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Patient Abandonment

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jgirl1730

Junior Member
What is the name of your state (only U.S. law)? Illinois
I had extensive cervical spine surgery and was forced to go on public health insurance (medicaid) temporarily. I recieved a letter from Illinois Health Connect stating I needed to pick a PCP. The letter did not state that my current provider may not be a provider with the program therefore I did not immediately get online to choose a different provider. My assumption was "well, I already have a doctor so I don't really need to do that." I have been with this provider for approximately 10 years and I have a chronic condition that I must take medication for and I have to see him every 3 months to have the medication refilled. I was on my last refill and was starting a new job (which has a 3 month probationary period during which I can not request time off). I made an appointment with my physicians office so I could have my refills covered before starting the job. When I handed the receptionist my public aid medical card she said "is this all you have, no other insurance"? When I told her I had no other insurance she said he couldn't see me. I was also told that I could not self-pay with a medical card and that they could not call me in any prescriptions due to the fact that I had a medical card. Didn't my physician have a duty to at least see my that day, prescribe my refills and at the very least explain to me that he would not be able to by my doctor anymore and why and to provide me with resources to assist in finding another physician. As it stands now, I was turned away and I have no medication refills and I can not get time off from my new job to see another provider before I run out of meds. I know rules are rules and I understand if I have to find another provider but doesn't the way his office went out it constitute patient abandonment?????What is the name of your state (only U.S. law)?
 


barry1817

Senior Member
medical

What is the name of your state (only U.S. law)? Illinois
I had extensive cervical spine surgery and was forced to go on public health insurance (medicaid) temporarily. I recieved a letter from Illinois Health Connect stating I needed to pick a PCP. The letter did not state that my current provider may not be a provider with the program therefore I did not immediately get online to choose a different provider. My assumption was "well, I already have a doctor so I don't really need to do that." I have been with this provider for approximately 10 years and I have a chronic condition that I must take medication for and I have to see him every 3 months to have the medication refilled. I was on my last refill and was starting a new job (which has a 3 month probationary period during which I can not request time off). I made an appointment with my physicians office so I could have my refills covered before starting the job. When I handed the receptionist my public aid medical card she said "is this all you have, no other insurance"? When I told her I had no other insurance she said he couldn't see me. I was also told that I could not self-pay with a medical card and that they could not call me in any prescriptions due to the fact that I had a medical card. Didn't my physician have a duty to at least see my that day, prescribe my refills and at the very least explain to me that he would not be able to by my doctor anymore and why and to provide me with resources to assist in finding another physician. As it stands now, I was turned away and I have no medication refills and I can not get time off from my new job to see another provider before I run out of meds. I know rules are rules and I understand if I have to find another provider but doesn't the way his office went out it constitute patient abandonment?????What is the name of your state (only U.S. law)?
Welcome to the world of government run health care.

There are instances where if a doctor violates the rules he faces substanial penalties and one can't expect a doctor to not only treat for free, but to be subject to penalties to do what you wished.

It might have been a kindness for him to just phone in a prescription, but then you have the problem with a doctor prescribing to a patient that has the health coverage you do and it goes back to him.

And when you read the 2000+ pages of Obama's health care, it doesn't get any better.
 

jgirl1730

Junior Member
If that were the case, that he wouldn't be subject to discpline etc if he called me in a script, why didn't they tell me that? The receptionist just kept saying no he can't see you, no he can't call in a script. No explantion, no reference to legal implications, just sent me out the door. And I believe that legally they had to give me information on where to seek treatment due to the fact that he wouldn't (couldn't) see me which they didn't.
 

jgirl1730

Junior Member
ecmst12~ No this isn't about money. It's about my dignity and how belittled and betrayed I felt when I left the office. !00% my fault for misunderstanding the system?? Oops, excuse me. Yes, I'm aware now that I need to find a different PCP because my current provider is not one but I honestly did not realize at the time that he was not. The letter did not spell out that my current provider might not be a participating provider and (thank goodness) I'm not familiar with the way the whole Medicaid system works. Contrary to your post on here I do not want to sue, heck I don't have the money to secure a lawyer anyway what I am looking for however is maybe a little leverage to use at my doctors office to at least get meds until I can get to another provider so my health doesn't suffer. I'm more scared than angry honestly. I grew up with my parents owing their own business and have seen my fair share of sue happy people; please don't label me in that category.
 

ecmst12

Senior Member
You were told EXPLICITLY what you needed to do and you chose not to do it! How could that possibly NOT be your fault!
 

Zigner

Senior Member, Non-Attorney
If that were the case, that he wouldn't be subject to discpline etc if he called me in a script, why didn't they tell me that? The receptionist just kept saying no he can't see you, no he can't call in a script. No explantion, no reference to legal implications, just sent me out the door. And I believe that legally they had to give me information on where to seek treatment due to the fact that he wouldn't (couldn't) see me which they didn't.
There is no requirement for them to explain the details of YOUR coverage.
 

jgirl1730

Junior Member
I understood it to be a request to assign a PCP to my account, not a requirement. As I stated, I misunderstood what they wanted me to do. I'm a registered nurse and I know that no one is perfect and people misunderstand instructions all the time and many times they must be re-explained and re-inforced and when that happens it doesn't help to go into blaming mode (as you are here). Yes, my fault but I was shown NO empathy or compassion whatsoever!!!!! Very disappointing.
 

jgirl1730

Junior Member
I have been all over the internet today and there is NOTHING that says my current PCP is NOT ALLOWED to provide any care to me at all because I have medicaid. I guess it all boils down to customer service and how to appropriately terminate the physician/patient relationship. I think his office handled it very poorly. In about a week I'll again be covered by private insurance but I'll never forget the way I was made to feel at that office and will be finding a new doc because of it.
 

ecmst12

Senior Member
It is usually illegal for doctors who don't participate with Medicaid to see Medicaid patients and charge them for it. Because presumably, if you are on medicaid, you can't afford to pay out of pocket for your visits, so it would be exploitative to see patients that you know you can't bill their insurance and you know they can't pay you but bill them anyway.

Had you taken care of this when you were first notified, you would not be in prescription time crunch now.
 

jgirl1730

Junior 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.
 

jgirl1730

Junior Member
That's a good idea Cyjeff. If I can find one that will see me on a Saturday I'll definitely do that. Wish I were leaving my current physician on better terms.
 

cyjeff

Senior Member
That's a good idea Cyjeff. If I can find one that will see me on a Saturday I'll definitely do that. Wish I were leaving my current physician on better terms.
I wouldn't look at it that way. I would look at it as the doctor is dealing with so many rules set down by non doctors that he is scared to say boo.

Doctors are not lawyers... and they tend to avoid even a HINT of something that could get them investigated.

Why not see if HE will see you on a Saturday once you get your new insurance?
 

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