Conference 7.286::digital

Re:                  <<< Note 1789.0 by USPMLO::JSANTOS >>>

>    This file is for issues about HMO Blue and Baystate Health Care. 

Isn't this a regional issue and therefore better dealt with in a regional 
conference rather than a world-wide one?

-  David

    Ditto to .1 
    
    If not, should I start a Lovelace note (for us in New Mexico?)
    

    
    
    	Ideally a whole separate conferenece should be created for
    	the HMO reps to monitor just like devlopers do for their
    	products.
    
    	Otherwise I suggest opening a note in the MASSACHUSSETTS
    	conf. and other reps opening up a note in their respective
    	regional conf.
    
    
    					Mike
    					----

    
    	re: .2 
    
    	I wish there WAS such a note! I have made my first contact with
    that organization today and find I  need to register a complaint.
    (Involves 60 days lead time for an initial appointment!!!_)
    
    	The suggestion in .3 is an excellent one.
    
    	/john
    	Albuquerque NM

    I agree that we need a conference for HMO's. Being new to notes can
    somebody tell me what I need to do to set up such a conference?
    
    re - 4. If you want to give me a call I can probibly help out with your
    situation. dtn 223-5402
    
                             John
                     

    Getting back to the question raised by the note......
    
    I have found HMO Blue at the Lahey Clinic to be very good.  I generally
    do not like HMO's (I was in one before that was terrible), but they
    do a very good job.
    
    The only complaint that I would have is that they did not get their
    prescription drug reimbursement straightened out, (as of a couple weeks
    ago), so instead of just paying the co-payment, you have to write to
    the prescription company to get a refund.  This is very inconvenient.
    (Especially for the pharamacists, who get the bulk of the complaints
    for something that is not their fault).
    
    Thank you for having the note here.  I think this notesfile has a lot
    more readership than any regional or hmo notes file would have, and
    there are a lot of things in here which do not pertain to the whole
    Digital population.
    
    Bob

I also have HMO Blue with Lahey, and have had no problem getting my 
presciptions filled at the pharmacy (I'm using a CVS) and just paying the
co-payment.  Could it be a problem on the pharmacy's end instead of the HMO?
I'd call the HMO office if I were you to see what's going on.  By the way,
to find out which pharmacies take the HMO Blue cards for just the co-payment,
I called the phone number in the info packet that I received at home to see
which pharmacies in my area would accept it.  Have you tried calling that
number?

And for the record, I am _extremely_ pleased with HMO Blue/Lahey, but then
I already had Lahey as my HMO so didn't really notice much change.  And I 
had lots of claims last year and absolutely no problems.  That included
things like homecare for my son when he came home from the hospital, oxygen and
monitor for him, and currently on-going physical therapy, developmental
evaluations, and various other appointments to specialists outside of the 
clinic, and I have yet to see a bill unless the provider accidentally sent it
to the wrong insurance company. My son was in the hospital for a little over 
6 months (he and his twin sister were born 12 weeks too soon), and I have only
positive things to say about the folks at Lahey.  How many medical plans do 
you know of who find the time to call (after their regular work hours no less) 
just to see how the kids are doing and make sure there's nothing that needs 
their attention.  They even went so far as to switch oxygen suppliers in the
time it took us to get from the hospital to home (about 1 hour) because the
first supplier messed up so bad that the releasing hospital called Lahey to
complain.  The plan administrator tracked us down in the Lahey pediatrician's
office on our way home to say they had switched suppliers due to their poor
service, and that another supplier would meet us at home.  And the 
administrator apologized repeatedly for the supplier's shabby performance 
and the trouble it would put us through when it wasn't even her fault.

I hope everyone's experiences with them are as positive as ours.

    Thanks, I appreciate the feedback. I'm looking into putting a HMO note
    up on a seperate file, but if nobody has a problem with it I'd like to
    keep it here for now.
    The notes I've seen kind of surprised me a bit because I expected to
    see, not only more notes, but more problems. Glad to see we have some
    happy customers out there. Most of the time I need to get involved with
    these HMO's its to work an issue so it feels good to see the other
    side. Its not to often that folks will take the time to list a note or
    send me mail about the good things in HMO's.

    John, this is a pretty good idea ! (Did you think it up all by
    yourself ?)  ;^)
    
    Symptomatic appointment (last week) Same Day...no complaint here
    
    HMO Blue, but then my family and I have been going to this same
    doctor for about 20 years.

    I have been a member of Baystate Health care since the birth of my son
    five years ago.  While I have been extremely pleased with the medical
    coverage we have received ( my son had a caridac defect at birth and
    has run up quite the medical bills ), I am not at all impressed with
    the administration side of Baystate.  I have lost count of the number
    of times I have been put on "collection lists" because Baystate takes
    their sweet time paying their bills.  Granted these things eventually
    get straightened out, but usually not until my wife or I has made
    numerous calls to Baystate, and whoever is looking to get payed.  I
    just don't think that I  should be placed in the middle of an agency
    like Baystate and the doctor's, etc. looking to collect their fees from
    Baystate - very frustrating.
    
    In summary, I would rate the health care that my family has received as
    excellent.  The down side, is that in general it has been quite
    frustrating monitoring the administrative side of my health care plan.

    Further info on .6...
    
    The prescription problem has been fixed.  With the exception of this
    problem, I have found the administrative side of HMO Blue/Lahey
    extremely good, significantly better than traditional health plans.
    
    Bob