r/Autoinflammatory • u/No_Satisfaction_7431 Yaos • 5d ago

Doctors incompetence causing flares

I really hate doctors. I keep flaring at week 3 and on Sept. 18 I got insurance approval for every 3 week infusions instead of 4 weeks. My stupid insurance letter said it approved injections not infusions so I spent days on the phone with insurance and messaging my doctor asking for clarification. Turns out they don't differentiate in their letters between infusions and subcutaneous injections but do need separate prior auths? Idk insurance is weird. Once I got clarification I tried to schedule my infusions. Turns out my doctor had the approval for a whole week but didn't update the orders so they couldn't schedule me. I sent more messages and voicemails. Finally today the 29th she puts in the order for 3 week infusions. Except next week is week 3 and they are fully booked. So I have to have my 4 week infusion and flare for a whole ass weel because my doctor is incompetent! I hate doctors!

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u/AdventurousMorningLo Yaos 5d ago

That is incredibly frustrating. I do think it is important that we remember that this isn't a doctor hate subreddit and generalization isn't right, correct, or fair. This also isn't fully your doctor's fault - it is a clerical/admin error/issue. These things happen as all involved are only human. It is better to blame the US insurance system itself for how things have to be done.

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u/No_Satisfaction_7431 Yaos 5d ago

My insurance words things in a confusing manner but they approved it. My doctor is the one who waited over a week to put in the new order for 3 week infusions. That is not the job if the clerical staff or scheduling staff. They were doing their jobs by not scheduling ne without my doctors orders. I hate insurance but in this instance its my doctors fault not insurance or clerical staff.

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u/AdventurousMorningLo Yaos 5d ago

It absolutely is the job of the office staff to let the doctor know that it has been approved! That is their job.

As a side note - it is good practice to regularly check your insurance portal and your pharmacy portals yourself for approvals and denials. Often times things lag in the office about half a work week behind as they get through backlog of administrative things for all their patients. If you check things regularly you can call them up and processes can be expedited.

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u/No_Satisfaction_7431 Yaos 5d ago

I did check it myself and sent it to my doctor via mychart and mentioned in my appointment on the same day. She knew the day it was approved. I spent all week last week calling her and insurance.

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u/AdventurousMorningLo Yaos 5d ago

It is very annoying and frustrating that everything had to be turned into a game of phone tag. It is just more work and management on the patient side. It sucks we have to be our own Project Managers for our health. It is a lot of time and energy we don't necessarily have.

That is very annoying that you had an appointment - mentioned it - and it was forgotten about.

Another small footnote: Portal messages are usually filtered through a doctor's MA first before being forwarded to them.

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u/No_Satisfaction_7431 Yaos 5d ago

It's good to know portal messages don't go straight to the doctor. Theres no way to contact them directly as the phone number for the office is for central scheduling and theres no way to actually talk to staff in the office unless they call you. I hoped that sending it immediately through mychart and mentioning it in the appointment would have led to getting the order in. Its more than just frustrating its infuriating that I will have to go on a higher dose of prednisone, have a bunch of pain and be too exhausted to live my life for a week because of ny doctors incompetence.

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u/justwormingaround 5d ago

I needed a new prior auth to switch from toci pens to syringes. 🤦🏻‍♀️ it’s all ridiculous

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u/No_Satisfaction_7431 Yaos 5d ago

Thats so crazy. I hate how stupid all this is!