Saturday, August 16, 2008

Healthcare insurance has a responsibility to protect patients/insureds from "bad doctors"

Dr. Chris Dangles treated me as an orthopedic patient from October 2000 and until he abandoned me in Spring 2002. Dr. Dangles told me that he did not know what to do.

When a surgeon admittedly does not know what to do, it would probably be a good idea for the surgeon to get a second opinion. Indeed, while being treated by Dr. Dangles, I could not obtain an orthopedic second opinion to find out why I could not walk without pain and falling down because I was an HMO patient in Health Alliance Medical Plans, the insurance company owned by Carle Clinic physicians (including Dr. Chris Dangles)

In June 2002, I changed my insurance policy from HAMP to Blue Cross and Blue Shield of Illinois so that I could obtain an orthopedic second opinion.

I wanted the second opinion to be at Duke University Medical Center. I specifically asked BCBSIL whether I could be treated at Duke orthopedics. I explained to BCBSIL that I had already had multiple ankle surgeries by Dr. Chris Dangles at Carle Clinic Association in Urbana, Illinois.

In June 2002, BCBSIL told me that in order for BCBSIL to pay for the Duke orthopedic treatments, I must contact an attorney and file a complaint against Dr. Dangles. BCBSIL expected to be reimbursed from Dr. Dangles and Carle Clinic.

Ultimately, Duke Medical would not let its orthopedic surgeon testify against Dr. Dangles and I could not proceed with the medical negligence case against Dr. Dangles. And over the last six (6) years, BCBSIL never helped me prosecute the medical negligence case against Dr. Chris Dangles and Carle Clinic Association. BCBSIL wanted me to get an attorney, prosecute the case against Dr. Dangles and then BCBSIL expected it would hold both of its hands out for reimbursement of the claims paid related to Dr. Dangles' deviation from the appropriate standard of care.

I just received this letter from BCBSIL. Evidently, BCBSIL wants to know why the medical malpractice case against Dr. Chris Dangles and Carle Clinic were dismissed. Evidently, BCBSIL did not want to "get involved" in testifying against Dr. Dangles but they did want/expect reimbursement monies.

BCBSIL wrote to me because BCBSIL wants an explanation from me about what happened to the medical malpractice case against Dr. Dangles and BCBSIL wants to know why Dr. Dangles is not going to be reimbursing BCBSIL for the claims it made on my behalf to Duke Medical. Am I in the land of Oz?

I cannot wait to call the BCBSIL reimbursement guy on Monday.

Stay tuned . . .

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