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| - The short story: incompetence of simple instructions from this place costed me $125 that should have been covered by my insurance. If you want simple things to be made complicated, this place is for you.
For my insurance to pay for a test, I needed a Doctor's referral from Southwest Medical Associates @ Tenaya (SMA@T). That referral would need to be sent to the specialist electronically so my insurance could authorize it. Pretty simple. My insurance is very common.
After explaining this process many times, they still had trouble grasping it. A few weeks later, they finally left me a message confirming that the referral had been sent to the specialist, and that I was good to go. We even called them back a few times to be especially sure that we were good to go.
So I go to the specialist thinking that everything fine. Well after being seen at the specialist, I find out that they did not have the referral (because SMA@T had not actually sent it) and I'm liable to pay the fee of $125. The specialist hadn't received so much as a phone call from SMA@T.
Turns out that SMA@T sent the referral to the wrong specialist. Then they cancelled it, but didn't resend it to the correct specialist. And they didn't bother to call me again to say that they had messed up. (It took a lot of time on the phone to get this information by the way)
The only reason I went to SMA@T was for that referral. Every interaction has been a hassle. Even after knowing all of this information, no effort has been made by them to remediate the situation. The most I've gotten is "oh, that's too bad. sorry."
If you've made it this far, you're obviously researching your options. I'd recommend that you go elsewhere. The Bureaucracy of healthcare is not easy to navigate, so you should usually give the benefit of the doubt. But each interaction I've had with SMA@T has been characterized by incompetence and a reluctance to accept responsibility.
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