Should I change our medical providor?!


Question:

Should I change our medical providor?

My husband had a bad earache, but he wasn't sure it was that only. We have Exclusive Care as our current providor. Anyway, he went to a non-network emergency room to get checked on, because he suffered a minor anxiety attack. He got dizzy and panicked. This happened while he was at work. He went to the nearest ER facility, not knowing it was a non-network facility. Our providor said they wouldn't cover the cost. We had to fork out over $750! It shows on our cards that if you go to a non-network facility the co-pay is $250. I questioned this to our providor and they said his case wasn't an emergency! Do they have the right to determine that? I appealed it, and we still lost. So what should I do? Any suggestions? I'd like to change providors, but do you think the same thing will happen with a new one? And should I demand to get a part of our money back with Exclusive Care? Any thoughts would be appreciated. :)

Additional Details

2 weeks ago
Can someone please give back some input into this matter? I'd really appreciate it.


Answers:

I'm sorry that I cannot be of much help with regards to your medical provider - the UK has a very different system. I'll give you my 2 cents anyway!

It's a difficult one - symptoms of panic are often very similar to symptons of a heart attack. Therefore, your husband was sensible in treating it like an emergency. However, the fact remains that it wasn't an emergency. Technically, I guess your medical provider was in the right. Morally and rationally, however, they were wrong. My guess if that you should ring round other providers and ask what their policy would be in such an event.

In the meantime, I have some tips for your husband to avoid getting panic attacks (and hopefully anymore $750 bills). They are simple and free!

1. If you control your breathing, you control panic. As soon as you notice the signs of anxiety, check your breathing: breathe in slowly through your nose pushing your tummy out (to the count of 5 or so). Breathe out slowly and for a bit longer (to the count of 7 or so) through your mouth. Do not breathe rapidly or shallowly (in the chest area). This will soon restore the balance of oxygen and you will feel a lot better.

2. Try Cognitive Behavioural Therapy! CBT is proven to be the most effective thing for panic attacks and anxiety. It takes a bit of work, but it is super effective. (After 15 years of panic attacks, mine stopped completely). You can take a course for free online at: livinglifetothefull.com It has been funded by NHS Scotland and has had great results thus far.

3. Try relaxation exercise tapes (progressive muscular relaxation). They really help if you practise often enough.

Best of luck to you both.




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