2.10.2005

Tricare - a shining example of the pitfalls of socialized medicine

So Little Man comes down with a rash 2 days before we are scheduled to leave and fly to CA and then on to Hawaii. Of course it's a Saturday so there are no appointments to be had. The earliest I could possibly get him in is Monday but The Husband will be doing his final clearing then (mind you, we have 1 car at this point) and most likely, they wouldn't be able to get him in anyway.

We are due to check out of lodging with our 10 pieces of checked baggage, 3 pieces of carry on baggage, 2 car seats, and kids at 1200 hours on Monday and be on the road to the airport no later than 1400 (that's 2pm for those of you not familiar with military time). There was no way.

But the rash didn't seem bad and it didn't seem to bother him - no fever, no other symptoms. Nothing. By Monday, the rash is worse but still not awful and I finally figure out that maybe it's his amoxicillin that is causing it so I stop giving it to him. He was supposed to be on it for 10 days but he got 8. Ah, well. I figure if it is the amoxicillin that is causing it, it will go away now that he's off the med. Nope. By the time we get to CA, his rash was worse. A LOT worse. I started thinking it might be the Measles so I called Tricare to get authoirzation to take him to a local Pediatrician that I know accepts Tricare (had to take Princess Trouble there once when she was a baby and we were visiting LA). I spend 30 minutes on the phone with a rep from Tricare who eventually tells me I have to call back to our clinic and get authorization from our PCM (Primary Care Manager) - Tricare can't give me the authorization. So I call our clinic and speak with the Triage nurse. I tell her the situation and she very curtly informs me that she can't do anything for me and that I need to call Tricare for the authorization. Excuse me? I try to explain that I *just* got off the phone with them and they informed me that the responsibility lies with my PCM, not them. She tells me no...it's TRICARE'S responsibility and that I need to access the Health Care Finder system to get authorization and then HANGS UP ON ME.

I was good - I didn't call back and ream her out. I called Tricare back and spoke with yet another rep and explained the situation, once again. He told me that he didn't know why the nurse at our clinic would not help me - it's THEIR responsibility - but that he would put in a note that I tried to gain authorization but could not and then he tried to transfer me to Management. After another 15 minutes on hold, I gave up and hung up. Called the Pediatrician's office and got Little Man an appointment for the next day. Had I been able to call that morning rather than sit on the phone all morning long, I might have been able to take him in that day. But no. Gotta love Tricare.

I never did get authorization. Took him in this afternoon and when we get there, the receptionist asks for our insurance card. She calls them and they tell her that Little Man isn't in the system. The rest of us are but he is not. ????? So I get on the phone and find out that not only is Little Man not in the system (I've personally been to the Tricare Service Center twice to rectify this matter), our eligibility address was at one location while our CLAIMS address was at another. And, of course, each address is in a different region so he had no idea WHO to direct me toward.

I finally said screw it and hung up. Told the receptionist that I would just pay cash and deal with these idiots later. I have $10 that says they deny my claim because we didn't have "out of network authorization from Little Man's PCM".

Those of you who like the idea of the government (or any other large scale buracracy) running any aspect of your life, beware.

There is a military acronym "CF" or "Charlie Foxtrot". That is what Tricare is and that is what any kind of socialized health care system will be. Those of you who don't know what a "CF/Charlie Foxtrot" is, e-mail me and I'll let you know.

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