Patient outraged by doctors’ appointment policy

It used to be doctors or hospitals would refuse to treat sick people if they did not have health insurance. Well, now it’s gotten to the point where having health insurance no longer guarantees you an appointment or treatment with a doctor.

Recently, at a doctors’ office in Hazlet, I was, for lack of a better term, discriminated against for being insured by Aetna US Healthcare. This particular doctors’ office is an in-network office for Aetna. In short, I called for an appointment, was offered an appointment for later that evening, and then had the appointment taken away by the office staff when it was determined my health care provider was Aetna US Healthcare.

This was not the first time I experienced this treatment from this office, so I was prepared to ask the question, What insurance do I need to keep the appointment this evening? And, if the appointment is open and I am an existing sick patient with insurance, then why can’t I have the appointment? Well, I was shocked to find out from the office personnel she has strict orders from the doctors regarding the treatment of certain HMOs.

In the case of this office, the Aetna guidelines stated the doctors agree to see/treat patients within 48 hours. This particular office pushes that guideline to the limit. Under this contract with Aetna, the doctor did not have to treat me that evening, even though he had open appointments.

Why could that be? I could only come up with one reason: other insurance companies have a higher negotiated rate-per-office than Aetna. Simple as that. I guess there is always the possibility that one of those insured people could get sick later in the day and might need an appointment, so they were going to keep it open just in case. What else could it be?

It is an outrage to think I was refused an open appointment because of negotiated office visit rates. Contractually, he didn’t break Aetna’s contract, but what about morally or ethically? He had open appointments, and I was a sick (insured) patient. Shouldn’t that be enough? Can it really be more complicated than that?

Kerri Grenger

Hazlet