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Patient Abandonment

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lealea1005

Senior Member
If that were the case, that he couldn't see me due to legal reasons, then they should have explained that to me. I'm a very understanding person, the peacekeeper type and I don't usually make waves. After I was made aware that I HAD to choose a PCP I did so immediately but it sure wasn't with any help or understanding from my physicians office staff. I'm working in the clinic setting now myself and calling in a prescription isn't a billable ICD-9 code.

While this is true, it is not as simplistic as you seem to think, or attempt to have us believe. The office visit required every three months for the type of chronic medication you're taking (standard of care issue) has a billable code which must be used/billed.

He, legally, could not see you because he is REQUIRED to bill for an office service. That office service was required (again, standard of care issue) for the purposes of assessing your condition before writing the prescription for chronic meds.
 


shellyscorner

Junior Member
:eek: Wow! I gotta say from the outset here, the venom, towards this lady is beyond surprising, and it's disturbing. We come here to the forum to try to understand something that has happened to us that has been at best confusing, and at worst VERY hurtful and painful. The last thing that any anyone coming here needs is to get jumped on for trying to understand their circumstances and find a few answers, even if "we" think they didn't handle things as best as they could have. I mean, isn't that why this is here, beyond the advice of did some doc do me wrong, to also learn from our own mistakes? Honesty is one thing, brutal honesty is another. So, for those who got a little Itchy, I'm a little embarrassed for you...I hope you find yourselves just a tad bit embarrassed too??? I can hope....

...If that were the case, that he couldn't see me due to legal reasons, then they should have explained that to me.
Now!! Hi Jgirl1730!!, ;) I think the one thing that should have been said near the beginning that would have been helpful is that the "girls" up front at registration are simply given an algorithm to follow ie: If patient comes in and has this, do this...If patient comes in and has that, do that etc. Kind of like following a medical guideline for diagnosis, "does patient have XXXX, if yes go to next question, if no, skip to part b...." What I'm saying is they're just following instructions. Most, if not all, will not know the why's to what they're telling you. Even if they do, they've most likely been instructed not to go into it with you (the patient) for OTHER legal reasons. Basically, the why's are above their pay grade.

The other thing that would have been helpful would have been for someone to have explained that Medicaid is set up kind like an HMO in that all physicians have the right to "OPT OUT" if you will, meaning they can choose not to see patients covered by Medicaid. I too lost my primary doc of 10yrs. because he had opted out. I too didn't find out until I showed up for my appt. I too was DEVASTATED!!! Though, I must say, his office did a much better job of handling it, I still left in tears. Several years before, I had literally died in front of this man in his office one day. I had gone in VERY sick with bronchitis and they had only one room available to put me in when it was my turn to be seen because he was so busy. It just so happened it was his resuscitation room!! He had examined me and was talking to me and my husband about how he wanted to treat me and I was laying on the table because I didn't feel well. One minute I was talking and the next he was screaming for someone to call an ambulance while he did CPR. He got me back before the ambulance got there. When he got me back, he looked at me and said, "Girl! Don't you ever do that to me again! You scared the **** out me!! Oh! by the way...Welcome back!!" Needless to say he and I were very close, and it was just a financial decision that had to be made. He hated losing me, and others, almost as much as I hated losing him. The amount that these doctors lose by opting in and agreeing to see Medicaid patients is just unfathomable! I truly don't understand how the government expects these doctors to keep their doors open! I feel really bad for them and for us the patients too! It's just a bad situation all around, and truthfully, Obama has just magnified the problem exponentially with his new "health care plan" I'll refrain from saying what I'd like to tell him to do with his plan and a few other things!!!

I know that this was long winded, but I hope maybe it helps take the sting out of the experience. In the future, if you ever another problem, like this one or another one, that hits you in the face and leaves you thinking, "HUH?????", ask to speak with the office manager. That individual is there to, among other things, help answer patient questions that the registration/appt. makers can't.

Hope your new job is going well, but I also hope that the next time a patient has a problem where you work that you remember YOUR experience and that YOU will now go out of your way to either answer the question or make sure the patient gets to the right person who CAN answer their question.

Be blessed!

Shellyscorner
 

lealea1005

Senior Member
Venom?? :confused:

What I saw was straight to the point LEGAL answers. The fact remains that OP was notified that she needed to choose another PCP...one who participated with Medicaid. She failed to do so.
 

shellyscorner

Junior Member
:confused:I never said it had to be, needed to be, or even should be a "FEEL GOOD" forum! I simply believe that what needed to be said could have been said with out the woman being made to feel like she was being attacked. And from her response to some of the statements made to her she clearly felt like she was being attacked, at least to some degree. It's just not necessary! Further more, though all were pretty quick to point out, and seem to still be, what she did wrong, no one really answered her question of why didn't they tell her "why" before they showed her the door.

YES!!! Without a doubt she could have avoided the WHOLE experience had she followed the instructions. But having been in her shoes in the past, I know that those letters are usually very poorly worded and less than informative. They sometimes leave LOTS of room for interpretation. I have misunderstood letters that I have received in the past from these agencies, and the number one lesson that I walked away with was to NEVER assume you understand the letter. ALWAYS call for clarification even if you think you understand it. In doing so, I have been told that I was sent a letter by mistake, or that all the info had not been included, etc, etc... These people are sooooo overwhelmed that sometimes they make mistakes. I therefore would reserve judgment on this woman for not being a good little soldier and not just conforming. Furthermore, I think, rather I know, that the general populous,and if the shoe fits,....,if they have not been ill with a long term illness, or injury you can't have a clue what that does to your brain and your ability to understand and comprehend what you read on occasion. And don't shoot back that if that's the case then they should have a friend or family member advocate for them. That's a nice thought, but not always possible.

Furthermore, it's great that people are here and are willing to give free advice to those that need it. Notice it doesn't escape me that it's free. I still think that that advice, opinion, thought, whatever, can be delivered without making someone feel bad for having written in and ask a question.

I have a very serious situation (serious to me, you might not think so) that I really wanted to write in and ask for advice on how to handle, but based on the way some have responded to the original writers post and the "how dare I" air in the responses to my first post...there is no way I would feel comfortable asking what I need to ask.

Simply put, I see no reason to belittle someone in your response.
 

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