Our coverage is through HBCBSNJ so I called them first. A pleasant lady told me that my behavioral services are managed by Magellan Health Services so…I called them. A pleasant woman at Magellan explained my coverage to me and asked what kind of therapist I wanted. I replied that I wanted a psychologist and then gave her my zip code plus the mileage that I’d travel. She promised that an email was on its way with a list of covered providers.
The email never arrived.
The following day I called Magellan again. A nice gentleman said he’d email the providers list and, lo and behold, it arrived. He also told me that while we needed to call back and pre-certify, after January 1st, 2013 we’d no longer need to go through that step. Great.
I started through the list which contained 21 names. All the names are printed in ugly font all caps. Like this:
XXXXX0000 3
JOHN SMITH MD
PRIVATE PRACTICE
580 ANY STREET BLDG A
STE 105
EAST BRUNSWICK, NJ 08816
732-555-5555
I began Googling the names, the phone numbers – anything that would turn up a website with info on the counselors. Of the 21 names, 1 had a web site. One is supposed to trust their mental health with a faceless, qualificationless name on a list. Great.
Lucky for me the one with a website I liked. They had the training I was told to look for. This would be my psychologist. I emailed them. Then I called them.
You guessed it. They were not taking new patients at this time. So glad Magellan had them on a list.
Day 3 I went to Horizon’s ‘find a provider’ service on their website. I started going through the names as I had with the list the day before. Same nonsense. 1 person had a website with info on it. I called HBCBSNJ and asked, “Can I use one of those providers?” The answer? I had to call Magellan and ask them.
So I called Magellan for now the 3rd time in 3 days. This time I got a CSR who seemed like they felt like they were being bothered with my questions. Would have been a great representative for a suicidal patient to get. A) No I couldn’t use the doctor on the BCBS list. (I could but they’d be subject to a $2k out of network deductible and then only covered at a 40% rate. Tough when they’re getting $300 bucks an hour.) B) She knew providers were often left on the list even though they were not accepting new patients. It would be hard to get professionals like that to let Magellan know when they should no longer be providing free advertising to them. C) Asked why Magellan didn’t have an online provider search function like the rest of the civilized world she said she didn’t know but ‘knew the guy in IT’ and would let him know my suggestion. D) Asked why the precert was ending come Jan 1 she said she thought it had something to do with Obama. E) She offered to email me a new list of providers.
That one arrived.
I emailed Magellan to complain about her demeanor and C above. 3 days later…still no reply.
I began going through the now expanded list of providers. Guess how many had websites? None. Except psychologist #1 from 3 days prior. The one not accepting new patients.
I never was able to select a behavioral specialist in what is now 5 days time. Imagine I had been a depressed patient. Would I have any desire to try again tomorrow? Probably not. Because I don’t now and I’m not depressed.
**Follow us on Twitter. Subscribe, or Return to BobsBlitz.com.
Tweet