Wednesday, August 26, 2009


So Constant Readers know that I have had weird vision issues in the past. Over the past few months they have been acting up again, but last year's visit to the ophthalmologist* was pretty disheartening, since I was basically told that I could have 1) wonky prism glasses that might help, 2) keep wearing my old contacts, which might help (and did, sort of, for a little while), or 3) surgery which might make things worse or help a tiny bit. Fatalistically, I resigned myself to a lifetime of cocked heads and episodic double vision. But of late it's become really obnoxious, to the point where it's hard to read, so I started researching doctors with experience in correcting this type of problem.

A brief search yielded the name of a physician who specializes in treating my issue, is considered one of the best in the area, and was listed as in-network for my insurance. I called his office to make an appointment. He is accepting new patients: Score! But wait:
"We don't participate in [Amber's Insurance]."

"But the insurer website says you are in their network."

"Yes, the doctor's practice at [Giant University Hospital] is. He sees the babies there. But his private practice is not. You can submit the claim for reimbursement or we can submit it for you."

" .... Okay. [Throws up hands, makes appointment.]"
I called my insurance, and sure enough, half of the addresses listed for this doctor are in-network and half are not. All of the surgical centers listed on the doctor's website are also allegedly in-network, per the insurance website, although who knows---at least a hospital location is not going to have multiple addresses, but I wouldn't be surprised to learn that somehow that doesn't matter. One of them is the giant hospital with the babies. Maybe anything that needs to be done can be done there? Clearly a question for the doc.

So basically I get to pay out-of-network (80/20) rates to see an in-network physician, and maybe out-of-network rates for any surgery he decides to do, because I am not a baby. Certainly I could try to find someone else, but this fellow apparently helps people who other doctors say nothing can be done for, and I'm tired of being brushed off with non-solutions when there are newer procedures that could potentially resolve the issue.**

* Not even the same ophthalmologist I saw in the immediate aftermath of Double-Vision-Fest 2007, who apparently moved and left all her patients to non-specialist-in-Amber-issue doc. And have I mentioned that I am still CURSING the random optometrist who lured me in with a coupon for a free eye exam and shiny frames and started this whole mess? I could cope just fine until then!

** Not that I have some principled objection to paying for care above and beyond the status quo as of N years ago, but having to pay because of addresses strikes me as perverse. Your doctor's in-network ... oh no he isn't! Grrr.
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