My 2 year old little girl was diagnosed with multiple stye. Until now I am still confused between stye and chalazion because on the internet it was mention that this two are different. Anyway when I check the doctor's recommendation for confinement it shows for externation (not sure if I read it right, you know doctors hand writing) of chalazion. She has 4 stye/chalazion that needs to be removed. She has both on her upper and lower eyelid on both her eyes.
August 3, 2010 (Wed)
I think its almost 7pm when we arrived at the hospital, Medical Center Imus. This will be our first time to have an admission here. We used to go to LPCM (Las Pinas City Medical Center) but since we moved I decided to try MCI since this would be more accessible. We went straight to the ER and presented the doctor's recommendation for confinement. I was asked to fill out patient's form and was told to go to HMO office. To my surprise I was told the coverage is "Subject for Approval". I am worried because we don't have money to cover the said operation. I even asked the lady in the admission why it is subject for approval. Maxicare based on the diagnosis should already be able to decide if its covered or not. I went back to ER and told my husband to talk to Maxicare again. He told them that he already talked to someone from Maxi and mention that this procedure is covered. He was told that its ok then. My daughter's coverage is semi-private but since there is no room available we agreed to upgrade to private. I was told the there will be incremental charges which I am familiar with.
As an SOP we went up to our room on a wheel chair with a nurse accompanying us. I am not expecting that their private room would be that small. As soon as you open the door the bed is on the left just beside it. We actually need to move the dextrose stand since it is blocking the door. Maybe 5 or 6 feet to the right of the bed is a long bench for visitor and would be a sleeping area for the watcher. Below the bed is the bathroom and in front of its door is a small ref with a small TV on top of it. Anyway this is still more convenient than sharing a room with other patient.
12midnight the nurses visited our room to put dextrose to my little girl. Good thing she is too sleepy and was not able to notice what is happening and did not cry. The next day will be her scheduled eye operation.
August 4, 2011 (Thurs)
8am is my daughter's scheduled operation. The nurse asked my daughter to change her clothes to hospital gown. My daughter is only 2 years old and she gave me a big one (for adult) bec. they dont have gown available for small kids. We went down to the operating room quarter to 8am. Before we enter the OR the nurse said "I guess you dont have cutics baby." Hehehe, she does. She went outside and get a cotton with acetone. Before 8am we are already in the OR. I am observing the room and it looks old. I can see like lots of iodine stain on the floor, the OR bed have a little rust, the wall are tiles which looks old...they have modern equipment but maybe not the latest. It is the anesthesiologist who first arrived. He did not greet us or introduce himself to us. He sip his hot tea and ask for a newspaper. Past 9am the opta arrived but the procedure started around 9:40am. I don't feel the comfort while waiting and we waited for almost two hours thinking that this is a scheduled operation. Anyway this is not an emergency so I guess its ok to wait. I was asked to wait outside the OR when they are about to start. Around 10:20am I was ask to go back in. I saw my baby lying on the bed with both her eyes covered. She has an oxygen and is crying like she is very tired. I wonder what she is thinking since she cannot see anything. We stayed in the recovery room I think until 12:30pm, I really hungry then. I guess my baby too since she was told not to take anything starting from 12midnight.
The whole day is interesting for her. As I look at her she knows how to observe by using her sense of hearing. She would even react to TV commercial. But if I ask her about her eyes she would point somewhere trying to divert the attention. She doesnt want to talk about it. She would also cry if she hears a nurse coming in. Sometimes she would ask to go down and just stand on the floor.
This is also the day when the Maxicare coordinator called me. She told me that Maxicare will cover hospital bill but we need to pay for the incremental charges since we upgraded from semi-private to private. He mention that we might also need to pay for the the doctors fee. I am thinking of incremental when it comes to professional fee of the doctor. By the way before the operation the doctor reminded me again that his PF is around P10500 and if my healthcard did not cover everything then I need to pay for the excess. I just agreed thinking it would not be that big. Beside when I had my cyst removed on my bread years ago I did not pay for anything using my Medicard. I am really relax that the difference will not be that big.
August 5, 2011 (Fri)
Our last day in the hospital. Every time a nurse would come in I would ask her what the time the doctor would arrive but nobody was able to answer. Anyway after lunch around 1pm, he arrived. Rhaine was actually crying then. The doctor removed the cover on her eyes and she slow open it. It looks like nothing happened. She was very happy to see us. The doctor said we can go home and he would just give the nurse the medicines she need to take. There was a note on the door that it takes 2 hours upon discharge before you can get the bill. It was past 1pm then.
Around 4pm I asked Robin to check if our bill is ready. I was really shocked when he told me we still need to pay around 13k. Waaaa!!! I am only expecting maybe 2-3k for the incremental. I find out that its because of the professional fee. I went to billing department and the girl (who is not smiling and looks irritated at me) told me that Maxicare only covered P2100 for the opta fee so I need to pay for the excess and there is also an excess for the anesthesiologist. I asked her if we can call Maxicare and she told I can call her. Well at my own expense I talked to the Maxicare coordinator who visited us. I talked to her for 20mins. She says the procedure that the doctor did is for outpatient. Their coverage is only about 1k something but since they consider that its a two year and they give 2100. She offered to call the doctor and she was able to get a discount. So instead of paying around 14k we pay around 11k, 9k of this is for the PF. Waaaaa.... For so many years I've been using healthcard and this is the first time I experienced this. I am really disappointed with the hospital, the doctor and Maxicare. I consulted our head nurse and maxicare coordinator at work and they mention that it do happen that some doctor still follow their original PF. I wonder why the coverage is too small. Imagine the PF of my opta is around 10k and Maxicare paid around 2k.... why is it that the difference is too big. Anyway my little girl would still need to visit the opta to remove the stitch in her eyes. I dont have complain with the doctor's service but with the experience of paying too big even I have a healthcard is really a very big frustration. I told myself I would never again have an admission in that hospital if we any of us need to. I pray to God to keep us healthy and away from sickness.
12midnight the nurses visited our room to put dextrose to my little girl. Good thing she is too sleepy and was not able to notice what is happening and did not cry. The next day will be her scheduled eye operation.
August 4, 2011 (Thurs)
8am is my daughter's scheduled operation. The nurse asked my daughter to change her clothes to hospital gown. My daughter is only 2 years old and she gave me a big one (for adult) bec. they dont have gown available for small kids. We went down to the operating room quarter to 8am. Before we enter the OR the nurse said "I guess you dont have cutics baby." Hehehe, she does. She went outside and get a cotton with acetone. Before 8am we are already in the OR. I am observing the room and it looks old. I can see like lots of iodine stain on the floor, the OR bed have a little rust, the wall are tiles which looks old...they have modern equipment but maybe not the latest. It is the anesthesiologist who first arrived. He did not greet us or introduce himself to us. He sip his hot tea and ask for a newspaper. Past 9am the opta arrived but the procedure started around 9:40am. I don't feel the comfort while waiting and we waited for almost two hours thinking that this is a scheduled operation. Anyway this is not an emergency so I guess its ok to wait. I was asked to wait outside the OR when they are about to start. Around 10:20am I was ask to go back in. I saw my baby lying on the bed with both her eyes covered. She has an oxygen and is crying like she is very tired. I wonder what she is thinking since she cannot see anything. We stayed in the recovery room I think until 12:30pm, I really hungry then. I guess my baby too since she was told not to take anything starting from 12midnight.
The whole day is interesting for her. As I look at her she knows how to observe by using her sense of hearing. She would even react to TV commercial. But if I ask her about her eyes she would point somewhere trying to divert the attention. She doesnt want to talk about it. She would also cry if she hears a nurse coming in. Sometimes she would ask to go down and just stand on the floor.
This is also the day when the Maxicare coordinator called me. She told me that Maxicare will cover hospital bill but we need to pay for the incremental charges since we upgraded from semi-private to private. He mention that we might also need to pay for the the doctors fee. I am thinking of incremental when it comes to professional fee of the doctor. By the way before the operation the doctor reminded me again that his PF is around P10500 and if my healthcard did not cover everything then I need to pay for the excess. I just agreed thinking it would not be that big. Beside when I had my cyst removed on my bread years ago I did not pay for anything using my Medicard. I am really relax that the difference will not be that big.
August 5, 2011 (Fri)
Our last day in the hospital. Every time a nurse would come in I would ask her what the time the doctor would arrive but nobody was able to answer. Anyway after lunch around 1pm, he arrived. Rhaine was actually crying then. The doctor removed the cover on her eyes and she slow open it. It looks like nothing happened. She was very happy to see us. The doctor said we can go home and he would just give the nurse the medicines she need to take. There was a note on the door that it takes 2 hours upon discharge before you can get the bill. It was past 1pm then.
Around 4pm I asked Robin to check if our bill is ready. I was really shocked when he told me we still need to pay around 13k. Waaaa!!! I am only expecting maybe 2-3k for the incremental. I find out that its because of the professional fee. I went to billing department and the girl (who is not smiling and looks irritated at me) told me that Maxicare only covered P2100 for the opta fee so I need to pay for the excess and there is also an excess for the anesthesiologist. I asked her if we can call Maxicare and she told I can call her. Well at my own expense I talked to the Maxicare coordinator who visited us. I talked to her for 20mins. She says the procedure that the doctor did is for outpatient. Their coverage is only about 1k something but since they consider that its a two year and they give 2100. She offered to call the doctor and she was able to get a discount. So instead of paying around 14k we pay around 11k, 9k of this is for the PF. Waaaaa.... For so many years I've been using healthcard and this is the first time I experienced this. I am really disappointed with the hospital, the doctor and Maxicare. I consulted our head nurse and maxicare coordinator at work and they mention that it do happen that some doctor still follow their original PF. I wonder why the coverage is too small. Imagine the PF of my opta is around 10k and Maxicare paid around 2k.... why is it that the difference is too big. Anyway my little girl would still need to visit the opta to remove the stitch in her eyes. I dont have complain with the doctor's service but with the experience of paying too big even I have a healthcard is really a very big frustration. I told myself I would never again have an admission in that hospital if we any of us need to. I pray to God to keep us healthy and away from sickness.
Hi Ma’am, I’m Mark, I’m a Maxicare independent agent. I am saddened to know about your experience in the professional fees.
ReplyDeleteIt seems that you are under a corporate account. The contract per corporate account is customized up to the very last detail (including the coverage for optha). Each modification will affect the total pricing as to what your company is paying Maxicare. You might want to clarify the clause of the contract with your HR that was executed by the Maxicare coordinator.
Hope everything goes well
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i had bad experience with maxicare, they say they don't have available doctor at makati med and i need to go their other office with their own doctors.
ReplyDeletethis happen after i queue for more than 1 hours on their office at makati medical centre.
why dont they just put a sign or whatever that they don't have any more doctor after 5pm so we won't need to fall in line for nothing.
and no doctors available??? hello? are you selling something here or want to keep your member healthy?