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Same song and dance in denials

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Editor, 

I’ve had seven denials for continued medical care by the Contract Health Care Department and mandated under the Tribal Health department.

I find it ironic that Acting Tribal Health Director Kevin Howlett stated to the Char-Koosta some time ago that they are going after the doctors that are over-prescribing narcotics. In order for him to make a statement like that, he would have to conduct an inquiry of each and every person prescribed a narcotic for their medical condition, needs, activities, pain level — a full assessment of the patient’s condition— which is impossible because they are always denying referrals for individuals that their primary refers patients to, such as orthopedic surgeons and back, kidney and rheumatoid specialists.

Last year I was under the care of a doctor off the Reservation. In order for me to continue my medications I needed to be seen at the pain management clinic. After careful review, I was all for the pain management, because they offered chiropractic treatments, acupuncture, whirlpool soaks, physical therapy, etc. Sounded awesome, for I was already paying for my own chiropractor treatments, and going to Hot Springs to soak.

So I tried my damnedest to get into the pain management clinic. I even went to the Million Dollar Clinic to see Dr. Soggie. She agreed that I would benefit from the pain management clinic. I had to write the Billings office to find out what happened to my referral from Dr. Soggie. They told me the referral had to come from my Primary, which makes no sense; they had already denied three referrals from contract care that my Primary had tried to get me — same song and dance.

If they want to talk laws and codes, then why aren’t they following their own Tribal code? It says in the Tribal laws that Tribal members that are from other tribes are to be seen by the Tribal Health doctor.  I’m enrolled here, yet when I saw the Tribal Health doctor, they found a way to deny me care.

Sharlene Peone
Pablo

 

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