Talk of The Villages Florida

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-   The Villages, Florida, General Discussion (https://www.talkofthevillages.com/forums/villages-florida-general-discussion-73/)
-   -   Help For 100% Disabled Vet - Is Dr. Pinnamaneni Ethical or Morale? (https://www.talkofthevillages.com/forums/villages-florida-general-discussion-73/help-100-disabled-vet-dr-pinnamaneni-ethical-morale-330377/)

Mrprez 03-20-2022 05:26 AM

Quote:

Originally Posted by tsmall22204 (Post 2074512)
I feel you are not really taking care of this vet or you would have had him at the VA facility in the Villages. Your story sounds awfully fishy.

Apparently you neglected to read the entire thread. The VA referred this vet to this doctor.

Eg_cruz 03-20-2022 06:20 AM

Is the VA on 42 able to help

Eg_cruz 03-20-2022 06:27 AM

Quote:

Originally Posted by ProfessorDave (Post 2074281)
Help! I' assisting a 100% disabled veteran in The Villages who has been on a significant pain medication for several years. His Dr. at Lady Lake Pain And Spine Centers of Florida (Dr. Pinnamaneni) won't take the time to do a simple "pre-authorization" which lowers the price by over $200 per month. Publix Pharmacy recently contacted the Dr. and asked twice. This veteran drove to the practice twice this week to ask the receptionist for help - and was promised swift action. The Dr's office has been called three times this week by me - and no response.

I checked with the insurance company - and the story get's worse! The insurance company (Blue Cross Federal) shared two things: 1) they personally put in a request to the Dr. for the preauthorization - and got no response and 2) it would also cost less if the Dr. provided a 90 day refill - but won't, because he bills more money by requiring the patient to come in once a month for a new 30 day prescription - and has been doing that for years. Ethical? Morale? You be the judge.

As a result, the prescription has cost this vet over $500 this year - which he frankly doesn't have! Because of the financial situation - he has been in pain for several days - until I found out about it.

Two requests to consider: 1) Recommendations for a new Pain Doctor to help a 100% disabled vet - with very little money? 2) Please tell friends and family to write to Dr. Pinnamaneni and ask WHY he would leave a war hero in both physical and financial unnecessary pain!!!

Has he tried medical marijuana or Microdosing
Both work great pain

Uncle Creepy 03-20-2022 06:34 AM

Oh come on.
 
Quote:

Originally Posted by Keefelane66 (Post 2074303)
Oh come on.
70 percent disability rating: $1,529.95 per month. 80 percent disability rating: $1,778.43 per month. 90 percent disability rating: $1,998.52 per month. 100 percent disability rating: $3,332.06 per month.

What the hell does this have to do with anything?

Duppman 03-20-2022 06:46 AM

Quote:

Originally Posted by petsetc (Post 2074312)
If he has VA coverage and they referred him to an outside doctor , the VA should pay all charges. I have a disabled relative (not 100%) who has been referred to private local doctors for specialty care.

Google it for rules/restrictions

Along with the referral the appointments should be made through the VA's Community Care office. That way the billing goes directly to the VA.

Marine1974 03-20-2022 07:22 AM

This war hero with a disability rating 100% should be getting
free care and prescriptions at the
VA or the VA sends the veteran to a private doctor under what the VA terms it Community Care . The VA pays the provider who accepts VA
insurance ( Tri Care ) for service related injuries .
I have VA healthcare not Tri Care , and make a little bit more money than most veterans and am charged co-pays . $9 or $15 dollars for prescriptions.
$15 for a primary care doctor . $50 for a specialty doctor . Although if you see more than one doctor in the same day the copay covers all VA doctor visits .
Alternatively since turning 65 my Medicare , Medicare part D and supplemental turn out to be less expensive than the VA . I have a $208 deductible for the whole year
I suggest calling or visiting the
the office of Patient Experience. They will make it happen, I guarantee.
Call Florida department of veteran affairs to get a briefing on his benefits.
If the veteran is low income he can apply for a VA pension.
His Primary care VA doctor is the
gatekeeper for prescriptions and specialty doctors .
If the VA sent him to a private doctor they would be paying his bill . Tri Care is a wonderful thing for our war hero’s . Thank him for his
service.

NotGolfer 03-20-2022 07:23 AM

Years ago I had lower back pain and my pcp sent me to that doctor. His office staff were the worst. Bad attitude on one hand. A few months passed after my treatment (that didn't help the issue---but that's not his fault) and we got a bill from our "former" insurance---I think what we had BEFORE we retired and moved here. I personally took it to the office and spoke with the person that handled it. It's been 12 yrs so I can't remember all the details now but I will say I decided "IF" I needed another pain dr. it wouldn't be that one. He's fine but it's his office staff that's lacking. I'm so sorry you're friend is dealing with this!!!

raynan 03-20-2022 07:59 AM

Call Richard Blair Veteran Service Officer 352-689-4400 email va@sumtercountyfl.gov . He is at 7375 Powell Rd in Wildwood (building with the library). He is great and will get this straightened out for your vet.

Lea N 03-20-2022 08:10 AM

Quote:

Originally Posted by ProfessorDave (Post 2074281)
Help! I' assisting a 100% disabled veteran in The Villages who has been on a significant pain medication for several years. His Dr. at Lady Lake Pain And Spine Centers of Florida (Dr. Pinnamaneni) won't take the time to do a simple "pre-authorization" which lowers the price by over $200 per month. Publix Pharmacy recently contacted the Dr. and asked twice. This veteran drove to the practice twice this week to ask the receptionist for help - and was promised swift action. The Dr's office has been called three times this week by me - and no response.

I checked with the insurance company - and the story get's worse! The insurance company (Blue Cross Federal) shared two things: 1) they personally put in a request to the Dr. for the preauthorization - and got no response and 2) it would also cost less if the Dr. provided a 90 day refill - but won't, because he bills more money by requiring the patient to come in once a month for a new 30 day prescription - and has been doing that for years. Ethical? Morale? You be the judge.

As a result, the prescription has cost this vet over $500 this year - which he frankly doesn't have! Because of the financial situation - he has been in pain for several days - until I found out about it.

Two requests to consider: 1) Recommendations for a new Pain Doctor to help a 100% disabled vet - with very little money? 2) Please tell friends and family to write to Dr. Pinnamaneni and ask WHY he would leave a war hero in both physical and financial unnecessary pain!!!

How frustrating. This is not as uncommon as one would think. I have a friend who was a caregiver to a loved one and went through the same thing.

I would find another doctor. Quickly.

Has your friend gone to the VA to apply for VA benefits? If not he should give it a try. It takes time and is a process, but in the end worth it. It is not a perfect process but cost of meds is determined by income. If your friend is in a low tax bracket this could be a tremendous help with the cost of prescription meds and more.

If your friend goes this route once he has applied for benefits have him go the local VA to register. Call first to find out if he is in the system yet. Once he is head down to register immediately. This speeds up the process and will get your friend in to see a VA primary care physician quicker.

I am a caregiver to a disabled veteran and am still learning to navigate the VA system. It's not always easy and is time consuming. Sometimes I just don't get answers, ever. I spend a tremendous amount of time and energy getting through the mess. But I did before my loved one applied and was approved for VA benefits too.

Your friend could reach out to the United Way. Within the United Way is a department (volunteer based) that helps veterans.

I wish your friend the best with this.

Ken D. 03-20-2022 08:42 AM

Quote:

Originally Posted by Lea N (Post 2074633)
How frustrating. This is not as uncommon as one would think. I have a friend who was a caregiver to a loved one and went through the same thing.

I would find another doctor. Quickly.

Has your friend gone to the VA to apply for VA benefits? If not he should give it a try. It takes time and is a process, but in the end worth it. It is not a perfect process but cost of meds is determined by income. If your friend is in a low tax bracket this could be a tremendous help with the cost of prescription meds and more.

If your friend goes this route once he has applied for benefits have him go the local VA to register. Call first to find out if he is in the system yet. Once he is head down to register immediately. This speeds up the process and will get your friend in to see a VA primary care physician quicker.

I am a caregiver to a disabled veteran and am still learning to navigate the VA system. It's not always easy and is time consuming. Sometimes I just don't get answers, ever. I spend a tremendous amount of time and energy getting through the mess. But I did before my loved one applied and was approved for VA benefits too.

Your friend could reach out to the United Way. Within the United Way is a department (volunteer based) that helps veterans.

I wish your friend the best with this.

Read the thread before responding. He’s already with the VA care.

DAVES 03-20-2022 09:19 AM

Quote:

Originally Posted by ProfessorDave (Post 2074281)
Help! I' assisting a 100% disabled veteran in The Villages who has been on a significant pain medication for several years. His Dr. at Lady Lake Pain And Spine Centers of Florida (Dr. Pinnamaneni) won't take the time to do a simple "pre-authorization" which lowers the price by over $200 per month. Publix Pharmacy recently contacted the Dr. and asked twice. This veteran drove to the practice twice this week to ask the receptionist for help - and was promised swift action. The Dr's office has been called three times this week by me - and no response.

I checked with the insurance company - and the story get's worse! The insurance company (Blue Cross Federal) shared two things: 1) they personally put in a request to the Dr. for the preauthorization - and got no response and 2) it would also cost less if the Dr. provided a 90 day refill - but won't, because he bills more money by requiring the patient to come in once a month for a new 30 day prescription - and has been doing that for years. Ethical? Morale? You be the judge.

As a result, the prescription has cost this vet over $500 this year - which he frankly doesn't have! Because of the financial situation - he has been in pain for several days - until I found out about it.

Two requests to consider: 1) Recommendations for a new Pain Doctor to help a 100% disabled vet - with very little money? 2) Please tell friends and family to write to Dr. Pinnamaneni and ask WHY he would leave a war hero in both physical and financial unnecessary pain!!!

As far as doctors and filling out forms, mine is also a pain in the butt on this. I have little patience with needing to constantly follow up. Truth, I stick my wife with this because after 3x I am no longer polite. I've asked around-THEY ALL ARE LIKE THAT.
EXCUSE? Thanks to Medicare etc they are so overworked they cannot spare the time to do a good job.

I of course do not know all the details. Pain meds? In an effort to control FROM excessive use of OPIOIDS, the government has clamped down on pain meds. Prescriptions are for 30 days. The problems with OPIODS is they are habit forming and while they are the most effective pain killers, it takes higher and higher dosages to get the same relief. The mentioned $500 for the year, have it or not, is not much money. ADVICE TO YOUR FRIEND, he should contact VA MEDICAL. My dad did two tours of COMBAT duty in WWII. He got cancer. His prescriptions were like $600 a week. The VA would fill his prescriptions at, it I recall, a flat rate of $20. ASIDE-with cancer, the hidden reality. It is not the cancer that kills you, though it would eventually.
It is the poisons and pain killers they give you that kill you.

TO REPEAT-prescriptions, if they are OPIODS are 30 days and not refillable.

Lea N 03-20-2022 09:21 AM

Quote:

Originally Posted by Ken D. (Post 2074676)
Read the thread before responding. He’s already with the VA care.

Well, if this is the case then he should contact the VA and let them know he needs a new doctor. They can assign him a new one through community care. I'm not sure if there is a doctor at the VA in Gainesville who can help him but there might very well be. If so it could be worth the trip depending on his pain level for travel.

Keefelane66 03-20-2022 09:40 AM

Quote:

Originally Posted by Lea N (Post 2074705)
Well, if this is the case then he should contact the VA and let them know he needs a new doctor. They can assign him a new one through community care. I'm not sure if there is a doctor at the VA in Gainesville who can help him but there might very well be. If so it could be worth the trip depending on his pain level for travel.

Transportation the VA reimburse Veterans portal to portal mileage is determined by address if you like the scenic route no it’s the most direct.

Psacc0 03-20-2022 10:12 AM

Quote:

Originally Posted by ProfessorDave (Post 2074281)
Help! I' assisting a 100% disabled veteran in The Villages who has been on a significant pain medication for several years. His Dr. at Lady Lake Pain And Spine Centers of Florida (Dr. Pinnamaneni) won't take the time to do a simple "pre-authorization" which lowers the price by over $200 per month. Publix Pharmacy recently contacted the Dr. and asked twice. This veteran drove to the practice twice this week to ask the receptionist for help - and was promised swift action. The Dr's office has been called three times this week by me - and no response.

I checked with the insurance company - and the story get's worse! The insurance company (Blue Cross Federal) shared two things: 1) they personally put in a request to the Dr. for the preauthorization - and got no response and 2) it would also cost less if the Dr. provided a 90 day refill - but won't, because he bills more money by requiring the patient to come in once a month for a new 30 day prescription - and has been doing that for years. Ethical? Morale? You be the judge.

As a result, the prescription has cost this vet over $500 this year - which he frankly doesn't have! Because of the financial situation - he has been in pain for several days - until I found out about it.

Two requests to consider: 1) Recommendations for a new Pain Doctor to help a 100% disabled vet - with very little money? 2) Please tell friends and family to write to Dr. Pinnamaneni and ask WHY he would leave a war hero in both physical and financial unnecessary pain!!!

Dr. P. writes my husband’s pain script every month. (Tricare). It is $3.00 at Walgreen’s

MandoMan 03-20-2022 10:19 AM

Quote:

Originally Posted by ProfessorDave (Post 2074281)
Help! I' assisting a 100% disabled veteran in The Villages who has been on a significant pain medication for several years. His Dr. at Lady Lake Pain And Spine Centers of Florida (Dr. Pinnamaneni) won't take the time to do a simple "pre-authorization" which lowers the price by over $200 per month. Publix Pharmacy recently contacted the Dr. and asked twice. This veteran drove to the practice twice this week to ask the receptionist for help - and was promised swift action. The Dr's office has been called three times this week by me - and no response.

I checked with the insurance company - and the story get's worse! The insurance company (Blue Cross Federal) shared two things: 1) they personally put in a request to the Dr. for the preauthorization - and got no response and 2) it would also cost less if the Dr. provided a 90 day refill - but won't, because he bills more money by requiring the patient to come in once a month for a new 30 day prescription - and has been doing that for years. Ethical? Morale? You be the judge.

As a result, the prescription has cost this vet over $500 this year - which he frankly doesn't have! Because of the financial situation - he has been in pain for several days - until I found out about it.

Two requests to consider: 1) Recommendations for a new Pain Doctor to help a 100% disabled vet - with very little money? 2) Please tell friends and family to write to Dr. Pinnamaneni and ask WHY he would leave a war hero in both physical and financial unnecessary pain!!!

There are some types of “significant pain medication” that are not supposed to be prescribed in ninety day quantities because they are highly addictive and are often abused or resold. Sometimes doctors are expected to require certain lab tests of the kidneys and liver, too, lest there be damage. Is it possible that you don’t know the rules for this medication? Is it possible that this doctor is following the rules, where some doctors don’t?

I don’t know what the VA pays doctors who agree to work with them, but I do know that my combination of Medicare and the Blue Cross I pay for through my retirement benefits pays doctors, hospitals, and imaging centers around a dime on the dollar and usually doesn’t allow them to charge me anything at all. I don’t know how doctors can pay for office rent, employees, bookkeeping, taxes, and insurance on what may turn out to be a payment of only $6 to $10 for an office call.

Sometime, medications are more expensive because of a new, more convenient formulation or delivery method for which the pharmaceutical company charges a lot of money. For example, an easier way of giving an insulin injection or an epinephrine injection or a slow release capsule. Sometimes, less fancy forms of the same med are much cheaper. Pharmacy fees vary a lot. For example, often CVS is much more expensive, but sometimes it is cheaper. Get the App GoodRX and find out what the various pharmacies around here are charging for the drugs you take. (That doesn’t help you know what your insurer actually pays, however—sometimes they get highly discounted rates.)


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