Phoenix Health Plan review: Failure to pay Physicians 4

The state of Arizona provides health care for those who are indigent whether through long-term unemployment and mental and/or physical disabilities. This sounds almost too good to be true, because if you chose Phoenix Health Plan it seems it is too good to be true. You might find Doctors behaving somewhat unhappily. Some very good Physicians have simply left the area. Clinics which were once efficient and trustworthy are chaotic and likely to give bad information per referrals. I am the friend and advocate of a man who is severely disabled. He would like to work. Sometimes he works a day here, a day there because he's frantic about money -- and he suffers for days afterwards. His spine looks like a concertina. He has to use oxygen and a CPAP machine to be able to sleep with reasonable chance of awakening again. I'm able to assist him in paying part of the utilities most of the time. He'd been seeing a Pain Management Specialist for nearly a year and has been given very strong medications to manage the pain. As many of you know, these medications are typically addictive. You cannot simply quit taking meds like morphine and Oxycodone. Even the printout at the pharmacy advises you not to stop taking the medication without consulting your Doctor.

So, my friend has a Doctor who is honest enough to tell him the truth. Phoenix Health Plan hasn't paid him for any of the patients covered under the plan in what is now over one year. Had my friend chosen the other option offered under AHCCCS, there would not be an issue.

Unfortunately, AHCCCS allows people to choose but once a year. And of course there's nothing to indicate problems with Phoenix Health Plan. My friend is referred by yet another Physician's Assistant at North Country to see a certain Doctor in Bullhead City. He schedules medical transportation more than a week in advance. The appointment, made five weeks in advance is cancelled quite suddenly -- three hours before medical transportation is scheduled to arrive. A receptionist or assistant informs my friend that "The Doctor is sick." He has just enough time to call and cancel medical transportation. However, he is about to run out of medications. The woman representing the Doctor who has suddenly taken ill and apparently will not recover for a full month assures my friend that he can simply go back to the Specialist who no longer accepts his insurance and get all of his prescriptions written. Yeah, right...

My friend is not at ease with bureaucracy, so when he attempts to speak with his former Pain Management Specialist's office about the dilemma, he's so stressed he asks me to speak to the person on his behalf, which I do. The bottom line: Phoenix Health Plan has still not done what is correct (pay the Doctor's fees) and they will not simply give him prescriptions without seeing him. The visit will cost $80. Then there are the prescription co-pays. It's too late to schedule medical transportation, so I will have to drive about 60 miles and use 1/4 tank of gas. Gas prices are nearing $4.00 per gallon.

While this might not seem like a huge amount of money to many people, this means my friend cannot pay his electric bill this month. I came up with $50 to help him pay the bill. If you suffer chronic pain you understand that stress and anxiety exacerbate the pain. I do not feel any ill will toward the Doctor who was kind enough to see him on an emergency basis tomorrow morning. After all, he is not providing a free service. I am, however, furious with the state of Arizona for theft of services from more than one excellent Doctors who accepted and treated patients under the "umbrella" of Phoenix Health Plan and believed they would be compensated for their time and expertise. Remember that "temporary" penny tax we voted in to guarantee continuance of Health services and prevent further cuts to Education? Where did all those pennies go, Governor Brewer?

What a thrill it is to receive a shiny, full color brochure printed on expensive paper a few times a year extolling the virtues of Phoenix Health Plan in English and Spanish. I wonder how much those brochures cost to create, print and mail to so many thousands of people who are out of work through no fault of their own. The post office bin is practically overflowing with the ones that are tossed out by people who don't even bother to read the useless things.

I think: does the state of Arizona have some wily strategy to kill off the poor and disabled? No, there is no logic at work behind the scenes..just plain old greed. Because in the short run, you're angering both Physicians and patients. And in the long run, you will find people like my friend filling hospital beds -- a much pricier proposition. FYI, my friend does not get a check from Social Security. He worked very hard for four decades and paid into the system and now he's going to have to hire a lawyer to fight for what is rightfully his.

As for the Physicians who've been cheated out of payment for services rendered, I hope they've got a Class Action Lawsuit in the works. I would happily testify on behalf of every good, qualified Doctor who has DONATED time to help my friend, thus far. Shame on our government for dropping the ball and deceiving Doctors and patients through obfuscation. I hope Jan Brewer inherits a hotel with 500 rooms and is found dead in every one of them.