the huge big freakin' mess

Here's the story.... It's kinda long, sorry...

I am on SSI/disability, and 2 months ago I applied and got accepted medical assistance through Medicaid. I got a list of general physician providers in the area who take medicaid, and I chose Dr. Mroz, a doctor who I saw high credentials for when i looked her up on the net. I mailed the form requesting her as my primary care physician (PCP), and a few weeks later, I got a letter in the mail saying that it has been approved that Mroz be my PCP. So the next day, I called her and asked for an appointment, telling her my medicaid approved her for my PCP, and that I need my vitamin D deficiency checked, my hearing checked, and a referral to the Neurologist for my Tourette's. The receptionist told me Mroz was not accepting new patients, and that she did not know why medicaid approved her to be my PCP.

So, I called medicaid, and told them that Mroz is not accepting new patients, and I was told that all I had to do was select another doctor from the provider list and see them instead. She told me it really didn't matter who shows up as the PCP and that as long as you show your medicaid card there would be no problem. So, I found another doctor, Montoya. I saw her 2 weeks ago. Everything was fine, and Medicaid was covering my visit. She did blood work on me for my vitamin D level, and is supposed to get me to see an ENT doctor as well as neurologist. She told me to schedule to see her again in 2 weeks.

That day is today. So, today I went to her office and signed in, for my appointment and sat down. Then the receptionist called me to the front. She asked, "Do you have ties with Dr. Mroz?" and I told her about how she was initially my PCP but she wasn't accepting new patients, so I came here instead. And she said that since Montoya was not listed as my PCP that medicaid would not cover my visit today. She told me to call medicaid real quick to see if they could work things out.

So i went into the hallway, and called medicaid. They told me that whoever told me it "didn't matter" who showed up as my PCP was wrong. It did matter. And that they could switch my PCP over to Montoya, but it would not take affect until May 1st. She told me I could either go to a free clinic until then, or try getting a referral from Mroz to see Montoya, because if Mroz was listed as my PCP, she had an obligation to either see me, or send me a referral to see someone else. So, then I called Mroz's office. They told me that I was not considered a patient, because I had not been seen, because they are not accepting new patients, therefore they could not get me a referral.

So i went back into Montoya's office to talk to the receptionist again, and told her what was going on and being said. She then went to talk to the administrator or whoever was in charge i guess, and she came back and said there's really nothing they could do, and that if I were to be seen by Montoya today, the charge would be $80, which I do not have. She told me to make an appointment with Mroz. (which I know i clearly told her she was not accepting new patients). I told her "that was the whole problem!" and said i was just going to leave, and so i left.



But now I am going to get entirely off medicaid and be put back on my dad's Tricare insurance because the rules have been changed so that any child of a parent with tricare can be kept on tricare as well, up until they are 26 years old. So hopefully that will be worked out soon....

It has just been a very stressful and emotional day. All that happened at the doctor's office, or in the hallway, and it made me cry and everything. What a Huge Mess. I hate medicaid.

I`m so sorry things happend like that!!!it sounds like a day in my life!!! i hope things get better for u!!!

well turns out tricare wont take me till may 1st anyway so i am screwed the rest of this month

Geez! I don't know why Medicaid did that, didn't tell you to talk to and get the doctor and then tell them who it was instead of the other way around. The doctor may accept Medicaid but not necessarily patients (as you found) and that's kind of important to know. Dumb of them not to just switch you though, too.

I'm having the same Government problems with my car and the pass for toll roads; I gave my old car to my stepson 4-5 years ago and he transferred the tags and title and everything fine but the idiot people on this new toll road take a picture of the license plate and then compare it to their old records; never mind who the license plate now belongs to or that they no longer have correct information on me so no one is getting billed! And they wouldn't talk to my stepson about my account either, until I signed a form telling them it was okay to talk to him/transfer the file to him, etc.

And now i have a very good reason to need a doctor.... like ASAP.... ugh

Yeah welcome to the system. Total incompentency imo. I hope once they combine departments (rather than having 26 departments doing the "same" thing) there will better continuity. IDK about how long the age 25 will stay, with all the changes in the lack of coverage no one can afford will exisit. Good wishes in the meantime.

Believe in Him or not --- GOD LOVES YOU!

Want to share your Christian faith? Click HERE

Krisakira,

I'm so sorry this happened. Something similar happened to me back in 06 and it ended up in a mental breakdown for me. Basically I was sent to a pdoc with an appointment when in fact that doctor had not worked at that location for over a year. It was the fifth time I tried to set up an appointment for a pdoc so i had a breakdown. I'm glad that did not happen for you. Regardless though it must have been uber frustrating. Still yet, I'm glad you can go back on your dad's insurance as that will probably be best all around.

Love and hugs,
Tara