Day 5 - 2017 RA Blog Week    Wildcard :  Caught in the Cross -Fire

I do my best to stay positive and upbeat.  But something happened to me recently that challenged even my positive outlook.  At the end of May, I received a letter from my rheumatologist office.  Not expecting anything out of the ordinary, I opened the letter and after reading it felt my world was crashing around me. It took my breath away. Tears began to flow.  "As of  _____ date, we are no longer accepting H______ Insurance. Please call your insurance company for referrals to another rheumatologist in your area".  Cold, direct to the point...not " we regret to inform you", or due to circumstances...".  My insurance company is a large, well known insurance company which covers millions of people nationwide.  Why would my doctor decide to no longer accept this insurance?  This did not make sense.

I felt abandoned, confused, angry and quite honestly, scared.  After all, we had developed a collaborative, warm working relationship over the years. Why would she just abandon me without preparing me??   Immediately I got on the phone to speak with the office manager to try and get an explanation.  She gave me an answer that actually surprised me.  Apparently, the practice was not happy with the promptness of the insurance companies claim payments.  In addition, the doctors in the practice decided to take a stand against the insurance companies step therapy policy and were not renewing their contract. It was a business decision.

Finding another rheumatologist in a large metropolitan area shouldn't be too difficult...right? WRONG!  After receiving the news, I started researching doctors in the area, getting recommendations from others.  There are very few rheumatologist in the greater metro area, and only two, yes two accepting new patients.  The first had an opening for a new patient appointment in November...at that time, 6 months away.  The second had an appointment around Christmas, but put me on a waiting list in case of cancellation.

By my quick calculation at the time, I would miss 3 infusions and 3 follow up appointments.  Painful realization .Luckily, my primary physician said he would call in my pain medication refills for me until I could get in to my new rheumatologist.

I am conflicted with my feelings - I am happy that my doctors are taking a stand against insurance companies and their policy of  forcing step therapies on their patients.  But, many patients are caught in the crossfire of physicians and insurance companies trying to make a point.  We must not forget that Medical Practices and Insurance Companies are businesses.

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