A doctor mix-up leaves an Upstate woman's medical care in limbo.
Marianne Richardson’s insurance provider told her, her doctor wasn't in its network.
Turns out, he actually was. Another doctor on the provider list shared the same last name, causing the confusion.
After several failed attempts at clearing up the mistake on her own, she called 7 On Your Side for help.
The 39 year old suffers from a rare disorder called hypokalemic periodic paralysis.
“Basically it's a disease where the potassium shifts in the body, so it's not in the right place. And when it shifts in the wrong place, in the muscle cells, it causes episodes of paralysis,” said Richardson.
It also causes her to need consistent medical care.
“It took six years to get to this doctor here once I moved to Greenville,” said Richardson. “So it was really important for me to keep a doctor who knew what was going on.”
Which is why when she was recently choosing an insurance provider, she went with Humana. Her doctor's name was on its provider list.
But she soon realized a problem.
“When he moved from one practice to another, instead of transferring his number to a new location, they erased it, and assigned him to the same number as a doctor with the same last name,” said Richardson.
So she had her doctor send a letter to Humana, verifying his credentials. She says she also called numerous times to get the mix-up fixed, with no luck.
To complicate things, her disorder was making her so sick, she had to go into the hospital.
“I was very sick, and if I didn't get care soon, it wasn't going to be a good thing,” said Richardson.
That's when she called 7 On Your Side.
We called Humana while she was still in the hospital. It said the request had to come from her doctor, and gave us a contact number for him to call.
Richardson says within an hour of our phone call, her doctor made the call, and Humana fixed the problem.
“She called right after I talked with you. And magically they had a provider ID number for him,” said Richardson.
Now out of the hospital, she's once again moving freely, and feeling confident in her care.
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