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Work rant

sv4338sv4338 member
500 Comments
in California-Inland Empire
Im so pissed! I flippin hate HMO's! I requested an authorization for surgery for a patient to remove the skin cancer from his face like 2months ago I also requested an approval for him to see a plastic surgeon for the repair not to make it look pretty when the surgery is over but beause this skin cancer is close to his eye that my surgeon is more comfortable with a plastic surgeon be available if needed.Well I just found out the patients medical group withdrew my request and said to do the surgery first then maybe they will approve the plastic surgeon if needed are u freakin kidding me! I just left that chick a message and she has 10mins to call me back before I call again!
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Re: Work rant

  • Kasi80Kasi80
    1000 Comments
    edited December 2011
    Wow, wth??  I don't really know what an HMO is compared to other insurance.  I just hear that people hate it.
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  • pashinfrutpashinfrut member
    10 Comments
    edited December 2011
    I don't think the chick knows how afraid she should be. : ) Hope it all works out. HMO's are awful.
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  • sv4338sv4338 member
    500 Comments
    edited December 2011
    I really hate HMO's with a passion! They are perfecect examples of something that looks good on paper but just doesnt work in real life
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  • jojochantijojochanti
    100 Comments
    edited December 2011
    HMO's have both a positive and a negative side to them. i went to school for health administration so i have studied both sides, but from biased people who were anti-HMO. i've seen it screw over people and i have seen it work in many situations. my dad has had open heart surgery, cancer, etc and has an HMO (kaiser). if he hadn't had an HMO it would have cost him a LOT of money out of pocket, where it didn't cost him a single penny to have all those surgeries. he doesn't even have a co-pay for medicine. it just depends on the HMO and the plan that they have. that is an unfortunate situation though sylvia, a classic example of gatekeeping, which is why people hate HMO's in the first place.
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  • sv4338sv4338 member
    500 Comments
    edited December 2011
    My personal HMO experiance was a nightmare I had Aetna HMO thru my employer and when I was 2or 3 months pregnant I started to miscarry I had so much hemoraging(sp?) the ER basically told me to go home and miscarry then when there was no heart beat they would "clean me out" so I left the bleeding lessoned and when I went back there was still a heart beat my insurance company never approved a sonogram they said I was not conscidered "high risk" my son was born with a cleft lip and pallett they approved his consultation with the craniofascial team at Loma Linda but denied his surgery because it was cosmetic (they did however aprove his pallet but they wanted him to see an adult ENT not a child specialist) I cancelled my Aetna and got on Medical and they covered my sons surgeriesI have another patient that before I started here had a skin cancer on his nose and it was a large one his insurnace company denied his plastic surgery well the skin cancer was so big they ended up removing his nose and now they will not approve the skin graft or the plastic surgeon because there is no skin cancer thereI would rather pay more money out of pocket then have an HMO we waste money eating out, clothes, hand bags thats all stuff I can do without.
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  • Kasi80Kasi80
    1000 Comments
    edited December 2011
    Wow!  that is HORRIBLE!  How sad is it that to get better care you have to get on Medical.  the system is so screwed up.
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  • jojochantijojochanti
    100 Comments
    edited December 2011
    yeah that is horrible. the only HMO i have first hand experience with is kaiser and there haven't been any complaints.. i was even born in a kaiser.
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  • amberg321amberg321
    1000 Comments
    edited December 2011
    I have heard terrible things about HMO's but DH had Kaiser and he loved it. He had to have surgery and it only cost him the $15 co-pay
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  • HisSunshine1220HisSunshine1220 member
    Seventh Anniversary 100 Comments
    edited December 2011
    syl thats awful! My parents have Kaiser, and love it. Between the colon cancer and the skin cancer, my mom has had her fair share of surgeries, and each time they havent had to pay a cent. When she went through chemo, i saw how expensive the medication was (some pills were 1500 bucks a pill. A PILL!!) but she didnt have to pay a cent. It really does depend on the HMO. Either way, we dont have insurance... lol i would rather have something than nothing!
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