Sunday, June 27, 2010

Denied Medical Treatment Based on Insurance Carrier…Are they Discriminating against the Military?

About a week or so ago Kayla started complaining of her ear hurting…I immediately thought swimmer’s ear, as much as we’ve been in the pool and ocean these past few weeks.  So I pulled out some ear drops from a previous swimmer’s ear infection she had.  We started using those and Motrin.  Several days later, her ear was better.
However, on Saturday morning she woke up and said her ear hurt again…I told her that she couldn’t get in the pool then…so Kelsie and I went out while Zack was cleaning ours out.  About an hour later she came out almost crying saying she couldn’t eat because it hurt so bad.  I told Zack that I was taking her to the walk in clinic.  So I got out got a shower and got dressed we left and went over to Seawind Medical Clinic.  We have been here a dozen different times between myself and Kayla.  I only use Seawind when I’m really sick or if it’s the weekend for Kayla and her normal pediatrician isnt’ open.  When I went in, I brought her last rx from there…my reason behind this is I didn’t remember how they file with the insurance company and what not.  I know that it’s less money up front for the visit if your not a new patient and this was my reason for bringing the rx so if they didn’t have her in the computer anymore I could show her rx from there for proof.  Well I didn’t have to get that far. 
I signed in and they ask if she’d been here before and I said yes but it had been years ago.  She ask if we were using insurance and who it was…I said Tricare and it all went  down hill from there.  The lady said we don’t accept Tricare and I said, that they used too because she had been there before, she ask if she had Tricare at that time of her last visit and I said yes, she’s always had Tricare, from the day she was born.  They said well their policy had recently changed and that they don’t accept it anymore and I said well that’s just crazy but I would just pay out of pocket then and not worry about filing.  They then said they still could NOT see her!!  I ask why, they said because I had to sign a paper stating that she didn’t have Tricare…and I said that even though I’m standing there willing to pay them without involving the insurance company that they wouldn’t see her…They said sorry.  I said who do I complain too, they said the office manager.  So I have the number to call and talk to her Monday.
I left there pissed off.  We had to make a completely unnecessary trip to the emergency room for an ear infection.  I even told everybody at the er that I had to come in contact with that I was there because the walk in clinic denied her based on her insurance carrier.  Luckily we do have a fast track in our er and we were in and out in about an hour or so.  That is beside the point, because the cost is far more for the er than to a dr’s office. 
I am going to find out everything I can, because I honestly feel like it’s discriminating against the military and their families.  Tricare is the only insurance that I know of that covers military.  Therefore if they are denying medical coverage for those under Tricare they are denying medical coverage for military.  I feel that is discrimination!
In other news…Kayla has an inner and outer ear infection.  She was running fever as well.  The er gave her two different ear drops and an antibiotic.  Her ear was so swollen that the PA almost couldn’t even see her ear drum! Poor thing, no wonder she couldn’t eat. :-(  She still isn’t feeling much better this morning either.  She’s taking her meds and laying around.  I’m headed to Toys R Us in a bit and buying her a couple of DS games.  They are buy one get one half off.  So she’s going to give me her b’day money and I’m gonna call her from my cell phone and find out what games she wants.


Jo said...

I've never heard of anyone not taking Tricare(my hsb retired from USAF 6 yrs ago) I would follow up with Tricare and with the office ppl at the clinic If still no good answer a letter to the editor with the tone of the clinic not supporting the troops -and their families - no one today wants to go down that road

Kelli said...

That's crazy...I know you'll be on the phone first thing tomorrow!