How are you this dumb????!!!!!!!!!!!!

[dorky_goddess]

I'm a military dependent, with multiple sclerosis.  This means that 1.  I have to have a referral sent to my insurance company, Tricare, if I want to be seen by a specialist,  2.  The referral must be put in by either my primary care doctor, unless I'm currently being seen by a specialist, who feels I need to be referred to a different type of doctor, and 3.  Usually, appointments with the primary care doctor (PCM-primary care manager) are booked solid for weeks at a time.

I was given an MRI by my orthopedic surgeon, who found MS lesions on my brain and spine.  He then referred me to my neurologist, to be diagnosed officially.  I was diagnosed, placed on treatment, and prescribed pain and anti-fatigue medicine.  The treatment is in the form of a shot, and a month's supply gets shipped to my home.  However, I have to be seen by my neurologist every month to get evaluated, as well as to get another prescription for my pain and anti-fatigue meds.  Why?  Because generally, the pain meds that MS patients need are either narcotics or opiates, which means I have to physically go in, to get my blood tested, to make sure my liver and kidneys are still functioning.

Referrals are given out easily, but they only last for about 8 visits.  If the specialist feels that the patient still requires his services, he will have his staff either extend the referral before it expires, or at least remind the patient before the referral expires, so they can call Tricare themselves.  Because it's easier and more efficient for the staff to call and extend the referral, and because a patient will more than likely lose track of the visits, usually they do it themselves.  Now, here's the problem:

My referral expired on Oct. 17th, and I'd lost track.  I lost track of my visits, because it takes  more than one visit to the neurologist to be diagnosed with MS.  The first visit is the initial evaluation, where you tell the neurologist your symptoms, and he schedules you for a spinal tap.  The second visit is the spinal tap, but my neurologist managed to mess up my spinal tap the first time, so I had to reschedule one at the local hospital that he's affiliated with.  I didn't even realize that counted as a visit!!!  After the results came back, I had to schedule an appointment just to come in for him to tell me that "Yes, you have MS."  He gave me a shitload of medicine brochures to look over, then told me to come back in about a week or two when I've decided which treatment I want to start.  So, I had to schedule that appointment, then wait another two weeks because he and his staff had to process my request and send it to the pharmacy that would be mailing my treatment to my home every month.  Meanwhile, I was still sick, and I had to go out of town for my granny's funeral.  So, I had to schedule an appointment, just to get some pain meds to hold me off until I came back home, and my meds would be ready.  Then I got back home, and all of a sudden, now I have to go into the office for my first injection!!!!!  Yeah, you get the drift now, don't you?!

Finally, it got to the point where I only needed to see him once a month, in the fall.  Even though they knew my referral was about to expire on Oct. 17th, they scheduled  me an appointment for Oct. 24th.  I went to the appointment on Oct. 24th, and was scheduled for another appointment on Nov. 24th-- a Monday.  On Sunday, November 23rd, I get a call from one of the daffy bitches in his office, telling me that I have a balance that needs to be paid, and that if I don't pay it, she was gonna cancel my appointment-- for NOVEMBER 24TH!!!!!  Last minute, much?!  She didn't give me any other information, so I had no choice but to cancel my appointment, because I assumed it was a minor glitch with Tricare that could be taken care of on Monday.

I called Tricare on Monday-- the day of my now canceled appointment, and the rep explained that the neurologist's office forgot to extend my referral.  Obvioulsy, the neurologist still felt I needed to be under his care, since he told his staff to schedule me an appointment for November.  When I called his office the next day, I spoke to the same daffy bitch who'd called me on Sunday, who proceeded to tell me that it wasn't her job to renew my referral, and that they deal with so many Tricare patients, that some are bound to "slip through the cracks".  Notice that I have that last phrase in quotation marks?  That's because those were her exact words to me!  The bitch flat out told me that I slipped through the cracks!  What the fuck type of shit is that to say?!  I don't know if I'm more shocked at the fact that they actually let this shit happen, or the fact that she basically admitted her fucking incompetence over the phone to me!!!!  How is she this fucking stupid, and working in patient care?!

After she finished her failed attempt at defending her stupidity, she told me she would call Tricare and renew the referral.  Unbeknownst to her and me, because she let the referral expire, she can't call Tricare and extend it!  This now means that I'm gonna have to start all over again, and get a new referral, from my PCM.  This is a problem, because 1.  My PCM didn't give me the referral in the first place, 2.  I can't go back to my orthopedic surgeon, because he's a specialist-- whom I'd need a freakin' referral for!, 3.  My neurologist didn't notify my PCM of his diagnosis for me, so they've got no flippin' idea that I have MS.  They don't even have any medical records for me concerning that, because the stupid neurologist didn't do what he was supposed to do., and 4.  Even if #3 weren't true, appointments are booked solid until December 23rd!!!!!

So let's review:  I am now out of migraine meds, pain meds, nerve meds, and anti-fatigue meds at least until December 23rd, because my neurologist and his staff don't have the good sense God the Almighty gave a fucking goldfish!!!!  And technically, it'll take about 7-10 business days for the referral to be approved, and since there are two holidays in between those business days, I'm probably not gonna get seen by the neurologist until the second week of January-- best case scenario.  Merry Fucking Christmas!!!!!!!!!!!!!!!!!

[damira]

Dec. 1, 2008 at 10:53 AM

for you and for the secretary

[SusieD250]

Dec. 1, 2008 at 11:08 AM

Have you spoken to the neurologist? He needs to know what is going on in his office. And he needs to call in meds for you. CALL your PCM and tell them what is going on and get a referral. They can retro a referral so that you don't owe. DO IT NOW before the time for filing is over.  That way they can refile that last appointment. I am not sure how long Tricare has for filing. There is no excuse for a  patient to be treated like this. I'm sorry!

[KristiS11384]

Dec. 1, 2008 at 11:15 AM

Yeah Tricare sucks ass!  There's a million hoops to jump through just to get the simplest thing done(like a DEPO shot)  much less something like MS.  Sorry about the  idiots you have to deal with!

[dorky_goddess]

Dec. 1, 2008 at 11:47 AM

Susie:  My neurologist works out of two offices, so I called the second office right after I finished posting this vent.  That office staff is way more competent, and I'm now waiting for the Tricare specialist who works in that office to call me back, to see if we can get this mess sorted out.  I wouldn't dare leave another message for the doctor at the 1st office, because they've "taken messages" for me to him before, and they all happen to get lost.  I called the family clinic at the base hospital, and they offered to make a telephone consult to see if she'd call in the referral, but because they don't have anything other than my EFMP packet on file that tells them I have MS, I might have to try and get the initial records from the orthopedic surgeon.  Having the records mailed could take weeks.

(Original Poster)

[dag57]

Dec. 1, 2008 at 11:19 PM

I am so sorry Leah......like you don't have enough damned stuff to deal with....ARGHHH.......can your doc get your some samples from a pharm rep????

[dorky_goddess]

Dec. 1, 2008 at 11:41 PM

I have to actually make contact with my doctor, in order for him to get me samples!  lol!  I've got 8 days worth of migraine medicine right now-- IF I only take one dose a day; if I should need an extra dose on any given day, I am screwed!  I have no more nerve meds, and no pain meds, and only about 4 or 5 days worth of anti-fatigue meds.  All I can do is hope my PCM has enough info on me in the system from my past referrals to my orthopedic surgeon.  If he does, then I won't need an appointment, and he can put in my referral over the phone.  I still won't know anything until Friday.

(Original Poster)

[dorky_goddess]

Dec. 1, 2008 at 11:51 PM

My neurologist doesn't have his own personal voicemail box, or even a fax number where only he could be reached.  All messages for him have to go through his good-for-nothing staff.  Talking to his staff is like  So, the only way I could possibly get another appointment, is through my PCM.

(Original Poster)

[rcullens]

Jul. 3, 2009 at 11:57 AM

Other people's children. LOL