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by Garth Oldham on May 8th, 2015

For the last five years my primary care physician has been one of the doctors at Southwest Family Medicine in Buckeye. For each of the last two years, after having a standard blood panel done there as part of my annual Medicare wellness exam, the billing/coding to Medicare has been done incorrectly so that I ultimately have been billed for some tests by Southwest's lab, Sonora Quest Laboratories. Each year I have then spent the next two to three months going back and forth between Southwest, Sonora Quest and Medicare before finally getting the matter straightened out and Medicare to finally pay for all the tests. Each year Medicare says the tests were not billed with the right codes. Each year Sonora Quest says it is Southwest that does the coding and that Sonora Quest cannot change the codes. When I can finally talk with the office manager at Southwest (that person is always in a meeting) I am told it will be looked into. Typically I am rebilled a couple times by Sonora Quest before the matter gets straightened out. Recently I realized that I was out of refills for my two prescriptions, so I had Right Source, Humana's fulfillment subsidary, request some 90-day refills from Southwest. They were to cost me nothing. After receiving nothing for a couple weeks (Right Source mails prescriptions) I checked on Humana's website and found that single 30-day refill requests had been sent to Walmart instead of Right Source and that there would be a small cost to me. I called Southwest and was told that I would have to come in and see Dr. Michael Brady before I could get any more 90-day refills. I saw Dr. Brady today, May 6, thinking he would need more blood tests to make sure my current dosages are still proper. He said, no, that he needed to talk with me about my psa levels instead, levels that he had ordered tested during my last wellness exam six months go or longer. My psa levels, which have nothing to do with the two prescriptions I am taking, have been creeping up steadily for the past decade or more. I asked why we were having that discussion again since we had talked about it after that wellness exam six months ago and again a year before that. I asked why he had not noted in my file that we already had that discussion, and he told me, to paraphrase, that "we can't write down everything about everybody." I asked him why he had sent refill approval to Walmart instead of Right Source. He said he did that because Right Source only fills 90-day refills and that he had needed to see me sooner than that. I had already talked with Right Source about that and had been told that, no, Right Source will fulfill for whatever term a doctor approves, in this case either 30 or 90-day supplies. I then explained the annual Medicare/Sonora Quest billing problems I have been having and asked him why, since Sonora and Medicare both say the problem arises with Southwest and their coding. Dr. Brady said he codes those tests "one way" and that I needed to talk with "my insurance company" to get those things straightened out, that it is their problem, not his. He then told me that I should look for a primary care physician that could do a better job for me. Anyway, I left there, went straight to another medical-services location and signed up there as a new patient. I should add that my new doctor is not affiliated with the same Integrated Medical Services organization that Southwest and Dr. Brady are. I am going to post this on as many medical services review sites as I can find.