To open, I have worked in medicine for the better part of 20 years so I am going to be drawing an image of my experience colored with this lingo. First, I'd like to say that Dr. Ludwig and his staff have been derilect at nearly every level of patient continuity-of-care, but especially their ability and timeliness of ANY communication. While I am sure that Dr. Ludwig is an intelligent and very competent physician, the same cannot be said for his staff (not to say they weren't nice, they certainly were, but being nice and be an advocate for your patient are two different things).
Starting with Misty (Insurance Auth), who was supposed to work with and keep me informed of my costs and the successive steps to ensure that my insurer received everything they needed for the approval, to the nurse, Sharon (Educator), who was supposed to be following me along the journey to ensure I was meeting specific goals and, of coursse, the collective coordination between she and Misty so that all team members were working toward meeting their patients needs. My first visit was encouraging and each team member explained their roles and what I could expect as they worked together to make the process seamless. On my second visit this coordination between team members was clearly abscent. As months went by I continued to meet or exceed every health goal and training/education goal set before me, but, as I achieved these the further behind my team became with making sure those markers were presented to my insurer so that a pre-apporval deadline was met. Eventually the date came where they wanted to set a surgery date. When I asked about costs, no one had any answers. I was told to call my insurers to ask them, which I did. My primary did not offer coverage, my secondary did. So we set a date. As the date neared I was notified about 2 weeks before that my secondary insurer had not received any of the documentation they needed from my doctor. When I called (and emailed) my care team about this, I was told that my insurer was being "unreasonable" and was essentially told that I needed to find a pathway around the roadblocks. So I called my insurer. They had not recieved ANY documentation for the pre-approval outside of a diagnosis code (really? WTF) so I contacted my care team and did confirm this. So, screw it, I gathered all of these items (as I had copies) and was then given an immediate approval. My surgery was then scheduled for a Wed. at 6am. and whent moment drew near, litterally at 5pm Tuesday night, (having fasted and witheld medications in preparation for surgery in the morning) I was told that the Hospital would require an ABN (basically a promise to pay $60K out-of-pocket for the procedure). When I asked why, a different person working in billing stated, that since my Primary insurer did not provide coverage, there was a loop-hole that says my secondary doesn't have to pay either (even though they DO provide coverage). So, at 6pm I miraculously reached my seconday insurer to confirm this, which, horrifyingly, they did. So, in litterally the last possible second, I was forced to cancel a surgery I had spent MONTHS jumping through hoops and spending THOUSANDS to get ready for...all for absolutely nothing...but guess who wins? That's right. Providence and their network. Now, if a close review had been done by my care team at the beginning, I would have known all of this ahead of time and would never have gone through tireless specialist appointments they sent me to meet insurance criteria that was never investigated or understood to begin with. I will NEVER again do business with Providence Gastro.
Finally, I will leave one last thought. Niether Dr. Ludwig nor ANY of his staff have ever reached out to me about this colossal f*ck-up since I was forced to call things off. Not a call saying they'd work with my insurer to figure out a new path, not a call to say "I'm sorry we dropped the ball" NOTHING but crickets. I am litterally heartbroken and out THOUSANDS of dollars for nothing. read more
