I sustained a closed, displaced, bimalleolar fracture on 1/26. I went to the emergency room immediately and got x-rays, and was told to follow up with my PCP to get a referral to an orthopedist, because I have an HMO. Well, there are only 3 orthopedists covered in Imperial Valley and was told that one of them doesn’t do surgery on fractures, and the other only comes to Imperial Valley on Mondays and Wednesdays. I was offered an appointment on 2/15 with a podiatrist, because the soonest appointment with an orthopedist was 2/23.
When I saw the podiatrist on 2/15, I was told he doesn’t work on unstable fractures, and that I needed surgery or else I would have chronic pain. He gave me an urgent referral to an orthopedist, and I was able to see him one day earlier, on 2/22.
When I saw the orthopedist on 2/22, he essentially took my x-rays and gave me two options. Either I could see him every two weeks for conservative treatment, or he could refer me to San Diego for a second opinion so that I could get surgery. I told him I wanted surgery, and he provided the referral. Unfortunately, there was no one I could get in-network in San Diego to work with me, so I was referred back to the other orthopedic surgeon in Imperial Valley.
The appointment was set for 3/23. I filled a complaint with the California Department of Managed Healthcare so that I could an appointment sooner, but ultimately I just called the orthopedic office every day until I moved up my appointment to 3/14. This orthopedist immediately ordered labs to get me started for surgery, but mentioned it would have to be in San Diego, 2 hours away. He said that they would be in touch with me regarding the appointment, but I haven’t gotten a follow up. I tried to call his office earlier but was told to call the office in San Diego. San Diego office representative said she had never heard of someone in El Centro coming to San Diego, and said she would call me back regarding my appointment later today (she didn’t).
At this point it’s going on two months post-fracture and I haven’t gotten any treatment for my ankle. I’ve fractured my tibia before when I had a different PPO and I was able to get surgery the next day, so I feel like this isn’t a typical delay, and I’m concerned that this will make my recovery take even longer. Now I’ve gotten a case manager from Molina but she neither follows through, nor does she know how to effectively contact my IPA for authorizations. I’m wondering if this is a normal wait time when it comes to getting surgery with Molina? What kinds of resources there are for me to help speed up this process, or who can I contact for help?
submitted by /u/badlemonnoh0pe
[link] [comments]I sustained a closed, displaced, bimalleolar fracture on 1/26. I went to the emergency room immediately and got x-rays, and was told to follow up with my PCP to get a referral to an orthopedist, because I have an HMO. Well, there are only 3 orthopedists covered in Imperial Valley and was told that one of them doesn’t do surgery on fractures, and the other only comes to Imperial Valley on Mondays and Wednesdays. I was offered an appointment on 2/15 with a podiatrist, because the soonest appointment with an orthopedist was 2/23. When I saw the podiatrist on 2/15, I was told he doesn’t work on unstable fractures, and that I needed surgery or else I would have chronic pain. He gave me an urgent referral to an orthopedist, and I was able to see him one day earlier, on 2/22. When I saw the orthopedist on 2/22, he essentially took my x-rays and gave me two options. Either I could see him every two weeks for conservative treatment, or he could refer me to San Diego for a second opinion so that I could get surgery. I told him I wanted surgery, and he provided the referral. Unfortunately, there was no one I could get in-network in San Diego to work with me, so I was referred back to the other orthopedic surgeon in Imperial Valley. The appointment was set for 3/23. I filled a complaint with the California Department of Managed Healthcare so that I could an appointment sooner, but ultimately I just called the orthopedic office every day until I moved up my appointment to 3/14. This orthopedist immediately ordered labs to get me started for surgery, but mentioned it would have to be in San Diego, 2 hours away. He said that they would be in touch with me regarding the appointment, but I haven’t gotten a follow up. I tried to call his office earlier but was told to call the office in San Diego. San Diego office representative said she had never heard of someone in El Centro coming to San Diego, and said she would call me back regarding my appointment later today (she didn’t). At this point it’s going on two months post-fracture and I haven’t gotten any treatment for my ankle. I’ve fractured my tibia before when I had a different PPO and I was able to get surgery the next day, so I feel like this isn’t a typical delay, and I’m concerned that this will make my recovery take even longer. Now I’ve gotten a case manager from Molina but she neither follows through, nor does she know how to effectively contact my IPA for authorizations. I’m wondering if this is a normal wait time when it comes to getting surgery with Molina? What kinds of resources there are for me to help speed up this process, or who can I contact for help? submitted by /u/badlemonnoh0pe [link] [comments]Read Morer/HealthInsurance