This request is about Tricare. Does anyone know how to file a grievance (complaint) against a doctor through Tricare? This doctor and his team is active duty or civilian (base clinic). They refused to see my daughter for suspected flu and even if I would get an appt with them, they told me that they would refuse to test her. That brought up several questions - like why not? If she has one strain, why do you want her to have all flu vaccinations anyway? (Please don't respond if you are against vaccinations, I am for them and have been injected with everything except anthrax) He told me that according to the CDC (per website) that they say not to test patients. Well, I checked the site and no where does it say NOT to test. I don't understand why some doctors are NOT testing - especially with H1N1 on the rise. I could go to an ER, but I don't want to risk paying for all of the ER visit if Tricare is telling my daughter's doctor not to test patients. I've explained to him and his nurse that I know other parents who children have been tested by other pediatricians - he said they are doing a disservice to their patients by testing. Does anyone have any answers? I'm getting frustrated. Thanks in advance!
Wow! You guys all have given great advice! She is slowly feeling better. Maybe my emotions got the best of me, so I'm glad to get some rational advice. It brought back bad memories of how they have treated my husband (knee pain - 7 years before they would give him a MRI for a torn meniscus) and my son (croup sounding cough - I suspected mold in his daycare) and myself (sciatica - base doctors refused to send me to a chiro). I was really emotional about getting her treated... and really needed to hear from someone else. I'm so glad I asked this question. I am still considering off-base care or switching teams. Thanks again! I will be printing these posts out and bring them to the hubby. You guys rock!
Hi T. - My ex is retired military, we have 3 children, not 1 of them goes to the base for healthcare. Never wanted them to. I use it because I am an adult and I know enough about my healthcare to make an informed decision, (plus it is free.)
Go off base.
M. F
T.,
I can't speak for Tri-care specificially. I think some of the insurances are not testing due to cost. Unless the patient is REALLY sick- it doesn't change how they treat. I think the recommendation is to only report deaths not morbidity (illnesses). The in office test they can distinguish between Type A & B, but not between sub-types. The seasonal flu & swine flu are both type A. testing is also being reserved for high risk patients (see links below)
http://www.cdc.gov/h1n1flu/guidance/rapid_testing.htm
http://www.cdc.gov/h1n1flu/identifyingpatients.htm
Keep in mind you are also dealing with Military. Their standards are often different than in the civilian world.
Hope the cdc links are helpful.
I have heard on the news many times that they are no long testing for the strain. He H1N1 has been reported to be milder than the regular flu and those that are dying from it already have neurological issues, immune issues or an underlying bacterial infection. I'm sure you can find another doctor to test but I'm sorry to say that I don't know who.
So sorry you are having problems with getting help for your child with tricare. I have a Disabled Vet husband and the only way I get help for him is to get loud. Unfornately this is the way health care will be if the government passes their bill for health care. Good luck with you little one.
I think Victoria said it best. If she has it or the regular flu you would be given the same instructions and treatment. CDC did recently recommend no longer testing everyone. The ERs were filled with people that had the sniffles and wanted to be tested for H1N1. Tremendous waste of time and resources. Is it possible they didn't want to see her also because her symptoms may not have been severe enough for an office visit?
Every year the most likely strain of flu virus is picked for the flu shot. Sometimes they are wrong and it's another flu strain so when you get the flu shot it isn't for all strains of the "regular" flu just the one they think will hit that season.
This is very tough because the media has had a field day with H1N1 coverage and made us all crazy scared.
There is a lot of confusion over the H1N1 out there. For MOST (not all, but most) people who have contracted it, it is nothing more than the "regular" flu. And from everything I have heard and read about it, by the time the test results are back, you would know whether you have a more severe illness to deal with or not. Also haven't found where any treatment is different based on H1N1 diagnosis vs. non H1N1 diagnosis. Treatment is the same based upon symptoms.
My son is in middle school and it was all over the news how rampant the H1N1 was running thru their school in particular the first several weeks of school this year. My son was sent home with a fever and not allowed back until 2 days later, just based on that alone. Even though he was symptom free. When I read more detailed reports from the local health office, turns out that once they confirm H1N1 is in an area they quit testing for it. So all these "rampant" cases at my son's school were basically guessing and paranoia at work!
As far as the vaccinations go, It is my understanding that the "regular" flu vaccine is ineffective against H1N1 and the H1N1 vaccines they are coming out with are ONLY effective against H1N1 and not other strains... which are also out there and statistically speaking, you have just as good (bad?) of a chance of contracting a potentially deadly case of "regular" flu. Thousands die from it every year.
I'm not defending your doctor, but I don't see what purpose is served by testing your daughter... if she is ill, treat her appropriately (which you don't need a confirmed H1N1 diagnosis to do as you only are treating symptoms anyway) and keep her home so she is not spreading anything to others. If she is not, then what is the problem?
I have heard from a healthcare professional that 1/2 of the H1N1 tests come back negative when they are in fact positive. Since both flus are treated the same, they are just treating with Tamiflu etc. since the tests are not surefire indicators and the diagnosis would not change the treatment anyway.
Hope your daughter is feeling better.
As far as complaining through Tricare, if it is a base clinic, your best bet is to talk to the patient advocate or write a letter to the Medical Group Commander.
As for why they are not testing, I have been told they are not testing because thy treat all Flu's the same and it is simply an added expense that gives no helpful info to the treating physician. If you become worried about your child's fever, hydration or breathing (the three biggest concerns) then definitely take your child to the ER and Tricare will pay, but if you go just for the test for H1N1 they may not.
I say this to you b/c I have had horrible experiences with the Navy hospital. GO TO A PRIVATE DOC. FACT: two weeks ago the same issue came up with a friend of mine. The docs at the navy hospital did not want to test her child for the H!N1. She knew something was not right with this case of the flu, she went out to a private doc and guess what, her son had the H1N1 strain. Do yourself a favor and see someone off the base.
I hope all works out for the best.
for everyone that has complaints about tricare or military doctors, there are many others who have very few or no complaints. Every system has it's share of glitches. Sometimes you have to speak up a little more.
In this case, I would let it go. Finding out what strain of flu your daughter has would not affect how they will treat her. Wasting time and money on visiting the ER would not be my first choice. Unless you can't keep her hydrated or her condition worsens, I would just keep her home (away from other people) and ride it out.
When you do have a legitimate complaint, you can contact the patient advocate. They DO listen, they DO report and things DO get changed or improved.
I've had tricare for more than 12 years now. Given birth the 4 children who also all use Tricare. I have no complaints. We've gotten every test we've asked for, every prescription needed and even a few surgeries along the way. And accupuncture!
Sounds like you've taken a moment and composed your feelings and are thinking more rationally. It's tough when the kids are sick and you can't do much to help out. But she'll get better. Hang in there!
My daughter went to the Doctors Walk In Clinic and was tested for the flu when she was sick because she is in college and not home.The tests the doctors office gives you does not tell you if they have the H1N1 virus. There is a special test that only the health department has. Our doctor said that he would have to give a flu test and then special order the H1N1 test from the Heatlh Department or send you there. Now if you do your research you will find that most doctors do not want to do the flu test unless they are pretty positive that the child has the flu. For one it's expensive. Second the child now has an open wound for infection and virus to get in. The test your doctor would give your child would not be the H1N1 anyways. It would be a regular flu test. Then if it showed the flu virus the child would then have to have the H1N1 test. These tests are limited and very expensive so they are trying to only use them when they are pretty positive that the person has H1N1. If your doctor woudln't test for flu then he/she was pretty positive it wasn't the flu....The doctor can't tell you from an office visit and a test if you have H1N1. He has to order a special test and then it takes five days for the results to come back stating if you have H1N1 or not. So these doctors that are telling people that they have it are not being honest with their patients. They are just guessing. Unless you have to wait five days then you are not getting correct results.
Also, my nephew is in the Marines and said that him, his wife and children get the best medical care you can get from the doctors there.
First, I am sorry you are feeling so frustrated. I can feel your pain! We try to be good and diligent parents to our children, which includes necessary medical care. Second, I know nothing about tricare, but I believe what the doctor is telling you is true. I recently read in the paper and then saw a doctor on one of the morning news shows and it's true that they are not testing for H1N1 any longer. Apparently, once it was established that a certain number of tests were all conclusive that the flu strain was H1N1, it was considered a pandemic (?) and further testing was not required. I don't know about the CDC site, but I would imagine that there may be a section that would be only available to medical professionals, not the general public. I hope your child is feeling better soon.
could you just go to a walk-in clinic for the testing? yo might have to pay out of pocket, but still less than the
e-room
What about seeing another doctor, go to the tricare office and talk with them. They can switch your doctor, tell you if the er visit would be covered adn such.
Every test has false positives and false negatives. We've been sick at my household for a month, tag-teaming, 1 week per member. My husband and I tested negative and are the beginning and end of the chain (so far, hopefully my 9 yo doesn't get sick). My 4 yo daughter tested positive and my 7 yo son wasn't tested. We went to the same pediatrician that's always seen our kids and we went to the same adult dr. There was no difference in the treatment with all four of us, but I'll tell you from first hand experience, the testing was very uncomfortable and my daughter is now traumatized by it. I don't have TriCare, and I was discouraged against testing. I don't believe it has anything to do with insurance. My daughter only got tested after getting better, then worse, and only because if she tested positive, they wanted to keep an eye on my boys, who have weakened immune systems. If your child does not have a weakened immune system, I would not push the testing. Plenty of rest, plenty of fluids, and meds to manage the body aches and fever. I feel that the hype is inflated and that the makers of Tamiflu are the benefactors. BTW, I also typically believe in vaccines and think that those that don't get routine vaccines are being personally and socially irresponsible. This is not about that AT All. Good luck.
T.
How is your daughter doing is she better? I am just wondering what will the testing for the flu do for her? Will they be able to give her certain medications that they only give to one strain of another of the flu? I honestly don't know.
My son was sick at summer camp this year and there was all this worry about the flu. _ He had a high fever was vomiting did NOT feel well. The took him and 2 other children to dr for testing ALL the children got Tamiflu and they sent to 2 kids home who tested positive while my son got to stay b/c he tested negative to the flu. He still took the Tamiflu and and he still took a few days 3-4 to get better enough to even get out of bed. Now while I was very relieved to have him well, How do I know he didn't have a strain of the flu they didn't test for? the Tamiflu seemed to have helped.
Here's the thing- why do you care so much about the label that you are willing to file a grievance against the dr? You child is sick right. Did they tell you how help her? If they knew she had "the flu" would you be treating her differently?
