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So many lawyers, so little time...

"The prospect of hanging focuses the mind wonderfully"--Samuel Johnson

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Location: Louisville, KY, United States

Gastroenterologist, cyclist, cellist, Christian, husband, father, grandfather.

Tuesday, October 25, 2005


Dear Beautiful Fields of Happiness Healthcare Insurance Company,

Thank you for thoughtfully sending me a "participating provider survey" two days after you refused to authorize nutritional counseling for a patient with recently diagnosed celiac disease. Please excuse the writing on the back of the survey, but as all your questions were designed to get a favorable response from your "providers" and you left no space for comments, the back was the only place I was free to write.

I really appreciated your thoughtful response to my letter of appeals (a copy of which is included in my last post). Don't you think you are being a bit too generous for giving me a whole five days to provide you with PROOF that my patient really has celiac disease? After all, I'm only a board-certified gastroenterologist who has signed thousands of documents reminding me that if I misrepresent a patient's illness in order to facilitate obtaining benefits, I've committed fraud and could go to jail. I see hundreds of patients who BEG me to put them on a highly-restrictive diet that they have to follow for the rest of their lives. I'll be damned if I give in to any of them. Let them eat cake, I say.

Once you give in and authorize nutritional counseling for celiac disease, just where would it stop? Counseling for patients with dumping syndrome from prior stomach surgery? Counseling for patients with weight gain before they become diabetics? Crap, can you imagine a more outrageous deal than to try to PREVENT diet-related health problems? What a waste of the CEO's year-end bonus, er I meant to say our precious financial resources.

By the way, your reimbursements suck and certainly don't cover the aggravation your company gives me. Don't come whining to me when you guys tank.

Have a good day.


Blogger SkiTheStars said...

Absolutely wonderful sense of sardonic sarcasm. or is that redundant ?

Daughter did finally make Med School, and we are thrilled, despite reading in your column what's lurking in wait for her.

You can always easily get a job at MAD magazine, as this piece plainly shows.



1:23 AM  

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