Saw the cardiologist, barely.

Another relative all-clear. Except I thought I would have a nervous breakdown before I got to see him.

Up till now, insurance has been relatively smooth sailing. I get lots of things that say "this is not a bill" and "total to be paid: $0.00." Great. A huge relief. My insurance even approved my visits to the ID doc, even though he's not in the network. How beneficent.

So I thought it would be a cinch to see a cardiologist who really was in the network, the cardiologist who'd seen me at Mt. Sinai and who works with the ID doc. I'd gotten a visit to him approved back in January, but then the referral expired while I was busy having surgery and losing half my vision. "No problem," said my primary-care doc. "I'll just refax the first referral."

I didn't think about it again till I got to the appointment, and the receptionist said she didn't have the referral. And that there was no way to see the doctor without it.

Is that even legal? I'd even just signed some random piece of paper that said I was responsible for the bill if my insurance didn't cover it. Which I pointed out, but it didn't carry any weight with this by-the-book gatekeeper.

So I had to spend the next hour on the phone--largely on hold, usually on the brink of tears due to infuriation at the gross unfairness and indignity of it all--with insurance people and the imperious little guy who's my PCP's assistant. Everyone involved was hostile, defensive and unsympathetic.

Turned out, I think, that the assistant had refaxed the referral as promised, but hadn't bothered to change the dates, so it essentially arrived expired. And no one in the cardiologist's office had the imagination to appreciate that if HIP had approved my visit to the doc before heart surgery, it surely would be merited after surgery as well. Also, a faxed copy of the re-re-faxed referral, with dates corrected, to show the process was in the works, simply would not do.

I felt like tearing off my shirt and pointing at my scar and throwing a tantrum, but crying real tears had drawn nothing but an exasperated sigh from the receptionist, so I didn't want to risk her having me carted off by security. Instead I just went to the bathroom and blew my nose and splashed water on my face and took many deep breaths. Reading the New Yorker helped too.

After another twenty minutes, during which some manager talked directly to HIP about my impudence, the receptionist came over and said, "Fine. It's approved. But just this once. If you ever want to see the doctor again, you have to get another referral." Like I'd pulled a fast one on them, but they were on to me.

I can't help but think this might've gone a little more smoothly in California.