Questions for the mama's - I'm a little concerned... (long)

Jackie012007 wrote: Hi moms! Lemme tell you the situation I'm in, maybe someone could help. Bear with me here!

I bought health insurance through my college, paid $900 up front for a year of coverage. Well, when I found out I was pregnant, I decided not to go back for the fall semester due to my broken tailbone and the fact that I'm due RIGHT after finals. So my insurance was due to run out on July 31st. This in mind, I made the decision to see what kind of insurance I could get through DF's job at Wal*Mart. Well, wally world doesn't recognize couples who are not married (even if they live together and are having a kid!?) so I couldn't get onto his plan. Next step was going to the county building and learning all about medicaid and all that good stuff... well I qualified given my present situation. I'm THRILLED because the thought of going without insurance scares me... so when I make my first appointment at the OBGYN, I tell them right up front that my insurance will be expiring within the next few months and then I will be on medicare... the lady tells me no problem and I fill out my info.

Fast forward to a few weeks ago... I went in for an appointment at 13 weeks. The office manager asks me to come chat and starts asking me about my fastly expiring insurance, so I'm like OHHHH no biggie as soon as it is up I'm going to switch to Medicaid. YYYYeah, she tells me they don't take medicaid because "we don't make any money off of it so it's pointless" . So she tries to send me to this other place to get insurance... which was nice except I live in a different county so they told me they couldn't give me coverage. At the 13 week appointment, I was told I would have to make an appointment to have bloodwork done to test for abnormalities and Down's because when I had my nuchal screening u/s, the baby wouldn't flop over so they couldn't measure the back of the neck. My Dr told me this had to be done between 14 - 18 weeks.

So I figure, okay, guess I have to change dr's. Which wasn't a big problem, I wasn't overall impressed with the treatment I recieved (*gasp* unwed mother!!!! ) and there is a OBGYN just 2 minutes away from my house in Utica. So I go there, and they tell me that I have to sign a release so that they can get my files from the other OBGYN...swell. I sign and they photocopy my license and then fax it over to the former OB, and tell me by law they have 7 - 14 days to fax over my records, then I will be able to apply for insurance through them and all will be hunky dory. So I think GREAT *sigh of relief*

Well, the 14 days is up. I right now have NO insurance (which is pretty friggen scary) and on the 14th day I'm like WTH?! and I go over to the new OB to see what's up. Well after repeated attempts to contact the former OB, the new OB has gotten no response in any way, shape or form. They even called and were basically blown off! So I'm SUPER mad... I call the former OB from their office, and am told that I "had to clear it with them before switching in the first place"... uhhh???? Since when do I need permission to switch doctors? So the OB is basically refusing to send my records over... I even asked if I could drive the hour out of my way to pick up my records and they said if they got clearance, it would take at least 2 weeks to get my files together???? And they wouldn't guarantee I could get copies and I should go to this place for insurance blah blah blah and I told them the place wouldn't give me insurance and they told me I was wrong... etc

Problem #1... I've had 4 appointments with these people... how big can my folder possibly be?

#2 is this even legal???

#3 by the time everyone gets their crap together, it will be past 18 weeks for me... is this dangerous? I mean regardless of what is wrong with my baby I will keep it, I'm not going to be like EEEW it isn't normal, get rid of it!! But I obviously want to do everything the right way and I'm kinda scared for my baby if I miss an important testing!

I dunno what to do, my parents even tried to get involved but because of HIPPAA they couldn't even get a word in with my former OBGYN. I'm so very stressed out and I feel the depression and anxiety kicking back in ... if I could afford to just have the blood panel done I would but without the insurance it is $1200 ... anyone know anything about this stuff (the 18 week deadline and if this is legal)? Sorry to sound dumb, but I swear I trust you guys more than the "professionals" who are jerking me around! Anything anyone can offer would be so very helpful, I'm at the end of my rope

C&K*s Mommie replied: Jackie, I will be more than happy to ask my instructor about this tonight when I see him. He is a Physicians Assistant, and an instructor of us, the medical assisting students. That is if you do not recieve an answer today.

kit_kats_mom replied: I never had any of the tests (except for blood and urine and u/s) done with K. As far as the other office being rude...it does sound like they were not nice about it but HIPPA has really cracked down on record sharing. Had you already signed a records release with the old office before the new OB requested the records? It sounds lilke maybe that wasn't done however the old OB could have worded it differently. The HIPPA changes have made everyone jump though more hoops than ever. Kind of a pain but it's for a good reason.

Boo&BugsMom replied: Jackie, I have never been to a doctor's office that refussed to send records because they are YOUR records. As far as I know, it is not within their legal right to withhold YOUR information. There could be some technicalities (like signing a release form or something that you haven't done yet), but I am certain that they have to at least send copies to wherever your new office is if you give your written consent. You have every right to switch doctors!!!

punkeemunkee'smom replied: My understanding is that they can not keep your medical recoeds from you but they can charge you for them,if you go pick them up(I have paid $5 a page for Xray reports),and they can remove content that is not health related...For example if your doc had put in your chart what a PITA you are he can take that out As far as the blood work-I have had more than one friend that has shown they have elevated levels of and that their babies may have some God forsaken abnomality and have perfect children so don't stress about that! You are young and healthy and like you said you have decided to have a baby regardless so if you miss the 'deadline' for that test I am sure you will be fine! I really hope they quit making things harder on you! Right now I would call and tell the office you are ready to file a complaint with the AMA and your local and state health officals-You may be surprised how fast their fax machine gets to working!

C&K*s Mommie replied: I was half awake this morning when I wrote that above, and I am barely fully awake now (a couple cat naps in the chair have helped me wake up) but medical records are confidential. I would definitely avoid taking the route of having your old OB fax over your records. You truly never know who will have access to it.

This is something that I found in my MA book, it may or may not apply, I am certainly not an expert in the ins and outs of this but here is what I found anyways: All medical records, including x-rays and other test results, are created by the doctor and are considered the property of that doctor. The records and all they contain, however, are considered confidential. ~ However, the law may require the doctor to release them, as in the case of a patient with a contagious disease or when the records are subpoenaed by a court.

MyLuvBugs replied: GIRL! You are being lied to and manipulated left and right by these people. WOW! (not the people on PC, but the Dr offices - just thought I'd clarify )

First of all, they are REQUIRED BY LAW to give you your medical records or transfer them to whatever Dr. you so choose. Remind them of that, and also tell them a little lie like "Well, according to my uncle, the LAWYER, you are required to send my medical records..." See how they like that!

ALSO! I'm on medicaid, and the clinics DO get paid from medicaid. So that witch telling you that "we don't make any money off of it so it's pointless" is a bunch of BS IMO! Definately go and get signed up with Medicaid IMMEDIATELY so you have insurance of some kind, and talk with your case worker about Dr's you can or cannot see, and explain the run-around you've been having. They're usually really helpful, and can offer assistance when dealing with "uncooperative" medical offices. KWIM?

Also, you are not "REQUIRED" to have any genetic testing done on your baby. So, don't worry about it having to be done. It's an option, and it's a costly one. PLUS, you're going to get another U/S anyway around 18-22 wks, so the measurement thing is not that big of a deal. It sounds like your Dr. was just trying to bully/manipulate you into procedures that are costly just to get some more money out of you to be quite honest!

Definately keep your parents involved, if only for support. They can help you with money and legal advice if you need it.

Everything will be ok, but don't let these people bully you around sweetie. Stand up for yourself. Educate yourself on state Statutes and medical laws. Do some research. It will be ok! KUP!!

BTW: What state do you live in???

MyLuvBugs replied: Medical Law

Check out this site for legal advice on HIPPA and PHI Laws. They also talk about medical records and stuff. Sounds like you'll need to contact your State Health Dept. to find out what your State laws are reguarding the obtaining of your medical records.

MyBrownEyedBoy replied:
#1, your file should contain copies of dictation regarding your u/s, your appointments and your med history. By this point, if you've never seen them before, under 15 pages.

#2, no it is SO not legal. HIPAA laws state that a patient has the right to a copy of his or her med records at any time. The office may charge a copy fee, but they have to give it to you.

#3, I skipped the triple screen blood work you are talking about. So, I don't know if it is dangerous, but they should still be able to do a u/s to rescreen the nuchal area or check for spina bifida. I didn't even have my first u/s until I was 18 weeks.

So, march over to the office, look up HIPAA regs on the internet first and copy relevant areas, and demand your records. YOu have the right to change doctors at any time.

BJ~Bre's Mommy replied: Not sure what state you live in but if you request a copy of your medical records they have to give them to you. I would possibly call a lawyer and have them call the dr's office then they might start listening!

luvmykids replied: ITA with what Kelly said, (and others, too many names to list LOL) and I don't even think it's legal for a dr to NOT accept medicaid, is it?

As far as Walmart not recognizing you guys as a "couple", that probably isn't their rule but the insurance company, as far as I know none of them cover unless you are legally married. If he's on the plan though they should cover the baby after birth.

lesliesmom replied: If you have an appropriate Release, then your previous OBGYN is required to release those documents to whomever you choose. That is the whole reason for a release and the information on the release will pertain and refer to HIPAA as well. I would go to that doctor's office and request a copy of your file right there. You have a right to whatever is in that file. Best of luck...

PS... you said something about Utica. Are you in Michigan by any chance?

Jackie012007 replied: nope, Utica NY!

I called again today and was ignored... I'm going out there anyway in a little bit, maybe they will take me more seriously in person. I dunno about the medicaid, but she explicitly told me that they don't accept medicaid at that office because they make no money on it so "it's pointless" . I hope things will get resolved today, I am so sick of this. I'll be back late tonight (visiting my parents while we are there), I'll let you know

~Roo'sMama~ replied:

It's not an important test, and definitely not dangerous to miss it! I didn't get it with Andrew and I'm not doing it with this one either. The only things it can detect are things that they can't do anything about before the baby is born, and a LOT of the time the results are falsely positive and you have to go through more and more tests (including an amnio which can cause a m/c in 1 out of 200 babies and just not worth it IMO) just to find out everything was fine to begin with. So I wouldn't worry about that part!

I don't know anything about medical law but what Kelly and Ericka are saying sounds right. I don't see any reason you should have to *clear it with them* before you go elsewhere.

boyohboyohboy replied: Jackie, dont let these dr's stress you out. Its just some office manager really trying to show you she thinks she is in charge.
I dont think you really need all your medical files from the old dr anyway. I would schedule your next appt with the new dr who does accept the medicaid, and then ask him what to do, and if there is something he wants to know about your baby, he can redo the test.
I never have the triple screen done, because like you it wont change the out come for the baby or our family.

I had to switch drs, and had to pay $50 for the transfer of records, and my ob admitted he never read them!
if there is something pertainate going on with you or the baby, then he can repeat the tests he wants not look at what the other drs thought, and thank God you did switch offices because look at the mess you might have had to deal with.

If you really want those records switched, call and ask to speak to the office manager again, ask her specifically what it is she needs signed, and ask her to fax it to you, go to the nearest fax machine, (library if you have too) and have it faxed to you, then fax it right back, and let them take the time to fax it to the dr, also if you have to pay, make sure its in the form of a check so when they cash it you have proof you paid it.

also tell her youknow the laws under HIPPA and she cant keep your records from being transfered, they dont have to give them to you, (I am a nurse and have worked in the office, and usually we dont give it to the patient, its usually sent to the next drs office) I think drs do that so they dont get sued for something in the files...if u are persistant, they might just do it to get rid of you, stick up for yourself, and make them understand you are not scared or easily frustrated, you wont give up....

but honestly I dont think you will be any worse off for not having them transfered.

Good luck, and I am sending you some de-stressing vibes, take care of yourself and that baby!

C&K*s Mommie replied: I would not let that stress you out, sweetie. Plenty of drs offices will accept Medicaid.

On the flip side, my mother who works for the business office of a local hospital. Admits that Medicaid is among the slowest payers around. Progressive (the auto-insurance co) is faster at paying medical bills than Medicaid. I do not know why if it is a state run health assistance program, that they would not pay claims faster than the next. Although Medicaid is not a form of insurance, it is a health cost assistance program for certain qualifiers, with the money at hand from the state and the federal govt, one would think that money is paid timely. Obviously it is not so.

Not all medical offices will accept assignment from Medicaid, thus they will not accept Medicaid at all. That is their choice.

Hope you get things figured out soon. KUP

kimberley replied: i have no advice as i am canadian but i just wanted to offer hugs. this must be frustrating.

C&K*s Mommie replied: I am certainly not a know-it-all, and never will be. But I double checked with my instructor, about doctors offices being required by law to submit med records to patients or to other physicians. He told me they are not bound by law. That the med records, for mere transfer to another doc or a specialist, is at the doctors discretion. They the medical records, are of work he has performed, and are his property and if he chooses not to abide by the wishes of another doc or a patient then there is no law requiring that of him. 99% of the time the doc is gracious enough to do transfer without a hitch, and may charge a fee. In your case, you are in the 1% minority. Except in the cases of court subpoenas, medical research, quality control treatment, or patient education. Also, he said it is at the doctors discretion to submit copies of all the records or portions for certain purposes.

If they are underlying medical issues that would be of constitute another doc knowing about your history, then that could be an impediment, but can be overcome. It just requires more work for the new doctor.

Jackie012007 replied: I AM THE MAN!!!

I got 'em... I went into the office after being ignored again on the phone (I told them I'M COMING OVER THERE RIGHT NOW AND YOU WILL KNOW ME BECAUSE I AM ONE $^#@%CHY P'D OFF PREGNANT LADY!!!) and when they all hid when I came in, I started spouting off in the middle of the office. My dad went with me... he got right in the face of the office manager who treated me like crap and was like LOOK this is hard enough on my daughter without your F-ing power trip to add on top... omg guys you should have seen her face, the blood like drained out of it.

So she was like uhh uhhh uhhhhh gee I dunno why they never transferred, we sent them over a week ago ... you know trying to make ME look stupid in front of my father, so I got WICKED P'd and DF was practically holding me back off of this woman, as I'm yelling YOU'RE A LIAR, YOU'VE BEEN JERKING ME AROUND FOR 2 WEEKS, YOU TREATED ME LIKE CRAP, I HAVE NO INSURANCE AND I WANT MY GD FILES NOWWWWWW. So she ran over and faxed them I WIN! I seriously sat over her shoulder, then called the other doctors to make sure they were really sent and recieved... and then was tapped on the shoulder and I was escorted out since apparently someone called security from the hospital across the street but I DON'T CARE!! Because I won

Nicole thanks for all the advice, you are totally not a know it all, just resourceful! And thanks guys for the info on the triple screen... maybe this is something that I don't want to have after all!






I WON HAHAHAHA I'm giddy

luvmykids replied: You go girl! Glad it got done, even if you had to get nasty. Sometimes thats just what it takes.

MyLuvBugs replied:
This actually depends on the State you live in. Each state has separate laws reguarding Medical Record requests/transfers, according to the info that I've found. Some states HAVE set up laws stating that medical offices Must comply if a patient requests their records or requests that their records be transferred.


And good for you Jackie! hopefully, you will have an easier PG now that this crap is all done with.

redchief replied: Well done Jackie. That's exactly what I would have done.

C&K*s Mommie replied: to that! Easier, and stress free from here on out..... well my fingers are crossed anyhow.

CantWait replied: Jackie, sorry you're going through all the hoopla, but glad it's settled now. WTG Girl.

Also Genetic testing (here in Canada at least) is completely your choice. They don't start reccomending it until you're 30, or have had a history of downs in the past or a history of it in your family.

Jackie012007 replied: I talked with my mom and DF and DF's mom about Triple Screen... GET THIS DF's mom had his sister (a SURPRISE) in her mid-30's and they made her have the Triple Screen and it came back positive for abnomalities... they did an amniocentesis (sp?) and it came back fine, BUT Hannah was born with a severely infected kidney that had to be removed right after she was born... they have no idea what happened to the kidney but Debbie said she thinks it has something to do with the amniothingy...I mean she doesn't KNOW because she isn't a doctor but she really really regrets having the Triple Screen as now Hannah only has one kidney and has been sickly her entire life! My mom never had one...

carl and I think we are going to skip the Triple Screen. We talked about it a lot today and it seems pointless since it isn't terribly accurate and all the worry over possibly nothing. I read a lot about it online and I'm not thorougly impressed.

On the positive side, I MADE MY BIG U/S APPOINTMENT TODAY!!!!! August 25th... omg I soooooo cannot wait! Monday I go in to sit down with a caseworker they have at the OB and she will help me file for insurance and such... YAY PROGRESS!!