I HAVE CONTRACTED WITH FOUR (4) Medicare Advantage companies since applying for Medicare years ago.
I currently am with Anthem/Simply Healthcare’s Simply HMO plan.
I long for December 31, 2018 when the plan and I will part company.
(I suspect Simply also similarly is waiting for year’s end.)
Getting information from Simply about contracted dentist is like – well, pulling teeth.
Simply has a lengthy list of dental providers on its web site
http://providers.simplyhealthcareplans.com/SimplyProviders/Masterpage/contentPages/ProviderSearch.aspx
The site can be accessed sans sign on; it’s an “open” page.
The problem is that the providers on the list apparently are NOT for Simply members.
If these providers are not available to members, WHY LIST THEM?
I asked Simply Member Services if I could see an orthodontist.
No. I have to see a general dentist first. The general dentist might refer me to an orthodontist and if the dental services subcontractor is in a good mood, I might be allowed to see the orthodontist.
- Same story with my eyes. I was told by Simply Member Services I would need to see an optometrist who could refer me to an ophthalmologist. Turns out Member Services was wrong (again) and I have to go back to my PCP for a referral.
Member Services gave me the name of several general dentists distant from my residence.
Rather than ASK where I lived, the Member Services person assumed one of the dentists she listed would be close at hand. We all know what “assume” means.
I checked Simply’s dental providers site and failed to find ANY of the names on the list Member Services sent.
Two weeks – and several emails later – someone at Simply Member Services sent an email with a link to DentaQuest, the dental services subcontractor Anthem/Simply employs.
Finally.
Again, I have to wonder if Anthem/Simply won’t allow Medicare Advantage members to use the dentists lists on the Simply web site, WHY LIST THEM? It would be better, at least to my Edward Bear mind, to provide the link to DentaQuest.1
DentaQuest is not without its own faux pas.
The first local dentist I called told me the dentist specializes in treating children! The dentist was listed as: “Dentist -General Practice , Dentist -Orthodontics And Dentofacial Orthopedics”. The Sweet Young Thing who answered the call quickly (and politely) disabused me of the idea that this was the practitioner for me.
The second call I made got me an appointment with a “Dentist – General Practice.”
Awesome Ella, the Sweet Young Thing at the second dentist’s office – everything was “awesome,” ergo “Awesome Ella” – managed to get me a next day appointment. Despite Ms. Ella’s upbeat charm, my anxiousness about sitting myself down in a dentist’s chair remains at a high level.
Hopefully I won’t have to go through this “Find a dentist” effort again, certainly not with Simply.
The amazing – and sad – thing about my several weeks search for a dentist could have been avoided had someone at Anthem or Simply used their head.
My opinion of Simply is based largely on Member Services’ performance. I give it an F minus.
The individuals may be competent but restricted by a PHB2 in what they can tell a subscriber or they may simply be incompetent. Either way. December 31 can’t get here soon enough.
Next year – if I survive this one – I’ll go back to a plan that actually has specialists in my area (I now have to go to Dangerous Dade [County] for an ENT specialist) and a hospital I trust. Fortunately, my PCP is a man of many plans.
A FEW MORE WORDS ABOUT DENTAQUEST
I was just at the DentaQuest site looking for an email contact to inform it of the faux pas on the list of dentists where it lists one dentist as everything but what she is: a dentist specializing in children.
I searched for DentaQuest contact information and Google returned a page that included a link to customer reviews. DentaQuest had an overall 1.5 star rating at http://tinyurl.com/y7l8v84k .
Most of the complaints were about the company, albeit a few were about the practitioners.
At least Simply has an email contact for Member Services; that’s more than DentaQuest seems to offer. DentaQuests’ customer service was not popular with the company’s clients.
Sources
1. http://tinyurl.com/ydenvxms
2. PHB: Pointy-Haired Boss (see Dilbert comics)
PLAGIARISM is the act of appropriating the literary composition of another, or parts or passages of his writings, or the ideas or language of the same, and passing them off as the product of one’s own mind.
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