The following is an appeal letter written by my grandfather to his insurance company after he was rushed to the hospital, nearly bleeding to death.
On the 4th of July, I went to the Emergency Room at St. Peters Hospital by ambulance after we called 911. I was so weak, I couldn't walk. Someone in ER called Dr. O--. He was on vacation. Covering for him was urologist Dr. R--. He arrived at the ER and started to work to stop the blood. He spent several hours with an attendant. They stopped the bleeding. They took my pressure and ordered me into the hospital from the ER. My hemo at that time was 4.2. They ordered two units of blood. Then two more units of blood. By Tuesday morning I had received 4 units of blood, by Tuesday I would have been gone.
My PCP [primary care physician] wanted me to go to his office on Tuesday. My wife called his office on Sunday, July 3. He told my wife his office was closed until Tuesday and he would see me on Tuesday.
While at the hospital, they called in an infectious disease control doctor, the endocrinologist, Dr. G--. He also ordered more blood to bring my hemo to at least 9. He prescribed medicine I was to get. I didn't ask who was a provider. I accepted what they sent me. When I was discharged several days later, Dr. G-- wanted to check me out. While I was in his office, I was informed that he was not a provider for my insurance. The team of doctors that was put together all worked hard to save my life.
I have called for a provider directory. To date, no directory. A big secret on the part of my health insurance provider.
My PCP, Dr. M-- visit was July 4th. Before that, I called a medicine marketing representative. He recommended Dr. Q--. I called his office and was told the next available appointment would be in the middle of September, but she told me to get a PCP before that in case I have a problem where I might need one.
I know you rejected Dr. G--'s bill because of no referral. How was I to get one? If you don't pay him, I will make arrangements to pay him. He was in the hospital every day to make sure I was doing all right. Also, Dr. R-- was there every day. I am alive today because of these two doctors.
God bless them both.
My grandfather's claim was approved by his insurance company on November 3, 2005.