I left a message stating that I needed a wellness visit for my insurance with Donna Sellers at…read moreDillon Family Medicine (DFM) which is now part of the McLeod family. The Saturday before my appointment, I suddenly felt like I had a UTI. Rather than go to the ED, I began dosing myself with 200mg erythromycin for fish. I started feeling better the next day.
When I arrived for my appointment, I told the RN that I was there for a wellness visit, that I had a UTI, and that I had been taking the erythromycin which she documented in my chart. When Donna arrived, I also told her that I was there for a wellness visit and a UTI. She asked where I got the antibiotics from, and I told her Chewy... I just happened to have some extra packets of fish antibiotics that I administered to my cat for a skin infection. When Donna heard this, she said that she was removing that from my chart and before sending me to collect a urine, she asked if there were any other tests that I wanted. I verbatim told her that everything covered under the wellness visit would be great. Upon receiving my collection cup, I noticed that the only patient identifier was "H. Kirkland."
Luckily, I am a devoted scientist and always carry a sharpie with me wherever I go. I crossed off the incorrect info and replaced it with my name and birth date. After handing off my specimen, I was told to step into a room to get my blood drawn which I politely declined. When I returned to my exam room, I informed Donna that I was not going to have my labs drawn there because the lab couldn't even get one patient identifier correct, that because of that I was not letting them anywhere near me with a needle, and that I would get my labs drawn at my place of employment.
At this point, Donna said she wanted to do a CT scan because she suspected that I had kidney stones. I declined, not only because my insurance didn't cover it, but also because I knew I didn't have kidney stones as I was feeling better after the antibiotics... all I wanted were some antibiotics for humans. Please be aware that at no time was I told that my wellness visit was no longer a wellness visit and that the labs that I requested for a wellness visit would no longer be covered.
Unfortunately, I was not able to get my labs done at work because of the way Donna entered the orders, so I went to people I knew I could rely on - Dillon McLeod, a previous employer. At this point, I was still under the impression that all would be well regarding my future bill. Then comes my billing statement of approx. $500.
I called my insurance to see why I was being billed this amount and was told that DFM billed it as a specialist visit and not a wellness visit. I then called DFM and told them of the issue. I was told, that because I thought I had a UTI, the "wellness" visit was no longer a wellness visit. This should have been discussed with me when I told Donna that I wanted all tests that my wellness visit covered. I asked the manager, Kasey, to please look into this which she did. She told me that my bill was correct because of my UTI. I then asked if a urinalysis was covered by a wellness visit. I was told by Kasey that yes, a urinalysis is covered by a wellness visit, but in my case it wasn't because I was symptomatic.
Furthermore, Kasey told me that Donna put into my chart that the reason I declined the CT scan was because I could not afford it, which was not true in the least as we have a 6-figure income. She also stated that I had been having symptoms for weeks which is false.
And now, because of all this, I do not qualify for my insurance incentive because, according to DFM, I did not have a wellness visit.
I have tried contacting McLeod in Florence, but have not been able to get ahold of anyone. I guess my next step will be to get a lawyer and file a suit for non-compliance with HIPAA.
