Ask MetaFilter questions tagged with insurance and doctor

You have cancer. Oh wait, it's just mono.

djpyk — Fri, 17 Oct 2008 10:42:43 -0800

They sad I probably had cancer. Turned out it was mono. Is this normal? In January of this year, I had a few strange symptoms--night sweats, extreme fatigue, flu-like symptoms without a runny nose, swollen lymph nodes. I ended up going to my universities health clinic, as I'm a graduate student. Anyways, it was a Friday, and I told the doctor my symptoms. I had a few tests taken (including a "quick" mono test, which apparently is horribly inaccurate), as well as an x-ray of my chest.

Well, the clinic doc took a look at everything and got really worried. The mono test was negative, and she didn't seem to see any problems with my throat. She consulted with another doctor, and sat me down. Basically laid it out to me: you either have lymphoma (bad), or sarcoid (pretty serious). I was to get a CT scan the next day, to make a better diagnosis and see if anything was spreading. I was blown away of course, but I had her call my parents and talk to them about the situation to make sure I or her wasn't crazy.

Anyways, I went in for the CT scan that Saturday, and she wanted to schedule a biopsy at a local ear nose and throat (ENT) clinic the coming Monday. After a traumatic weekend with some of that nasty CT scanning liquid, I went into the ENT. The doctor there sat me down and said plainly, "I don't do biopsy's based on other doctor's orders." He basically thought I was nuts, and a bit confused by the CT scan. He took a look at my throat and after about a minute declared, "Yup, mono, almost 100% sure of it." He also took a look at my CT scan "readings" and they all, of course, came up nearly clear, with just a few blotches where some of my lymph nodes were big. I ended up getting a "real" mono blood test, which, of course, came up positive for being a recent infection, and several months later I'm fine, but a bit poorer.

So my (open ended) questions: Was this normal procedure? Does mono get misdiagnosed for cancer often in people of my age (early 20s)? Should I contact the health center to let them know that one of their doctor's is a bit of a sketchball? Do people trust health clinics like this (I am much much more cynical of them nowadays, for obvious reasons)?

I ask this because yes, I do have health insurance, but I'm a pretty poor graduate student. My family helped me out since after coverage, all of this ended up being around $10000 before insurance, and $2000 out-of-pocket (all I have to say is... CT scans are mighty expensive, ENT checkups are comparatively cheap).

I also ask this because I forwarded my file during the "you have cancer" weekend to my friend's doctor-dad, and he took a look and noticed that the tests suggested that there was a very small chance I had lymphoma whatsoever. Also, the wary nature of the ENT doctor made me wonder that the clinic doc was... wildly misdiagnosing me. I also have no (that me or my father/mother knows of) history of lymphoma or even cancer within my family, which would seemingly improve my odds against having cancer.

Thoughts? Similar experiences? I've taken a few months off from it all, since I was a bit frustrated by the whole experience. But recently I'm thinking of seeking some sort of closure... The clinic doctor did call me the following week after everything to apologize profusely, but also tried to justify her position at the same time (annoying to hear that of course).

Anyways, (very) long post... thanks for reading!

GP for Chico

Pontifex — Sun, 04 May 2008 21:47:31 -0800

Recommend a General Practitioner in Chico California. I've done a bit of reading on Metafilter concerning finding a good practitioner. From the reading it seems asking about a specific location is the last step people take to "check around" about doctors in their area. I feel comfortable going out and doing the leg work of "interviewing" doctors, but I wouldn't be doing the due diligence for myself if I didn't post about it here.

So my question is twofold: Can anyone recommend a good doctor in the Chico Area (South of Redding north of Sacramento - for the curious) that I can use as a GP? And, related to that, if you were looking for a brand new doctor what characteristics would be most important for you?

The second questions required some explanation. During my reading I've found that the majority of the respondents recommended finding a doctor that was "right for you", but I have no idea what would be right for me. I haven't been to a doctor in at least 5-7 years due mainly to having shitty college health insurance and not having anything "seriously wrong" with me. Now I have some pretty nice insurance I want to exploit as much as humanly possible. But, I need some advice on what makes a good doctor. E.g. Good bed side manner, likes to throw around numbers, not a schmuck, etc. Hearing about what other people think is important for their own doctors would help me identify which traits I would like most.

Thanks in advance.

I need to see my shrink more often.

hulahulagirl — Wed, 16 Apr 2008 12:46:32 -0800

Doctor-insurance filter: Any doctors out there have experience with becoming an "in network" provider for United Health Care? Can I convince my doctor to do this? I needed to see a psychiatrist rather urgently (med. management + some other stuff) and looked up who was in-network for my insurance co., United Health Care. Unfortunately the doctors on the list who I called were not accepting new patients. But I got a call back from the receptionist saying another doctor in their building was open. Assuming (I know, stupid) that he was also in-network, I started seeing him (fall '07). I didn't realize he was out-of-network until almost $2500 dollars later (spring '08). I paid my in-network co-payment at every visit, but for out-of-network, they only cover 50% after the first $1000. I talked to my dr. about this, we decided to ask for a gap extension (allowing him to be treated as in-network since we had established a relationship); however, my employer doesn't allow that on their plan. So now I pay $100 (which is 50%) at every visit, meaning I can only afford to see him every other week where my visits used to be weekly. It sucks, but I've been dealing with it.

My husband and I just decided we are moving later this summer. So there are some things I want to tackle in therapy before I leave town. Obviously more frequent visits would be helpful but I can't afford it. So I'm going to ask him if he would consider trying to become in-network so I can see him weekly again.

So I'm wondering if he'll feel that's too much hassle. I'm thinking it would mean he makes more money (depending on the rate the insurance pays---on top of that I would pay co-pays of $40 4x/month instead of the $100 2x month that I pay now). But paperwork is not what he (or anyone else) lives for, so how can I convince him this would be beneficial, even though I am a relatively short-term patient.

Is UHC a pain to deal with, as a doctor? Do they pay less?

Obviously I will ask him directly, but I wonder if anyone out there has any experience going from out-of-network to in-network, especially with UHC?

ongoing billing issues w/ doc...

keith0718 — Tue, 04 Mar 2008 13:00:56 -0800

I'm having ongoing billing issues with a doctor and it's time I seek resolution with a third party. Where should I go? This is in response to this previously asked question. The situation is still not resolved. Basically, there is a large discrepancy between what the doc charged me and the info he's given me to charge my insurance. I've done pretty much all I can and now it's time to take the matter to the next level. Which would be what, exactly?

Switch from OTC to prescription meds

0xFCAF — Tue, 12 Feb 2008 09:38:28 -0800

Will my doctor switch me from an OTC medication to prescription if I just ask nicely? My employer's health insurance plan has a $0 co-pay for prescriptions. Currently I'm taking Prilosec OTC (paid for out-of-pocket) as recommended by my dermatologist to prevent heartburn aggravated by a different prescription. I'd like to a) not have to pay for it and b) not have to spend my time cutting the pills out of their blister packs.

Medically the Prilosec is working perfectly, so will a reasonable doctor object to switching to a prescription equivalent? I'm assuming there's some slightly different formulation that's not OTC-approved but has the same efficacy profile that I can switch to. If you happen to know the name of such a thing, that'd be good to know.

Barring all of the above, if there's a proton pump inhibitor that just comes as pills in a bottle rather than the ridiculous Prilosec packaging, I'd love to hear about it.

Mid twenties male with medical dilemma needs some collective advice.

debu — Tue, 22 Jan 2008 20:15:32 -0800

I'm a male in my mid-twenties, active, and have been for the most part healthy. A few months ago I started getting some strange symptoms, and pain in one of my testicles. I was uninsured so I went to the doctor anonymously and paid cash. His thoughts were it was probably just a standard infection, and gave me some antibiotics and told me to come back if the pain persisted. Around that time I also went to an anonymous city clinic to see if it could be an STD and everything up until then checked out OK. There was a test *Syphilis that I hadn't called back on for results, I did so today and they said the test was negative as well, but there was "something else was going on".. Apparently, the second part of the Syphilis test showed them this. I also asked again about the STD related stuff and they said all that was fine. Up until a couple weeks ago things were feeling better but since then, for some reason, I've been going downhill with symptoms quickly. So I have a few questions (3rd question is most important)

1. I'm not sure the specifics of the test that indicated "Something else" was going on, but I'm guessing it's because of a low blood cell count? If so, that could be anything compromising the immune system right? Or does the second part of a Syphilis test tell something more specific?

2. I'm self employed and thought I could only afford a high 5000.00 deductible plan. As of a week ago I now have insurance, but obviously picked the wrong plan. A few days ago I sent the form to change that to a O deductible higher monthly rate plan, but I have no clue how long this process takes? According to my series of doctor visits at 18 there was a chance I could at some point develop neurological problems (Parent and other family members died of) these "other issues" the clinic was referring to could be related to all this and be chronic. Should I sweat it out not seeing the doctor until my plan changes?

3. If I go in soon to a new doctor, I'm not going to mention the STD clinic visit (Rather not have that on my records, whether things were ok or not), and I can't go back to the first doctor because I went in anonymously and my new insurance will attack me if I disclose this. So what do I say if I go into a new doctor and he asks "Have you recently taken antibiotics for anything"? "Well doctor, now that you mention it I did take some I found lying around ten days in a row, and they didn't do anything for this pain that I hypothetically haven't been treated for". How do I convince him I know something else is going on without seeming like I'm trying to self diagnose?

I'd like some collective input on ANY of these before I pull the trigger. advice? thanks

Doctor won't give me info to file w/ insurance.

keith0718 — Wed, 26 Sep 2007 15:30:55 -0800

What can I do if my doctor will not give me the information I need to file with my insurance? I used the telecounseling services of a reputable psychotherapist in a different state for about 8 months. At the preliminary session I made a point to inquire about insurance. The counselor told me that while he doesn't file for his patients he had "no problem" giving me the information to do so myself. With that I went a head with the counseling. After a few months my wife and I solicited the counselor by email for the to-date information that we may file with the insurance. Our requests were initially ignored, then pacified over the next few months. After we got pretty firm about the matter we received a seemingly sincere apology by the counselor wherein he took full responsibility for neglecting to follow through on the matter (incidentally during our last counseling session). We got the said information in the mail a couple weeks later. A few weeks after that we decided to crunch the numbers, whereupon we discovered that there was a huge discrepancy between the amount the counselor billed us, and the information he gave us to bill the insurance. Only about half of the sessions were included in the insurance information (which translates to about $1000 I could--but won't be able to--get reimbursed from my insurance. I promptly wrote a firm yet polite email to the counselor (apologizing for bothering him with this again) and explained the discrepancy...complete with a detailed itemization. That was almost three weeks ago and we've heard nothing. What should I do? Do patients have a legal right to correct information with which to bill insurance?

Can I tell my doctor I smoke weed?

Anonymous — Tue, 04 Sep 2007 20:41:53 -0800

Are there any potential downsides to telling one's doctor that he uses marijuana? I'm thinking about it getting in my records and being used against me for insurance purposes or possibly getting out. How confidential is this sort of thing?

Doctor, doctor...how do I choose?

BitterOldPunk — Fri, 27 Jul 2007 22:26:38 -0800

How do I choose a primary care physician? For the first time in a decade, I have good health insurance (I'm in the US), and at age 41 it's time to take advantage of it and have all that unpleasant probing done that I've been putting off for far too long. I've googled extensively, I've contacted my insurance carrier for a list of approved providers, and I live in a city with a world-class medical center. So I should be set, right? But just picking a name at random from the list doesn't seem like the best way to go about it. I know there are sites that purport to give doctor ratings, for a fee. Has anyone used them, and are they worth it? I want a doc for more than a check-up: I want to find a genuine health-care provider who'll be my doctor for the next thirty years. Is that even possible these days? How'd you pick your doctor, what questions did you ask them, and what were your criteria? (If it matters, I'm a lifelong heavy smoker who'd like to quit, a moderate drinker, and I've never been seriously ill or even hospitalized, except for breaking my jaw in a bicycle wreck as a teenager.)

finding a doctor.

Anonymous — Thu, 22 Mar 2007 23:19:44 -0800

i'm 31. i recently got medical insurance for the first time in 13 years. i am exhibiting some symptoms of stomach cancer and would like to get it checked out. how do i find a good doctor? i'm in the dallas area.

there are seemingly hundreds of "find a doctor" websites, but what differentiates them? should any of them be relied on, anyhow? where can i find some comments about experiences people have had with various doctors? what critera am i even looking to judge on, besides whether or not my insurance covers them? do i just start with a general practitioner and get referred? if so, what do i look for in *them*?

i'm obviously new to this. what do i do?

Finding a doctor in Cambridge, Mass

olinerd — Tue, 20 Feb 2007 17:19:27 -0800

Help me and my boyfriend find a/multiple doctors in Cambridge, MA. Difficulty: BCBS HMO Blue plan. I had a horrible experience with the Windsor St Clinic in Cambridge, so I'd like to find a new doctor (ideally with a less stupid stance on women's care than my last doctor), while my boyfriend just got his insurance and he's trying to find his own PCP.

The only other AskMe thread I've found involving this asks for both a person doctor *and* an animal doctor, and the only Cambridge-area suggestion is for a clinic that's not on our HMO Blue plan.

So, MeFites, help us be healthy! We live in Kendall Square but can go anywhere the T goes very easily. We can drive but prefer not to given traffic and how hard it is to park. Cambridge is preferred over Boston given busy schedules.

Lousy doctor's visit. Refund possibility?

hoborg — Fri, 16 Feb 2007 14:30:18 -0800

I wasn't at all satisfied with the doctor I chose for my yearly checkup. What's the best way to get a refund, if possible? I went on Wednesday, and the usual Doctor problems occurred: was waiting for more than an hour after my appointment, etc.

But the part that bothered me the most was, of course, the quality of the 5-10 minutes he spent with me. He stethescoped me over my shirts, looked in my ears with the pointy light deal, and asked me a couple of questions about drinking, drugs, etc. I told him I had some tinnitus, which he actually laughed at, and proceeded to ask me if I had asthma when I was a child. He (and the receptionist) also told me that my insurance was crap (which I'm aware of), and that I should get better insurance, something with a lower deductible.

He seemed curious as to why I was getting a checkup when I'm not sick, which I thought was odd. He also told me that generally during a checkup, they do a blood test, but since my insurance wouldn't cover it, it could be $120-$140 more out of my pocket. After that, he told me he didn't think it was necessary.

Coupled with the evidence of the more disturbing trend of seeing drug medication advertisements everywhere (I think Zolcam lined the deli paper I was sitting on while I waited), this guy's "Well, you seem fine" attitude really irked me, and I feel like I should try to get my $125 back.

So should I write to him, or the insurance company, what should I ask for specifically, and is all this enough to justify a complaint? I'd really like to go get a more thorough physical somewhere else, but feel rather chumpish paying twice, even for something as mundane as an annual checkup.

Really appreciating the advice in advance.

How to Pick a Doc in a HMO/PPO? Chicago Loop Recommendations?

WCityMike — Sun, 04 Jun 2006 00:04:29 -0800

A twofold question, both procedural and specific, about doctors, insurance plans, choices, research, and, optionally, the downtown Chicago Loop area. The specific aspect of the question: does anyone have a recommendation for a general practicioner or internist (what's the difference between the two?) who has an office in the downtown Loop area (and I do mean strictly in the Loop, as I need to be able to schedule an appointment on a lunch hour)? And, if you do have a recommendation, what do you like about them?

The procedural aspect of the question: assume I've taken a list of doctors from my insurance company's database and narrowed it down by my geographic requirements above already. By what method and using what resources can I take this list and gain enough information about their temperment, demeanor, and "bedside manner" to make a choice I'll be happy with?