Just a Vent (sorry its long)
UGH..I hate Tricare so much sometimes!!
Ok so when DH and I first got stationed here in VA I went and saw the PCM at the MTF. They evaluated me and basically told me that I needed to be seen by an RE (duh!) So the PCM referred me to a civilian provider which is my RE that I have been seeing since then. She has been with me for all of my losses except Bradley (we lived in NC then) So now that I am pg again she has been following me for the past two weeks and said that once I reach 10 weeks she will be referring me to Maternal Fetal Medicine (high risk OB) Well there are two options for this, they have MFM at Portsmouth Naval Hospital (which is about 45 mins from where we live) and then there is the MFM Clinic which is related to my RE office which is 20 mins from where we live, my RE prefers I go to that MFM since she is familiar with all the doctors and I would be delivering at the hospital which is attached to the Children's Hospital (just in case I deliver early again we would be closest to the best available NICU) Well yesterday I called Tricare to find out what I need to do in order to get a referral to the civilian MFM clinic. They gave me this HUGE run-around and said I needed to call the Women's Health Clinic and make an appt to be seen by a regular OB and then they will refer me to high risk OB, I told them that I am not followed by the womens health clinic for GYN services that I am seen by a civilian provider. The tricare agent then said "oh then your military PCM needs to write the referral" So I call the appointment line to make an appointment with the PCM and when she asks what the appt is for I tell her "I'm pg and I am followed by a civilian RE and now I need a referral for high risk OB services" She proceeds to tell me that my PCM can't provide a referral for high risk OB that only the women's health clinic can!!!
So I call the Women's Health Clinic and when I tell the girl everything including what tricare said she says "Well what makes you believe that you are high risk, cause some people think they are when they really aren't" By this time I was so fed up with being jerked around that I told her " Well first of all I am high risk because a RE with 21 years of experience thinks I am and secondly because my first pregnancy resulted in a cerclage at 11 weeks, I had preeclampsia by 20 weeks and my placenta abrupted at 24 weeks causing my son to have a stroke and was a stillborn; not to mentioned the two miscarriages I suffered after that" She kinda took a deep breath and said "Oh yes then you are defintely high risk" DUH! Did she think I would lie? Anyway...after all that she tells me that I need to call Tricare back on Monday morning and make an appt with my PCM and there will be a note in the system saying that I have been referred out by the Women's Health Clinic.....I hung up feeling like I had fought a 6 round boxing match!....UGH..sorry this was so long but I'm been upset about it since yesterday and I needed to vent.
Re: Just a Vent (sorry its long)
Ugh, I understand how that goes. I went through about 10 different people before getting everyone to coordinate and figure everything out. I think I was almost 12 weeks along before I FINALLY saw a high risk OB thanks to the damn run-around. In the end I went to my RE until 8 weeks, then had to see my PCM for a referral. The referral was just for an OB, so I still couldn't see anyone high risk until after having my initial appointment where they go over history and everything. And of course the wait for the initial appointment was almost a month. Luckily the NP doing that appointment was awesome and got me in with a HROB that same day. I think she could tell I was about to have a nervous breakdown in her office.
Good luck with everything! I hope your pregnancy is easy and very uneventful.
Living in VA is exactly why I switched to Tricare Standard. I got so fed up with go around in circles trying to get care with the PCM and MTF.
Good luck hope you get some answers on Monday.
Parking and tunnel traffic aside, the MFMs at Portsmouth are wonderful. I saw several of them because of my PTL with DD. They supposedly have a great NICU too.
Yes we are at Langley and so is my PCM but I hardly ever see him because my health problems are handled by civillian specialists so the only time I ever go to Langley Family Practice is for flu shots and referrals. It terrifies me to think about trying to make it to Portsmouth while I am in labor!! I mean the other day I had to drive to Virginia Beach and it took me three hours to get there because there was an overturned truck in the HRBT!!! What would I do if we got on the freeway and got stuck in traffic...it's a good thing I'm an RN cause I would probably end up delivering my own baby!
It terrifies me to think about having to take a tunnel to the hospital while I'm in labor. I drove to VA beach the other day and it took me three hours because of an accident in the tunnel.....I absolutely hate that you have to take bridges and tunnels to get anywhere in this city!
Yes, she did think you would lie.. because people lie about a lot less. Or if you look back at the one post about early induction, you can see a perfect example of how people lie to doctors, so lying to office staff isn't a big deal. If someone would lie to get an early induction, people would totally lie about being high risk.. kwim?
Sorry you are having issues with Tricare. Maybe you can try the patient advocate on base? They might be able to help cut through all the bs. GL!
It scares me to think that someone would lie about that, I mean what is the benefit of lying about that type of thing? Most people (myself included) want a normal healthy pregnancy not one where they have to constantly worry if something bad is going to happen. Not to mention that being high risk means a ton more appointments and tests which I personally don't find fun. I mean right now I am going every other day to get beta/p4 drawn...my arms look like I got beat up and the last time it took her three sticks and 45 mins just to get a vein to cooperate enough to get one vial...if anyone likes doing those type of things and would lie about their pregnancy status they have serious issues! It is amazing though what people will lie about... I mean look at all that MUD on 1st Tri...
I will defintely be calling the patient advocate if they refuse to make me an appt with my PCM for a referral..I did everything they asked of me and now they need to hold up their end.