Wednesday, February 13, 2019

Amusing Health Insurance Anecdote of the Day: Matchmakers

Old Lady Sophie


Sophie's estimable private health insurance company, Blue Shield of California, has been sending out a number of "helpful" missives in the last month. Today we received a notice that as a PPO member, having a PCP means you have a doctor you can turn to for healthcare advice -- whether it's preventive care, treating common illnesses and injuries, or help determining if you need more specialized care. The letter then politely continues to explain why Sophie received the letter and what else she might find enclosed: a list of members covered under your plan and each member's PCP match. Your PCP match was based on factors such as where you live, your age and your primary language. I scanned the rest of the page's verbiage that I've read quite literally hundreds of times, partly to stave off what generally ends in some nightmarish proposal for rate increases or claim denials, and partly because there's always some fodder in them for the old blog. I was pleasantly surprised to see that this time, Blue Shield of California had indeed made a match for Sophie and the match had a telephone number with an area code quite close to mine. Sophie needs a general internist, so I considered it serendipitous. I have an open heart and the hopes of flocks of birds.

Reader, I looked him up.

This doctor's specialty was GERIATRICS. In fact, he is a prominent geriatrician who has been in practice for over 45 years. I am now wondering what sort of algorithm was used to make this match. The tiny little mother mind™ is thinking all sorts of funny and probably to some of you, sad things, but mostly she's shaking the damn head that holds her that she fell for this gesture of humanity from an American health insurance company.  The last line of the missive was this: We hope that you take advantage of the opportunity to build a lasting relationship with your PCP. 

Yours in good health.

Bless their hearts.

8 comments:

  1. I've been reading an article in the New Yorker today, on and off, and as I've read it I've been thinking of you because it reveals so much of the shitty and horrible and criminal ways that insurance companies are run.
    https://www.newyorker.com/magazine/2019/02/04/the-personal-toll-of-whistle-blowing
    It also makes mention of our former governor, now senator, (P)Rick Scott. And not in a good way.
    Anyway, good post and yes, one more example (how many do you think you've documented here now?) of why this country has to get up off the baby potty and pull up their under roos and create a system of health care that works for everyone and which does not involve private companies.

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  2. Oh, FFS. I wonder how the docs feel about it. I wonder how many of them are getting calls from patients they can't or won't treat because the "match" is ridiculous. Good thing your sense of humor is in tact. XO

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  3. Oh lord! Elizabeth, when I read this, I laughed with little humpfing noises that made my cat look up from her nap. Bless you for your sense of humor. I imagine Sophie laughing, too, bless her heart. It just confirms what we already know: corporations are not people, no matter how much they fake it when they do stuff like that.
    Sending love--Verna (not Sheila, as Google insists)

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  4. The System, as it stands, is so unbelievable, that one must laugh and find the Gallow's Humor in it all! Valentine's Day we took The Son in for Detox/Rehab for Dangerous Drug Addiction... where they provided intake was actually NOT a Detox/Rehab Facility like they led us to believe. But it was the only place he 'Qualified' at his 'Level of Sickness'... it was a Psychiatric Lockdown Facility we found out HOURS later... needless to say they were not equipped to deal with his situation and couldn't meet him at his point of need... and since he voluntarily checked in he voluntarily checked himself out and after 17 HOURS of runaround, being turned away from Facilities and re-directed to inappropriate placement Facilities they Warehouse people with either lack of Coverage, lack of Qualifying Factors, lack of Room... ad nauseum, I had to deposit him right back at his Home where we had begun the arduous Journey... still in the throes of potentially life threatening Withdrawal... so I am not the least bit Surprised about Sophie's Letter... your Wonderful Humor about it is born from too much Dealing with such disgraceful Medical System situations. You can't make shit like this up and if we didn't find the Humor we'd just be left with the rivers of Tears and Frustration trying to Cope with it all! And Yeah, it does make for unbelievable Blog Fodder for us, doesn't it?!

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  5. Wow, they got that right, didn't they.

    XX Beth

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  6. I’ve been searching for some decent stuff on the subject and haven't had any luck up until this point, You just got a new biggest fan!.. compare auto insurance companies

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