By Tim Callender, Esq.
In this second installment of “The Guilty Shall Remain Nameless” I can’t help but think back to an encounter I had with a walk-in clinic in Las Vegas, Nevada. Now… it’s worth noting that any walk-in clinic, one block from The Strip, is highly likely to be an interesting experience, period. And it was. First – this is the only urgent care clinic I’ve ever seen with armed guards. Now, it should be noted that I’m a small town guy from Idaho, so people walking around with guns is pretty normal, but not in this setting. It was quite odd.
Armed medical professionals aside, the key point to this story is network confusion. I had a foot injury that I had “received” on The Strip while walking between casinos. I will leave the details alone for now. Long story short, I needed stitches. I was referred to this particular clinic by the concierge at Caesar’s Palace. One, quick Uber later and I was surrounded by armed guards and a whole mess of humanity.
I did not have my medical insurance card with me so I had my wife email me all the information. I took a sticky note and wrote down all the details for our health plan. When it was my turn at the counter, I presented all of this information to the “helpful” person manning the counter. She responded, “I’m sorry but I will need the information off of your insurance card.” I responded, “Yes. The info on that sticky note… it is literally all of the information from my insurance card.” She responded, “No. But I need the information off of the card.” I responded, “Right. The info from my insurance card is copied, verbatim, onto this nice, yellow piece of paper. It’s all right there.” She responded, “Sir. I need the information from the card itself.” I responded, “Yes… Is there someone else here I can talk to?”
Three people later, someone finally understood that they could take the information from my sticky note and enter it into their system, just as if they had the insurance card in front of them. The information was… THE SAME! However, the battle was not over. Once the information was entered into their system, one of the helpful individuals asked me, “This shows you are in-network for ABC Network. But we see you are from Idaho. Will that work?” I responded, “Yes. ABC Network is the same.” They responded, “Where is Idaho?” I responded, “We are in Nevada right now, correct?” They responded, “Yes.” I responded, “Idaho borders Nevada…”
13 months later I received a bill from the urgent care clinic in Las Vegas. It was for north of $700.00 and listed as an out-of-network service provider.
I’m currently working through the details with all parties involved. Moral of the story… if it’s this hard for me – a sophisticated healthcare consumer… imagine how it is for everyone else.