Tricare: Running in Circles

Here I am at my next doctor's appointment.  She tells me that I need to see a cardiologist.  I have a history of Mitral Valve Prolapse.  She is concerned that the increased blood flow may be hard on my heart.  So she tells me that I need to get a referral from my insurance and PCM (primary care manager).  I never imagined I would have to see so many doctors during a pregnancy!

So my first step is to contact my PCM to see if I can get a referral over the phone.  This was something I had always been able to do if it was to see a specialist.  When I called the appointment line on base the lady was beyond rude.  She said I had to come in and see the doctor before I could get a referral.  I tried to explain to her that it wasn't necessary, but she wouldn't listen.  So I got my appointment setup, now I had to wait 5 weeks before they could get me in.

Finally my appointment is here to see my PCM.  Once I get into the office the nurse wants to hear the babies heartbeat to make sure everything is okay.  She runs down to the pediatrics unit to get a fetal heart monitor.  When she comes back and begins to listen the machine doesn't work.  So, here I am all lubed up and she has to leave me there to go find another one.  A few minutes pass and she comes back.  She places the monitor on my stomach and nothing!  This machine doesn't work either!  For this to be a military base, you would think that would have working equipment.  The doctor comes in and does a basic assessment.  After all this hassle he tells me that for the future I could always call in and he would give me a referral!  I thought my head was going to explode.  My PCM referral to Tricare would take approximately a week.

One week later I got a letter in the mail with the doctor I would be seeing.  Now all I need to do was to setup an appointment with them, easy right?  Wrong.  I proceed to call the doctors office.  After talking with the receptionist she tells me that it's basically stupid to see them since it was in another part of the city.  She told me to call my insurance company and try to see someone else. 

Since I have been through this before I knew to get on Tricare's website and find a doctor myself.  I found one in the same area that was covered.  I then called the insurance company and told them what had happened and the new doctor I wanted to see.  They said it wouldn't be a problem and I would get my referral in 7-10 business days.  

I finally got the referral for the doctor.  I called the office to setup an appointment with them, will it be easy?  No.  I speak to this receptionist and she not only needs a referral from Tricare, but also my OBGYN.  So, I call my OBGYN and get them to fax over my information.  Is that good enough? No.  They make the doctor's office call for my referral, a fax is not enough.  Needless to say I have my appointment with the cardiologist in 2 weeks.  It only took 9 weeks total!!

LEEP = High Risk Pregnancy

At this point we were so ecstatic that everything seemed fine with the baby.  The pregnancy was just to early to detect during the first visit.  I was officially 7 weeks, due date Nov. 22, 2012 Thanksgiving Day!  As the doctor went over my records she began to ask me about my previous surgery I had a few years earlier.  I had a LEEP procedure, which is a removal process done in cases of woman that have precancerous cells on their cervix's.  When I had the procedure done I was never told about the side effects, something I should have ask about, but didn't.  My OBGYN began to explain the worries with this procedure and pregnancy.  Narrowing of the cervix that can cause infertility may occur.  Also, after a woman has had a LEEP procedure, she has a higher risk of delivering a baby early due to the thinning of the cervix.  This was a concern for my doctor.  She said that I would not only have to see her, but also a high risk specialist.  I could look at this two ways, worried that I might deliver early, which was a high possibility either way.  Or I would get more ultrasounds and see my precious baby, I chose the second one. 

Our next step was to contact our insurance company, Tricare and wait for a referral.  Those reading this that are military understand the long process of waiting for approval.  It always seems to be a hit or miss of whether it's an easy process or not.  Luckily, for us this time within a week we had our referral.  You might have to jump through loops every once in a while, but overall military coverage is great and well worth the hassle. 

Our appointment was set to see the high risk doctor in 2 weeks.  Now it was just waiting until then.