article re Medicaide payment to providers

[dreamer]

www.northwestherald.com

state senator Althoff was quoted saying "Tom my knowledge, there is not one(private practice) physician in the county that will take Medicaide patients"
Yup, that has been my personal experience, and it is a huge problem. It makes my daughters coverage useless. She has been seeking a doctor for her high blood pressure and bipolar for 1.5 years. Becuz she has no doctor, so is not under medical care, she is going to lose her soc sec.
But many private practice docs cannot afford to accept Medicaide- it takes far too long to reimburse providers and does so at such a low rate. :-(

 

[DammitJanet]

That makes no sense to me. I know of only one doctor in my area that doesnt take Medicaid or Medicare reimbursement. That doctor is a dermatologist. Well, I take that back.. there are a few dentists that dont accept it but there are plenty who do.

Maybe its because we live in a poorer rural county and if they didnt take medicaid then they wouldnt have a client base at all but when you look at some of the houses they live in...well they seem to be doing just fine!

 

[dreamer]

Our county is rather affluent, origianlly a rural farming county, it has caught attention and has drawn a very affluent crowd the last 20 years. Our population has doubled and even tripled or quadrupled in many of our towns here in last 10-15 years....
BUT even several years ago when the whole family was on Medicaide, we had grave difficulty finding a doctor to accept the Medicaide. I remember maybe 10 years or so ago, an article in paper (backed up by letters to providers) that docs could not be guaranteed tobe reimbursed at all for services given thru Medicaide, and Medicaide is who sent that article out.

It is further compounded by our local hospital ERs while not openly and obviously not treating patients with Medicaide, they undertreat, and discharge without exams, evaluations, tests- they discharged my husband after a motorcycle accident and I took him straight to military base hospital, and THEY admitted him to ICU for 3 weeks.- He had a head injury, liver injury and extensive road rash and a messed up shoulder that had him in PT for over a year. THey refused to set both of my daughters broken arms, saying they do not set broken arms, but- not a one of the ortho docs accept Medicaide, either.
Many people I know have truly scary and horrible horror stories re Medicaide here. Closer to the city, you can find more docs to accept Medicaide, BUT, often if we go there we are told we are not "from their service area" Ironically, our community clinic, they will not see Medicaide holders.....yeesh. They ONLY accept totally uninsured people, on a sliding scale fee service, cash up front. BUT they also do not dispense any medications and are only open 2 days a week, by appointment only- no walk ins.

 

[dreamer]

On a side note, our local food pantrys? where people faceing difficult times can get help with getting some food? In order to go there and get food, you must have three written referrals from specific agencies (such as battered womens shelter, mental health facility, and county health dept) - and then you can come once per month, on a tuesday between 9 am and noon, and they will give you x items depending on family size and ages of family members.....our family of 5 many years ago, got one grocery bag, it had 1 box of cereal, 5 pkgs sugar free jello, a can of spam, 2 cans tuna, one bag of cornmeal, one loaf bread, one pound hamburger 2 pounds pasta. You were allowed 3 visits in one year, but each visit had to be 30 days apart or more- and each visit had to be by the 3 referrals.

We have a homeless shelter, it is at a different church in the county each nite. Males are not usually allowed....there is no trasnportation from one facility to the next- and they are many many many miles apart from each other, so where you stay tonite is quite far from where you stay the next nite. You must be there by 6 PM and gone by 7 am.....(it is not open in warmer months) so our county wanted to build a day shelter for people to have access to newspapers for jobs, somewhere to take a shower, clean up, maybe with washer and dryer? It took several years becuz all the communities kept saying "we have no need----and we do not want to "encourage" homeless to be here in our county" Yeesh.
At one time when I had WIC and my kids got free school lunch, a parent volunteer from our school found out and blasted me hard ...wanted to know what my problem was to ask for such a thing as free lunch? _ screaming such things at me at a school event. `Our county - I think they think if they pretend there are no problems or difficulties anywhere, then maybe there won;t be any.

 

[flutterbee]

I know that in my area, it's not too hard to find a pediatrician who takes medicaid, but finding a doctor for an adult is harder. Not impossible, but there will probably be some travel involved. Same with dentists. I actually don't know of any dentists that treat adults that take medicaid. And the ones that do are the ones that just pull teeth instead of doing a root canal.

Our food pantry can be used by a family 3 times per year. There are other agencies - churches and such - that offer food pantries, but I don't know how that works.

For the longest time, we only (only - that sounds so terrible) had one homeless person in our town and everyone knew him or of him. He's a schizophrenic named Raymond, I think. Then there was another homeless man and a local church opened a shelter.

 

[Tiapet]

Back in PA in the area I lived you found that was close to being the same too Dreamer. Doctors were hard to come by, especially for adults and of the ones that did take it they weren't very good. You were lucky to get a pediatrician too but they were more bound to provide care because it was a child. Forget about dentistry! UGH! NO ONE basically would cover that at all unless you traveled a really long distance. I saw about your pain clinic problem to in another post, that too was a very very big issue! It is very hard to find a pain clinic that would take you on and even if you had a doctors referral and a very clear case, good luck! You'd have to travel 3 hours in hopes they'd take you. I was even turned down by Hershey medical at one point. They wanted me to go to John Hopkins in MD (which would have been 5 hour drive!). They said "go back there". I had never even been there for any kind of pain treatment or consult ever to begin with?

Now down here I have found no problems finding any doctor, dentist or otherwise to take Medicaid for kids or adults. I don't know why that is. Janet said she is in a more rural area but it seems to me that this state in general has a lot more available md's ( of all specialties) who will take it (having looked into it for not only the county I'm in but several of the surrounding counties encompassing where I'm in).

Any chance on making a move? lol j/k

 

[klmno]

Thanks for bringing this up, Dreamer. I saw your repsonse to my thread about insurance, too. I need to keep these things in mind since I am having so much difficulty finding an available psychiatrist to replace difficult child's unresponsive one, and he is still on private insurance right now.

 

[flutterbee]

klmno -

It does vary by area. Generally speaking, you are going to have an easier time finding a medicaid provider for a child than an adult. I live in an affluent county and people have no trouble finding a provider for their children. If you have medicaid (or even if you don't) you can access mental health services through your local mental healthy agency. You should also check out your children's hospital and their behavioral health unit. Probably the sooner the better as there is more than likely a wait to get in. More than likely, children's will accept medicaid.

 

[klmno]

Thanks, Heather! I got discouraged because the psychiatrists I called earlier this week were not accepting ANY new patients- regardless of insurance. I want to look into the other links you gave me too, to see if more providers accept them than medicaid. I have put it on the back burner because of preparing for difficult child's court in June and just wanting to keep same insurance and providers until then. Except psychiatrist- he's unrepsonsive so I have to find another one.

 

[DammitJanet]

For some reason I think that the Carolina's have set up so that doctors accept medicaid. I think NC is a bit better than SC. I have yet to find any hospital in NC that wont accept Medicaid but I did find one in SC that wouldnt accept it unless it was an emergency. Now in an emergency they certainly didnt skimp on the care! I had a miscarriage and was rushed to that hospital and they admitted me and took very good care of me, no problems at all. Also one other time Cory drank a poison and they took him right in. They just dont routinely take medicaid patients if they can make it to the county hospital.

Here in NC I have only found one Dr that wont take medicaid for an adult and that is a dermatologist and he will take it for a child. Maybe we have a law down here or something that says if they take ANY insurance they have to take medicaid?

 

[Wiped Out]

I also live in a fairly affluent county. We have not had any trouble finding providers who take medicaid for difficult child. In fact, we have had as good of access as with our regular insurance which is also really great.

 

[dreamer]

I just had to swallow hard to see that what we once knew from experience is now being admitted to by state rep in newspaper.
ANd yes, difficult child is now "an adult" - but, it did not make much difference here, when the kids were small and we hit some hard times and got Medicaide, even then, we had enormous difficulty and yes dental? OMG! We DID find a dentist, it was a mere 2 hour drive (compared to the 5 hours for my sons current eye doctor) BUT we went there twice a year for 3 years, and very often when our school district did in school screenings, we would get nasty nasty letters commenting that we NEEDED to go to a dentist, and get a large amont of work done.one time the school screening was the day after our trip to dentist where dentist once again proclaimed all 3 kids cavity free and doing well. Another time easy child broke her top front tooth at school, and it took months before we could get any dentist to even LOOK at her mouth- ER turned her away, her regular medicaide dentist said they were not cleared to fix such problems, and at least 6 other dentists refused to see us simply becuz we did not have dental. We wound up traveling to a further away city, at a homeless dental walk in clinic, arriving by 7 am, first come first served.

Our "affluent" county has the idea that if they pretend something is not happening, then it isn't, and if they turn their back on things, those things go away and occur elsewhere..very far away from their own back yard. It is not a charitable county in any way shape or form. Nor is it a very friendly county. Heck, the state of the court system and police etc is yet a whole nother huge mess. <sigh> if only I had known when I fled chicago hoping to get away from chicago/cook county corruption. :-( I am so glad it is only difficult child and not the rest of us anymore who have to cope with Medicaide.