Help, My Grandson Is Stuck with a Provider Who Treats His Mother Horrible!

Updated on February 15, 2008
S.M. asks from Webb City, MO
10 answers

Does any one have any insight into the new medicaid law that says you cannot change your provider once Jan 1, 2008? I have researched the web like crazy and can find nothing specific. I wish I had caught on sooner. My daughter is in her teens and still in HS. Though I HATE that she ended up pregnant, I now have a beautiful grandson! The baby ended up having RSV and spent a night in the hospital and I stayed home the next day to watch him. He had a very serious episode of wheezing and extreme coughing, so I took him to the doctor. He proceeded to tell me that my daughter treated the chilc like a dog and he would never get better. That's just the tip of the iceberg. I had my daughter call all the pediatricians in the area and no one will see him. Help!

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So What Happened?

Thank you ladies for all your wonderful advice. I have found a NP at a local clinic that will keep my grandson up to date on well baby things and a pediatric hospitalist who will see him if he is ill. I have also fired the cranky physician. Thank you!

More Answers

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C.S.

answers from Bloomington on

Sorry to hear that a DOCTOR would have such little regaurd to your daughters' parenting skills. I was too a teen mother. I know the hard ships that come with it. What might help is to go above the doctors head and let his boss know. It might not do awhole heck of alot. But aleast it will be known that this doctor is not so nice. Not sure if you are in the Illinois area but I know a few doctors that might be helpful if ya are. But other then that just tell your daughter to keep looking or call the local public aid office and see what they say.

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D.B.

answers from Wichita on

looks like you got some good advice concerning the doctor situation. Also you might consider some holistic methods of helping him. Email me ifyou want more information ____@____.com

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A.X.

answers from Tulsa on

What plan is he on? This came right off of the MO HealthNet website:

How can I change my MO HealthNet managed care health plan primary care provider?

You have a right to change the primary care provider in your MO HealthNet managed care health plan. You can change at least two times each year. Some MO HealthNet managed care health plans may allow more. Children in state custody may change their primary care provider as often as necessary. To change your primary care provider or to find out more about your MO HealthNet managed care health plan, call the membership services number on your managed care health insurance card.

If all of the physicians in the area refuse to see him though... you may still have a problem. It really depends on the reason they said they wouldn't see him. It could be that they simply said that because he's a patient of another dr. Could be that your daughter gave too much info when she called. I would not mention any dissatisfaction with the other doctor when trying to change. I'd just say that their office was recommended or that it was closer to school/home/work/babysitter/whatever.

By the way... here's the website where I found that info:

http://www.dss.mo.gov/mhd/faq/pages/faqpart.htm

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L.R.

answers from Kansas City on

Have you tried Pediatric Partners? They are located in South Overland Park.

I can't see why you couldn't change pediatricians. It's your progrative on what doctor you want to see your grandbaby.

Good luck to you. Hope your grandbaby gets better.

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M.P.

answers from St. Louis on

I work with medicaid on a daily basis at work. I file medicaid for pts and we just went through this with our son as well. You DO have the right to change your provider. When we did for our son, it was because we could not find a doctor to take the provider either. It took about two hours of calls, but do not stop until you get it. Please let me know if I can help futher

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R.

answers from Columbia on

I'm not sure where you are located, but I work with physician's and hospitals in the Columbia area. If you have straight Medicaid, then you can go to any Medicaid provider. If you have an MC+ health plan then you have to go to a provider that accepts that health plan. I would suggest your daughter call Medicaid and file a formal complaint against the provider, and ask them what she needs to do to be able to see another provider. It is ridiculous for a provider to say those types of things! No matter what the situation, they have no right to say anything to you or your daughter. Also the state of Missouri Medicaid has a website for participants, you may check it if you haven't already, it's http://www.dss.mo.gov/mhd/participants/index.htm
I hope everything works out for all of you. Not all providers are like that.

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D.E.

answers from Springfield on

who is the provider? The child is what matters, not anything else. No one should smoke around this child. I don't know medicaid rules, but I do know that hospitals like st.johns claims to take anybody no matter what.
D. e.

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C.D.

answers from Springfield on

I'm not familiar with any new laws regarding medicaid but maybe you and your daughter should have a discussion with the baby's pediatrician. He obviously made that statement for a reason, it doesn't neccesarily make him a bad doctor, just a straightforward one.

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S.B.

answers from Wichita on

As long as the new provider accepts medicaid you should be able to switch whenever you want. It is my job to coordinate health care for people with disabilities, and i have helped some of my clients change providers with no problems at all. Also, as far as the way they have treated your daughter, they should be reported to the AMA.

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H.C.

answers from Enid on

You might try Newman Memorial Hospital @ Shattuck I have found that the drs there are really nice. We usually either see dr Dersch or dr Berry. Dersch was there for the delivery of my youngest daughter and my oldest daughter and my son both see Berry.

I hate the drs here in woodward!!!!

When I was PG I went to one dr here who told me that even tho I had already had one ultrasound I would need at least 3 more, and I according to him was high risk for diabetes, and high blood preasure. I walked out and swore I would never go to him again....that I would rather give birth at home first before I ever let him touch me or my child!

My boss linked me up with dr Dersch and I was able to see her just twice before my daughter was born. She understood that previously I had used a midwife who I loved so when I was in labor she just let me be in charge and told her nurses to watch and learn. She just sat back and held my hand and told me I was doing fine and asked me if there was anything I wanted her to do. I pushed for about 10 minutes on my hands and knees and she was born DR D handed her to me and then instructed my husband on how to clamp and cut the cord. I have never been treated so nice by a DR!

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