A Quest for Sanity

This post may be a little personal, but it's nothing to be ashamed of.

I have never, in all my (yikes!) fifty-seven years, had an appointment with a psychologist… not to talk about me personally, anyway. A clinical psychologist diagnosed my son’s autism in 1987.  The early intervention center that I attended in the late eighties, to learn behavior modification and language stimulation techniques to help my son, was run by child psychologists.  But lately, as in the last couple of years (friends and family know), things have been a tad stressful around here.  I have been sort of, er, short-tempered.  Okay, mom’s been exasperated, depressed, frustrated, occasionally resentful and, in the words of the peanut gallery, “yelling a lot.”

“So what brings you here today?”  I rattled off my laundry list of family and career-related situations to the nice doctor.

But this post is not about any of that.  It’s about the insurance company practices and rules plus blatant incompetence and how I finally managed to arrive at that appointment.  It’s about how, if you are borderline stressed before you begin your search to find mental health providers, you become practically psychopathic by the time you are done.

My quest began (after I stopped the above-mentioned alleged yelling, of course) when I logged into our insurance company’s web site and, lo and behold, under mental health providers, there magically appeared a directory of names and numbers, including a list of specialties.  I called a few doctors (I wanted a doctor, not a master’s level counselor), but many were not taking new patients at this time. But, I eventually I received a call back from a woman therapist, I’ll call her Dr. J.  I spoke to her on the phone; I really liked her and I made an appointment.  At this point, the beginning of the insurance company's ineptness, misguidance and ridiculousness began with a vengeance.  Dr. J.’s office manager called me the following day, after running through the insurance approvals, and said that Dr. J. is actually not in our network.  What? She was listed on the website.  It turns out that the main health insurance carrier farms out the mental health network to a sub-provider called Value Choices (not real name of network).  So, after canceling the appointment with the first doctor, I called Value Choices.

A cheery and helpful female person, I’ll call her Chrissie, took my call and she first asked me if I was in danger of hurting myself or anyone else.  “No, I just need a list of in-network providers that I can call to make an appointment.”   Well, I found out, via Chrissie, that through our EAP (Employee Assistance Program, by way of my husband’s employer), that I can visit a provider up to five times at no cost, then, if necessary, there will be a $25 co-pay.  “Good,” I said. “Who are they?  Can you fax me the list?”  She did.  So… more phone calls to numerous doctors’ voicemails, more messages left, and more responses from doctors who are not taking new patients (there must be a lot of us crazies out there booking up all these shrinks).  Then, Dr. B., a woman, called and said that yes, she was taking new patients, but only daytime patients.  She seemed nice and her office is located only a few miles away.  Perfect.  I made an appointment for a second time and now I needed to contact Value Choices to procure an authorization number.

This time I got chirpy Susan on the line.  After asking me if I was in danger of hurting myself or anyone else, she double checked the above-mentioned provider and proceeded to inform me that Dr. B. is in fact not an EAP provider, but she is in network, therefore will require a $25 co-pay.  Okay, not so bad.  But wait.  I am responsible for full payment until my annual medical deductible is met.  Since I have not so far been to any doctor this year, my deductible is obviously not met and it would cost me full shrink visit cost.  So.  “Now, who can I see instead?”  Susan informed me that the closest EAP is in Philadelphia but there is one in Jersey, but a further distance away.  Tons of traffic, both places.  Okay, give me the name and number of the guy in Jersey. I called there, or should say, tried to call; the number was no longer in service. 

Back on the phone to Value Choices.  I spoke to merry Roberta. She also asked me if I was in danger of hurting myself or anyone else. I launched into the sequence of events thus far.  Now Roberta was not only cheerful, but also a bit smarter than Susan and Chrissie.  She actually read down to the bottom of the computer screen to where it said that the deductible does not apply to outpatient services.  Since they provided me with misinformation, would I like to her to speak to her supervisor to see if there is anything they can do to remedy the situation?  “Roberta, that is the best idea that I’ve heard all day.”  What they would do, she reported back, is contact Dr. B. and ask her if she would provide services as an EAP.  I was told to keep my appointment; they would take care of it. 

As it turned out, no one contacted Dr. B.  I found this out as I sat in her office.  I called Value Choices again from the waiting room  (I almost had the number memorized by then) and spoke to happy Jill who of course asked me if I was in danger of hurting myself or anyone else.  After ten minutes of frustration the issue was not quite totally resolved.  But I went ahead with the appointment since I was there and I was fully stressed and frustrated, and we were back to a confirmed $25 co-pay again.

Later that night I received a follow-up call from merry Dorry from Value Choices; we went through it all once again.  But first things first...again, was I was in danger of hurting myself or anyone else? I replied that it depended on whether or not she was planning to come over.  At the end of the conversation, she asked, “Is there anything else we can do for you?  We are available 24/7.”

So nice to know you are all there, in full force. to frustrate me – 24/7.

Breath in through nose.

Breathe out through mouth.

Repeat as necessary.