This review is for my experience today with the office staff, appointments, billing and insurance. This review does NOT cover the actual doctors or other aspects of the practice. I saw Dr. Fong several years ago and was pleased with the visit.
As background, after many years of suffering with sinus infections, I saw an ENT specialist at Stanford who suggested I undergo surgery. I decided to make an appointment with Dr. Fong to get a second opinion.
When I called to make the appointment they didn't have my information from my previous visit and asked about my insurance. Specifically they asked if it was 'covered california'. Since I've had the same Blue Cross/Anthem insurance through my employer for over 10 years and was not up to speed on what the affordable care act was named in our state, I didn't know what 'covered california' meant and I couldn't answer that question at the time. I was then told that since their office may not accept my insurance I couldn't make an appointment... even if I was willing to pay out of pocket.
I then logged into Blue Cross online and looked up my in-network doctors. Sure enough, Dr. Fong is listed. I called back and told them she was in network and we made an appointment for a month or two later.
The day before my appointment the office called and asked that I fill out a long set of paperwork they had mailed. I did this and also spent time collecting my health record and CT scan data, as well as cancelling meetings at work and arranging childcare drop-offs due to the appointment.
About one hour before the appointment, the staff called me to say that my insurance wouldn't cover the visit and they wanted to cancel 'so I wouldn't run the risk of being stuck with out of pocket payments'. They also mentioned that they had listed my insurance as 'covered california' - which it is not.
I quickly called Blue Cross (instead of feeding my child breakfast) and spoke with an agent who said Dr. Fong was indeed in-network and completely covered. When I called the office back they said that Dr. Fong had recently 'changed management' and that maybe Blue Cross didn't know about that yet. They gave me the number for the billing person who coordinates with insurance, but she didn't answer any of my 3 calls this morning or give me a call back before the appointment time.
It is a very difficult situation as a patient to be told there is some 'unkonwn' extra information that neither you nor your insurance has that means you won't be covered and therefore can't see the doctor (even if you are willing to pay out of pocket). Furthermore to not be told exactly what that is so you can check with insurance.
Finally, I couldn't even get anyone to answer the main staff line to hear if they would still see me or not, so I left a message and I waited until I could get through because I didn't want to be a no-show for the appointment. When I eventually got through, the staff member said she had heard my message asking whether to cancel 'a while ago' but hadn't bothered to call back. I could have still made it to work on time if they had called back and confirmed that they wanted me to cancel.
I can see how changing management and insurance can put a big strain on an office, and patients coming in and not being able to pay out of pocket can be a big problem for their business.
However, what I CANNOT see is why they couldn't have looked into this more than 1 hour in advance of the visit. If there was some 'extra' or recently changed information, couldn't they have given that to me when I made the appointment? Or how about bringing up this concern the day before when they called and talked with me about remembering to fill out all of the paperwork?
In the end it shows a blatant disrespect for patient's time, and the conversations this morning were curt and clearly meant to force me to cancel the appointment.
I hope this review can help others in setting up their new appointments. Please ask up front for the Tax ID, claim code, and other information your insurance will use to decide on the claim, and then set aside the time to get detailed information from your insurance, before re-arranging your work and family schedule for the appointment. read more