Jeff James, MD, CEO

Jeff James, MD, CEO
Wilmington, Health

I am providing you with some of my observations and concerns that I hope will benefit your organization and your patients. For the sake of efficiency let me generally list rather than provide a narrative. Maybe you are already aware of these kinds of issues.

I received many texts, phone calls/voice mail and two letters from Humana
saying there were attempts to receive authorization for my medication but were receiving no responses from my Wilmington Health provider. This happened every quarter on 3 successive occasions. Each and every time, I needed to get involved so that Wilmington Health would provide authorization to Humana.

I decided to change providers not because of the above, but because I changed to an HMO with Humana. Since I needed to sign a release of records with you, I was asked to come in person to complete the form with my signature. When I arrived at the 1202 Medical Center Dr. Location I was advised that I needed to go to the 1124 Gallery Park location because that is where my provider was.The form was completed and signed in late November. After 6 weeks I followed up. The records were as yet unreleased.
I met with the Unit Supervisor: To get my meds authorization and to request again the release of my records. After an additional 2-3 weeks my records were still not released. I m in person for a third time for my medical records which I received immediately.

The following is what I learned: Humana Pharmacy informed me that it would have been more efficient for my provider to have written a year long authorization for the med in question. However, what happens per your Unit Supervisor, Wilmington Health receives a hundred requests or more from insurers on any given day and it s difficult to meet that kind of demand. Note: In this case, the patient became aware of what to do and informed your management re med authorizations. (It s becomes a scenario where the squeaky wheel gets the grease). Med filling is reactive rather than proactive.

Apart from my doctor s visit there have been two issues. 1. Inefficient medication handling and failure to release my medical records nearing two months. Also, it would have been prudent to have sent a letter advising patients that our providers have moved to a new location. How many times did patients go to the wrong location?

The letter I received from Catherine Daum re my decision to terminate my relationship with the Primary Care Division of Wilmington Health only serves to add insult to injury. In the course of the last 8 months, I have spent many hours being the communicative conduit between my Wilmington Health provider and Humana. Spending my time and driving across town many times isn t free. So I have been patient. Finally, while borne out of frustration, I said to your staff, that it seems they either need to hire more people, smarter people or both. Maybe Ms. Daum isn t aware of these aforementioned circumstances. However, she apparently has time to write a snarky response to me.

I can tell you from my own work experiences in the ministry and health care. People don t care what you know until they know that you care. Let us know where you are if you move. Care about our meds. Release our records the first or second time. Don t insult us in writing. It isn t professional. Catherine can emote if she wants but what I have provided you is heathy feedback and a normal response given the circumstances. They should have apologized but they didn t.

Former patient