Sunday, May 22, 2011

Doctor's Office

I've been doing a lot of thinking again about doctors and doctor offices and trying to decide what is the best route for me to take. It is a tough decision that I keep going back and forth on which way I should go. Usually when I decide to go down one route, something happens and I will flip flop.

My current doctor has always gotten high ratings on those doctor rating sites while her office didn't fare so well, but I never experienced any issue or even an inkling of an issue with the office - until my last visit. At this point, I don't need anything else from my doctor or her office, but I will have a funny intermittent FMLA approval for the next six months.

My first iFMLA was awesome! I had a six month recertification period which meant my doctor did not need to fill out another FMLA form until the six months was up. I was also approved for two to three Migraines per month that could last for up to three days each episode and I could have a covered doctor visit at least every two months. FMLA has annual hours limitations, but it's nice to know I had this time to take during a month if I needed it.

I was caught off guard with my second iFMLA when I didn’t check right away to see how much time I had been approved for before the iFMLA needed to recertified. As it turned out, it was only for two months this time. I found this out when I received a letter from my leaves department telling me my time was almost up and that my doctor would need to fill out a new recertification form.

After talking to my leaves department, they told me that the forms from the first two applications were filled out identically and that they typically only certify iFMLA applications for two month certification periods, but can certify it for a maximum of six months if the doctor writes something to that affect on the form. They also let me know that our form had changed recently and I should have my doctor complete the new form. I didn’t see a problem with either request as my doctor and her office have always been most accommodating.

I talked to my doctor's office and faxed them the new form along with the instructions I had just talked to them about the six month notation. There didn't seem like there would be any problems. I still had the fullest confidence in my doctor's office as they had never given me any reason not to trust them.

A week had passed and then I was away for another week before having a doctor's appointment during the week of my return. I decided to call my leaves department the day before my appointment to make sure everything was in order and approved as expected. Oh boy. They never received anything from my doctor which also meant I had a gap in my iFMLA coverage as I was not currently covered!

Of course when I talked about this during the visit with my doctor the next day, she was very apologetic but also felt the need to show me that she, personally, did not receive the fax [from her office staff]. This also made me feel like she lacks confidence in her own staff. I gave her a copy of the new form I brought and explained everything I needed along with asking to have everything faxed to me. No problem.

I was pleasantly surprised to receive the fax shortly after arriving back to work. Oh boy again. A) it was an actual copy of the old application that was filled in before along with a prior signature and date B) it was not on the new form C) it did not include the verbiage to have the recertification period good for six months.

After taking a deep breath, I called the doctor's office to explain my conundrum. Their first question to me threw me completely for a loop. I was asked, are you ready for this? I was asked 'what is FMLA'. I was dumbfounded. My expectation is that a doctor’s office would know some basic terminology such as the Family Medical Leave Act especially since there are about six neurologists in this office treating all kinds of neurological conditions which, I’m sure, would require a medical leave. Maybe I am a little off base on my presumptions.

After we got that straightened out, then we needed to sort through the updated form issue. Long story short, I was told the form had changed, it was complicated and that I would be charged for this office staff person to fill the form out. Don’t get me wrong, I’ve always been prepared to pay to have the FMLA form filled out even though I had not been charged previously. I was between a rock and a hard place while talking to her on the phone so I instructed her to complete the new form along with the note about the recertification period.

When all was said and done, my iFMLA was approved for a recertification period of six months, but it has a very bizarre configuration of Migraines that I am covered for during these six months. For this period, I am approved for three Migraines a week, but only one day per episode. Hmmm. I guess I can’t have a two day Migraine? It might even look funny if I have two separate Migraines two days in a row?

I’m being kind of facetious here as I know if I needed to go outside of these approved parameters that my leaves department would get in touch with my doctor who, ut oh, would probably need to fill out another form. The other thing about this approval? My doctor visits are now a minimum of every three months. It may not matter much right now, but typically I will go every two to three months depending on what happens during each visit.

Here are my conclusions about this experience with having the form filled out:
> if my doctor fills out the form, I won’t get charged
> if my doctor fills out the form, I will get approved for an awesome iFMLA
> if the faxed form gets lost and gets completed late leaving a gap in my iFMLA, I will get charged
> if the office staff fills out the form, I will get charged
> if the form is filled out incorrectly, I will get charged
> if I stay on top of the office staff to include the notation needed on the form, I will get charged
> if the office staff fills out the form, I will get unpredictable results in my iFMLA approval

Seriously, I need to talk to my doctor about not paying for the filling out of the form this time. However, I really want to circumvent the office and go right to my doctor as I don’t think she will have a problem waiving this fee. But on the other hand, if I need to spell all of this out to the office staff, so be it. Oh wait, they don't even know what FMLA is. There were just too many errors with the form and other things that I don’t think I should have to pay for it this time.

There was a slight misunderstanding before I left her office before this happened and all of this has me rethinking how important the office staff is to the whole relationship you have with your doctor. For me, the big things are my iFMLA, getting appointments when I need them and general communications. Two big reasons I did not pursue a true Migraine doctor a few of months ago, who is only a couple of hours away from my home, is the amount of time I heard it would take for his office to fill out the iFMLA paperwork, how hard it was to get in touch with the office and some other miscellaneous items. As always, I am currently reevaluating everything again to try to determine what I need to do.

Onward and upward. I’ll make it work out the right way for me. I have my list of questions for the true Migraine doctor's office - protocol type of stuff. I was recently able to ask some of his patients questions about his office which was helpful and gave me more to think about his office as well. Right now, I don't know what I have to lose and can see how much I have to gain.



Bose said...

Its as if i was watching a TV serial, thanks for the subjectDoctor Office Form

MigrainePuppet said...

Thanks, Bose. Life can be full of drama... :^)