Complaint Review: Dr. Marcus Higi

Dr. Marcus Higi comes off like a nice enough person when you first meet him. A nice-looking guy, he is a lot like the stereotypical used car salesman; he puts on a show to gain your confidence. But, just like the negative steretype he fits so well, he's completely focused upon selling you the least amount of healthcare for the highest price.

When I first went to Dr. Higi, I had already been receiving treatment for reactive arthritis, but my other provider had retired. Dr. Higi was helpful for the first year; he wrote the prescription that had changed my life and gave me no trouble. When the second year rolled around, he renewed the prescription again. Then, a week later, he called and told me that the facility giving my treatment was refusing to continue the care.

Thus began a long---eight months and counting--process in which I tried to get my care re-established. Throughout this ordeal, Dr. Higi has revealed his true colors.

His staff began verbally abusing me and started finding it impossible to perform basic referral tasks. When I complained about the delays in testing, etc, Dr. Higi accused me of being too difficult. His staff, despite the filing of grievances with Presbyterian, continues to treat me badly. They religiously fail to perform basic tasks related to my care. They cut me off when I speak and mock my pleas for help. Dr. Higi is even worse.

Since having my treatment stopped suddenly, I've breen thrown into a severe medical crisis. Rather than help me find a way to get this treatment, or find another one, Dr. Higi lectures me about psychology. 

Dr. Higi doesn't stop there. For the past four months, I have been waiting for a response from Presbyterian Healthplan about my efforts to see another provider of these treatments. Throughout this time, Dr. Higi has told me repeatedly that he filed the prior authorization form. When I inquired about it at the insurance arm of Presbyterian, they had no record of it. After filing a grievance, I learned that the form was never sent. 

In a phone appointment with Dr. Higi, I asked him about the prior authorization. He insisted that he had sent it. When I read him the letter from grievance, he changed his tune and said he'd done it in January and that was enough. Truth is, he never sent one in January, to anyone. He never sent one to the provider I discovered in March, either. 

I told him that Presbyterian had told me the treatment is covered. He demanded written proof. It does not exist; they told me this by phone. Dr. Higi ultimately said he would send the prior authorization form and that he would send me a copy of it. 

What came in the mail a week later was insulting. He sent a letter telling me that he contacted an un-named person at the healthplan and that they told him the treatment is not covered. He informed me he would do nothing more. 

By not filing the proper forms--which Dr. Higi has not yet done--he takes an action I cannot appeal. The insurance plan still has no record of the request. This means they cannot approve or deny it. Without an official denial, I cannot appeal. This has been going on now for eight months---the exact same move was made when the treatment was stopped. 

Dr. Higi told me that he likes having only ten minutes with patients because it allows him to provide his wife with a very nice house. This was probaly the only honest thing the man has ever said to me. He sucks up $250,000 a year in base pay and gets an average of $200,000 in bonuses each year that he keeps costs down. To do this, Dr. Higi gives patients extremely miinimal care and relies upon pop psychology as a means of bullying patients into submission. Avoid this guy! He will ruin your life if you let him!