to be broken again so as to heal correctly.

The first - AND I MEAN FIRST - thing I am told (along w/ "we need to register you") is that I will need to bring $250 CASH in when I come in!!! Agitated, perturbed, angry, distraught, DO NOT EVEN begin to express my response to this. I explained that insurance would be covering this. In the worst case of her letting her insurance lapse my uninsured/under insured coverage would kick in and take care of it. The lady from ONE reiterated that I would need to bring in $250 cash.

At this point I offered the following gem of thought, "How about I just walk in this afternoon with a medical complaint and let you refuse to see me. Then, when something goes bad w/ my hand we'll let the lawyers figure it out in court - how about that?" She told me that she was just informing me of their policy.

At this point I allowed her to get my information but did NOT set an appointment!

I called Fort Wayne Orthopedics (FWO) and scheduled an appointment through them. The lady in billing explained that we would file through my insurance as the other insurance would not pay until the entire process is complete and that could take 6 monthes or a year or more. I am still not happy with this but she was at least friendly and explained their reasoning.

I will drive clear across town tomorrow morning for a 9:45AM appointment with Dr. Caldwell. So far I believe I have griped to everyone I have met about ONE - Heartz, my office, Centennial Wireless, FWO.

Don't misunderstand me, I believe everyone has a right to be paid for their work. However, the medical industry has the entire INSURANCE INDUSTRY (an industry that makes billions of dollars both in income AND investments) guaranteeing them payment. This is the reason we all pay insurance premiums, to cover our butts in an emergency. To be presumed a "nere do well" by ONE and demand CASH up front IS AN AFFRONT!

Of course this is just my opinion. What is yours???

Respectfully,

Doug
By at

6 comments:

Doug said...

The Docs get jerked around by insurance companies, just like everyone else. The cash up front is probably just their effort to shift the risks of insurance company bureaucracy from themselves to you. The whole thing is a snarled up mess, so it's hard to know where to point the finger (assuming your hand is capable of pointing).

Good luck on your recovery!

27 December, 2007 13:05
Jeff Pruitt said...

Doug,

I've been to ONE several times and never had the bad experience you describe.

Hope you heal up soon...

27 December, 2007 16:32
Robert Enders said...

First of all, I don't think that anyone has been determined to be at fault for the accident yet. I would advise against publicly admitting fault or accusing the other driver of being at fault. Is Allstate your insurance company or the other drivers?

Keep in mind that in order to deter and detect fraud, insurance companies have massive, government-like bureaucracies. If any liberals expect this to change under a single-payer system, dream on.

Healthcare providers have to ask for money up front. They look out for themselves just like you and I do. Often people would provide an insurance card only to realize that either that injury wasn't covered or that the insurance plan had expired.

Threatening to sue them won't do much good. They are not legally obligated to treat you unless it is an emergency.

28 December, 2007 15:53
Doug H 3rd Dist Rep LPIN said...

Doug, I understand that each industry gets jerked around by the other to one extent or the other. I am not really talking law here but rather "standard operating procedure". In EVERY other environment (medical) I have gone into I have presented proof of coverage and billing was taken care of after the fact. I took huge offense when I was presumed a bum.

Jeff, I don't doubt you there buddy. Through my work I have taken MANY folks to ONE and not heard much bad about them, but I don't know how many were taken in due to an auto accident.

Robert, I agree that fault has not been legally determined (although if you read my accident report it HAS). The point is that as I explained to the lady in the WORST CASE SCENARIO my uninsured motorists coverage would kick in. Had they wanted proof of my coverage I would have understood, but stating CASH ONLY and implicitly implying "no checks allowed" is rude and unprofessional. (in my opinion)

As to their legal obligations I must admit a lack of knowledge. That said, this injury IS the direct result of an accident resulting in a broken bone that could become infected and/or heal improperly. I must believe that somewhere in that Hippocratic Oath the "do no harm" could well be taken as to "harm by inaction".

In the end I don't know anyone that would be pleased with the stress of loosing their car, loosing their glasses that they need, loosing time from work, still having their normal bills, knowing they have insurance and STILL being told "cash up front" for an injury that they did not contribute to.

So far you have all brought up some not unreasonable points but I'll still say (in my opinion) FWO over OnE (the bastards).

Respectfully,

Doug

29 December, 2007 01:27
barranda said...

Doug,

FYI, the police report would not be admissible in court for purposes of establishing fault.

I'm glad to hear that you are ok.

29 December, 2007 13:15
Doug H 3rd Dist Rep LPIN said...

Barranda,

While the report itself may not be admissible in court the TWO WITNESSES that are listed certainly are.

I would also presume that the results of our breathalysers would be as well.

Finally, I would presume that the FWPD officer(s) who responded could be questioned and discuss their findings.

Doug

29 December, 2007 14:25

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