Wheelchairgate: An Update

Today is August 15th, 2007 and today authorization was finally given for the repairs to be made to my long-defunct wheelchair wheel. Henceforth, my wheel is officially now in the process of being fixed. It only took nine weeks to get to this point. Why does it take nine weeks to get a piece of paper faxed to a doctor, signed by the doctor, and faxed back to where it originated? As an outsider to the process, I can only make inferences based on observation and information collected post-fact, but my conclusion is that it takes a delicate combination of ineptitude, negligence, irrational bureaucratic protocol, and a lack of accountability on the part of those involved. Here’s a recap:

On June 12th, I took my malfunctioning wheel to Michigan Wheelchair Seating for repairs. Unable to repair the wheel in-house, I was informed by the repair technician that the wheel needed to be sent back to the manufacturer for repairs. The wheel would be sent out the next day and I should have it back within three weeks. I was loaned a power wheelchair for the time being. The information given to me by the technician seemed plausible and operating under the assumption that it was true I did nothing more about my wheel and went about my business for the next two weeks. Yes, it is true that the repairs would be done by the wheel manufacturer, but the timetable given to me by the technician was completely erroneous. In addition he left out a major detail that no work on the wheel would be started until the necessity of the repairs was confirmed by my doctor and authorization of payment for the repairs was confirmed by my insurance.

June 25th I called Wheelchair Seating to find out if there was any information on when I would get my wheel back. The receptionist seemed confused about what I was asking and wanted to know who I spoke to about my wheel repair. I gave her the name of the technician who took my wheel in for repairs and asked to have him call me back. He never did.

On July 2nd I placed another call to Wheelchair Seating again inquiring about the repair of my wheel and this time spent the majority of a fifteen minute phone call on hold as the receptionist looked up my file. I was told that the paperwork was being processed and that my information was in the system. Still operating under the assumption that the manufacturer was in possession of my wheel and performing repairs again I asked when I would be getting the wheel back. I was told by the receptionist that she didn’t know when it would be finished. I asked if she could have someone call the manufacturer and find out when they would be returning the wheel. This also did not happen.

After the Fourth of July holiday week in which I knew nothing would be done on my wheel, I called Wheelchair Seating again on July 10th. At this point in time it was approaching a month since I had dropped off my wheel for repairs and now I was expecting to have my wheel returned to me. This time I was passed on to another person’s voice mail account to which I left a message explaining what had happened up until that point and that I was expecting to hear when I would be getting my wheel back. The person never returned my call.

I called back again the following week and was shuffled to the same voice mail account as during my previous call. Again, I explained the situation (as I knew it to be true) and asked for an update on the progress of my wheel repair. For a second time the person responsible for that voice mail account did not return my call.

The week of July 24th I placed yet another call to Wheelchair Seating, but instead of being shuttled off to another anonymous voice mail account I asked to speak to a personal contact I had there from my time in Michigan’s out-patient physical therapy program. My former physical therapist had taken a position at Wheelchair Seating performing wheelchair fitting evaluations and although she was not responsible for any of the repairs being done to my wheel, I called her to see if she could find out what was happening. Par for the course, I did not speak with her directly, but instead had to leave her a voice mail explaining that the three-week timeframe I was given had stretched to six and I was still in the dark about the status of my wheel repair. Two hours later I checked the messages on my phone and I had a message from the person at Wheelchair Seating responsible for confirming the authorizations for all repairs. The information she had for me was not good.

When I called the authorizations person back that afternoon, fuming over the impending news that nothing had happened with my wheel repair yet—which it had not—it was explained to me that she was still waiting for my doctor to sign the referral confirming the necessity of the repairs and equipment I needed. Wondering why they would need my doctor to sign off the work order, I told her this was a repair and not a new equipment order. She explained that the repairs I needed were not covered under warranty and that anytime insurance needs to be billed the doctor must sign off on the repairs. Why wasn’t I notified of this and when did the doctor get the referral that needed to be signed? After a long pause and much paper shuffling she informed me the referral was faxed to the doctor’s office on June 19th. There really wasn’t a date she could give me that would justify any of this delay, but when she came back with the 19th I immediately realized this was a full week after I had brought the wheel to Wheelchair Seating. A week’s delay in getting the necessary paperwork together is ridiculous; especially in conjunction with the new information I was just given concerning their protocol of needing a doctor’s referral to bill my insurance. In my mind it seems once the problem is diagnosed, sending the referral to the doctor should be the first thing that gets done and there is no reason it should be done any more than a day later. In fact, the buildings that house Wheelchair Seating and my doctor’s office are literally within a mile of one another. I could physically walk the referral request to the doctor’s office from Wheelchair Seating in less time and it takes two people to help me walk.

So there was one week’s delay accounted for, but what the hell was going on in the intervening five weeks? The authorizations person at Wheelchair Seating couldn’t answer that question, but she was pretty sure my doctor was on vacation for part of that time. I told her someone over there should have called his office to find out what the hold up was and someone should have called me to let me know they were waiting on my doctor to sign the referral. None of this happened. For five weeks my wheel sat in their shop and collected dust. The technician who took it from me probably walked by it every day and not once did he think to himself, Man, that sure has been sitting here a long time. I wonder if I should find out what is holding up this repair? Or, if he did have those thoughts he didn’t get very far in acting on those notions. Not one single person at Wheelchair Seating took any initiative to find out what was going on with the referral, nor did they take any initiative in contacting me to fill me in on what was going on, or more appropriately, not going on. Had I not called and gotten someone completely uninvolved with this repair order poking around in my favor, I would probably still be none-the-wiser. She apologized for the communications breakdown and asked that I call my doctor’s office and see if I could get them moving faster. Her rationale was sound in asking me to do that, but it was also a bullshit way—whether intentional or not—of absolving herself of some of the responsibility for resolving this fiasco. But I made the call, because I also knew it was going to be up to me to get everyone involved on the same page from now on. Before I concluded that call, she asked me that once I talked to my doctor to call her back in a week to see where everything was at. Right, a week; because what’s one more week when six have already been wasted? I wanted to punch her.

When I called my doctor’s office and finally got a hold of his administrative assistant, I was informed that yes, it was true he was indeed on vacation and wouldn’t be back in the office until August 9th, which was the following week. When I asked whether or not the referral script had come through like I had been told it had, after much paper shuffling I was told that they did actually have the script. Why my doctor did not sign the referral before he left on vacation—you know, tie up loose ends like everyone else in the world does before going on vacation (he had ample time: at least three weeks by my calculations)—remains a complete mystery. I have my suspicions and those start with his assistant and her organization skills, but no way to prove them. I asked if anyone else, one of the other doctors, maybe his Physician’s Assistant, would sign off on the referral. It was not for a new equipment order, just a repair; it seemed logical to me that whoever was covering for my doctor would do that, especially considering the circumstances. The administrative assistant told me she would ask the Physician’s Assistant and get back to me that afternoon. She didn’t. I called the next morning to see if my request had been considered, she said she would ask the Physician’s Assistant, if I could hold. I waited on hold and after a few minutes she came back on the line and explained that, for whatever reason, the Physician’s Assistant didn’t feel comfortable doing that. So, I was again told the doctor would get to it when he got back in the office on Thursday the 9th. Fine, I said and hung up. In my mind it was, Fine. Fuck you guys, this whole thing is preposterous!

In the interim of all this wheelchair fiasco, I have developed a pressure sore on the back of my thigh. Pressure sores aren’t good and I’m pretty sure it came about from one of the activities I do at physical therapy. I’d like to be able to attribute it to not having my wheelchair in working order, just so as I can focus all my problems and blame around one central issue and group of people. Realistically, the sore and the wheelchair are unrelated, but coincidentally the state of the sore put me in my doctor’s office the day after he was supposed to have been back from vacation. My morning appointment time put me in the examination room with the Physician’s Assistant and not my doctor and led to this conversation:
“How are you Dan? It’s been a while since I’ve seen you.”
“Well, the reason I’m here is because of this sore, but I’m also still waiting on the doctor to sign the referral for my wheelchair repair.”
“Oh, that’s right. Yeah, with Medicare cases, as a Resident, I’m not allowed to sign off on the doctor’s refer—“
I cut her off, “I’m not on Medicare. I have private health insurance.”
“Oh. I can probably sign it then. Let me go check,” and she hurried out of the exam room. A new reason for me to want to kill; she made her decision to not sign off on the referral based on misinformation, easily verifiable misinformation. When she re-entered the exam room, she said, “The doctor already has the referral. He’ll sign it today.”

That was last Friday. I know from discussions with the authorizations person at Wheelchair Seating on Tuesday of this week that the referral actually came through on Monday, but really, what is another day at this point anyway?

What pisses me off about this whole ordeal is that the people I’m dealing with work on a daily basis with clients and in an industry of providing necessary services. Wheelchairs by their nature, with very few exceptions, are not luxury items. It’s not as if I took Grandpa’s old pocket watch down to the jeweler and asked the guy to clean and refurbish it “whenever you get the chance.” I’m not cruising around in this wheelchair because it’s a good way to pick up chicks; I need this wheel repaired and I needed it repaired six weeks ago! If there are going to be delays in the repair beyond what Wheelchair Seating can control, I can understand that, but this whole fiasco was caused by a breakdown within their own well-worn system and the fact that nobody lifted a finger in my favor speaks volumes about the quality of service they care to provide.

So, once again I have learned a lesson the hard way. And what I have learned is that these people can’t be expected to provide quality service even though that is the job they have chosen to do. The question is will they learn anything when I no longer take my business to them?