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I need a Pain Medication Management doc in AL- Medicaid.

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I need a Pain Management doctor in Alabama that takes Medicaid. Does anyone know of a doctor? I don't have Medicare or any other insurance. PLEASE HELP. My pain doctor quit taking medicaid and I only have a few days of medication left. He can't refer me anywhere else because he says he honestly doesn't know of any doctors that handle pain medication and take Medicaid. I'm not a druggie. I just don't want to abruptly go off my pain medicine. I called the Duragesic company and they say it's not good to abruptly go off of the patch (100 strength)! My primary care doctor won't write me a prescription to wean me off my patches. He said he doesn't write prescriptions for pain meds. I don't want to really go off my patches at all, but if I can't find a pain doctor that is what I am going to have to do. What ever happened to that word titrate? If you know of a doctor please contact me. Thanks
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replied April 19th, 2008
Experienced User
I do not specifically know of a pain doc in AL that takes medicaid but am aware of several that have recently dropped the program. With the influx of managed care medicaid or traditional medicaid with increasing cumbersome and arcane rules and regulations, coupled with the reimbursement that effectively requires free treatment by the physician, it is not surprising medicaid is being dropped all across the country.
Search the following sites for lists of pain doc names:
american board of pain medicine
www.sppm.org
www.spinalinjection.com
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replied April 19th, 2008
in need of a pain doc that takes Alabama Medicaid
Thanks for answering. My first pain doctor quit taking medicaid and abruptly dropped numerous Medicaid patients. After that I found a great pain doctor but he moved to Chicago. Neither of these doctors cared enough to worry about me abruptly stopping my medications. Heck, they wouldn't even face me. They both let their assistants or receptionists tell me to just "find another doctor." It might be easy to find another doctor if you have real insurance but with Medicaid it's almost impossible! Luckily a wonderful nurse, from Chicago bound doctor's office, called me when she applied for a job at a doctor that took Medicaid and did pain management. That is how I found my last doctor, the one that is now quitting Medicaid. He may actually be moving too. I can't get a straight answer from anyone. All I know is that he won't treat patients that have Medicaid and want pain help.

So, I checked the doctors that you said to check and they don't take medicaid. I called one of them previously and the first visit is $490! I am on SSI and my monthy income is only $637. It seems highly unlikely that I will ever have $490 unless I don't pay my rent for a few months. But making myself homeless to see a doctor doesn't seem like a very good solution. They probably wouldn't see someone that doesn't have a permanant address. There is that horrible fear that all poor people are illegal drug users or drug sellers. I'm neither. I just want pain relief!!

If a doctor won't take Medicaid it is unlikely that he wil be willing to fill out some Medicaid pharmacy paperwork (prior authorizations & theraputic duplication pharmacy override forms) so that I could be a prescription filled. For some reason, non-Medicaid doctors don't want to do that paperwork! Doing the paperwork doesn't mean that they take Medicaid patients. Medicaid requires extra paperwork for the pharmacy. It's Medicaid's way of checking that there are no double prescriptions for the same problem (especially narcotics!) But if a person needs two prescriptions for the same thing, (example- breakthrough medicine) there is a form for " theraputic duplication" to fill out. Most doctors hate all this paperwork. I'm used to the paperwork because for 4 years now I've had to have it all filled out just to get my monthly prescriptions filled. My first doctor (that quit taking medicaid) was feed up with all that paperwork. He would mention it occasionally. I am pretty sure that is why he won't take medicaid patients that need pain medicine. Funny thing is, I think he will still do blocks for people on Medicaid. That doesn't seem right either! To treat one thing and not the whole person... I'm sure too that it was a money move. He probably didn't make very much money, if any, on an office visit for pain medicine. There is more money in procedures.

I've had 4 low back operations. The procedures didn't seem to help after the second operation. I don't want another operation, though I'm sure that is my only option if I can't get pain relief any other way. I also have fibromyalgia which started right after I had an anterior cervical fusion. My neck and shoulders still hurt constantly. I also probably need another cervical fusion, but the first one didn't help and only brought fibromyalgia. I don't want to do it again. I had a block on my neck before my second doctor quit. It didn't help at all.

One of those local pain clinics does clinical trials. (found at clinicaltrials.gov) I can't afford the place but I thought maybe I could get in volunteering for a clinical trial. But, no one will call back. My luck I'd get the placebo anyway. But I'd be willing to try anything if I can't afford to pay $490 to see them for a first visit.

I don't know what I am going to do. It sure would take a load off the system if all the pain patients just ceased to exist, wouldn't it!!? I guess that is what the doctors are pushing poor pain people to do. Only rich people could afford to pay $490 for a doctor visit. And the poor people should just suffer, I guess. Why do the doctors of this area want me to suffer so much? Why can't they just take Medicaid? Maybe just a limited amount of patients or something.
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replied April 19th, 2008
Experienced User
There is one study that shows 60% of Medicaid patients receiving chronic opiate narcotics are engaging in substance abuse or are selling/trading the prescribed drugs. Medicaid patients have a much much higher rate of having prescription narcotics lost or stolen, have a much higher "no show" rate for scheduled appointments, use illegal drugs more frequently, have a higher rate of running out of their prescribed narcotic medications early, and make more frequent calls to the clinic for an array of problems. The paperwork for Medicaid patients is a nightmare and the rules/regulations are constantly in flux for Medicaid, which would require a physician to check the Medicaid website daily for changes in some states. For some physicians, it is not the fact they are treating Medicaid patients for free (they make enough to pay for the secretarial and nursing time to answer the hundreds of Medicaid patient telephone calls and stay on the telephone for 30min to an hour with Medicaid for each patient needing a preauthorization for some medicine or procedure), but instead the reasons some physicians don't want to treat the Medicaid population is the misbehavior of the Medicaid population itself. Individuals with Medicaid, no matter how compliant with clinic policies regarding prescription narcotics, are lumped with the Medicaid population that cannot control their use of the prescrption narcotics.
In most states, Medicaid is not an insurance plan, it is a law. A patient having Medicaid cannot pay out of pocket to the provider above that permitted by Medicad for services covered under Medicaid, and a physician charging cash and not filing Medicaid paperwork may be committing Medicaid fraud if they are aware the patient has Medicaid.
It is not the fault of the individual that they have to rely on a social welfare program such as Medicaid, but there is a disproportionate percentage of Medicaid patients that create a drug abuse or diversion nightmare for physicians. The low reimbursement by governments is ridiculous and is certainly a factor, but many physicians would happily treat the poor for a steeply discounted rate if they did not have to deal with the paperwork nightmare created by your state government.
So there are many factors the poor must face in finding medical care, and in the realm of pain medicine, the population behavior of the pain patients as a whole has made treating them hell for the physician. I have no good solutions, other than continue to expand the radius of your search for a physician that will accept medicaid.
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replied September 8th, 2012
Don't "Stereo" Type Anyone, Especially the Sick.
I had Aetna Insurance through my employer before I became disabled. There is a huge difference being on Alabama Medicaid. I was in college and working full time too when I became disabled. I have never failed a urinalysis at the pain clinic I go to since 2001. My meds were never lost or stolen. I'm not on this "medicaid" by choice...I hate being stereo'typed' by doctors, nurses, and staff at any facility. What about the oath "Doctor's" took????? It's a shame to treat all people the same because WE ARE NOT ALL THE SAME. I worked, had fantastic insurance, was in college, had a plan until a illness made me physically disabled. I hope to God it doesn't happen to YOU and any of YOU who so easily 'stereo'type people like me...being disabled and on Alabama Medicaid is a job in itself. I am not a poor pitiful person looking for a FREE ride, I had it all going for me and was HAPPY until something out of my control PUT A STOP TO MY GOALS. Please think before you judge 'anyone', it could happen to you. God Bless.
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replied October 14th, 2011
I am a veteran
@algosdoc! I am a medicaid patient! I beg to differ not all people on medicaid is an abuser/seller, nor are we all drug addicts. I served in the army for 3 years and I suffered a severe neck injury. My reward??!! discharge, 2 years pension and a life time of pain and disability and I believe I deserve more credit. So for you to say just because you are poor and need medicaid you are more likely to abuse drugs, is preposterous. Yes, its more paper work but that's what they get paid for!! I also am a single mom that opted for no child support from his father who makes good money, just that he keep health coverage on my son. Having money does not make you better than some one nor does it give you a right to place a label and those less fortunate! I have known many people of higher society (from being married into money) that has participated in a lot of "recreational" drug use. So please retract your statement for you are wrong! It is people that think like you that cause alot of bad things to happen to the less fortunate, that doesn't have to. Sorry to be so blunt but fact is fact. Oh and the "misbehavior of medicaid population" if that refers to the out bursts and being straight forward, its all because of how they are viewed and treated at the physicians office!
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Users who thank 4himallmylove for this post: countrygirl80 

replied October 14th, 2011
Experienced User
The study was solid. I will retract nothing. Medicaid is a sad place for patients to be but the costs of doing business exceed that which Medicaid pays. For most doctors, it is worse than charity care: at least with charity care you don't have to deal with mountains of paperwork and reams of ridiculous and everchanging rules.
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replied December 1st, 2011
@painfulback and 4himallmylove,I can relate to what you are saying!I moved to Alabama in August 2011 at the time Medicaid was undergoing all their changes everywhere!I'am a lung cancer patient in remission and also have severe damage to the c-spine t-spine and s-spine have been in pain management since 2005 now here it is 2001 and cant find a Dr. to accept me with medicaid there has to be something we can do we cant help that we are disabled and poor and should not be expected to suffer because of the bad apples (abusers) they shouldent be on the medicaid program to start with the drug testing in the pain Dr. office should show if there is abuse of the medications or any street drugs being used by these folks it is so sad we are sterotyped by others behavior!@algosdoc there has been alot of studies that have been done on alot of things that are NOT solid as you say!!!I agree the paper work is a nightmare for the offices but also agree thats what the people that work there are paid to do!Do the Dr.'s not care anymore what happens to a person or is it all about money?This world has become a very sad place with all the greed..I personally think healthcare should go back to the way it used to be when your family Dr. took care of everything !Instead they had to make all these speciality Dr.'s so everyone could have a peice of the pie and frankly I think there should be limits as to what they are allowed to charge it has all gotten out of hand and your right only the rich can afford to pay those prices!If either of you find a Dr that accepts this insurance please reply and if i have any luck I will let the 2 of you know.
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replied December 1st, 2011
what happened to Dr.'s that cared?
@painfulback and 4himallmylove,I can relate to what you are saying!I moved to Alabama in August 2011 at the time Medicaid was undergoing all their changes everywhere!I'am a lung cancer patient in remission and also have severe damage to the c-spine t-spine and s-spine have been in pain management since 2005 now here it is 2011 and cant find a Dr. to accept me with medicaid there has to be something we can do we cant help that we are disabled and poor and should not be expected to suffer because of the bad apples (abusers) they shouldent be on the medicaid program to start with the drug testing in the pain Dr. office should show if there is abuse of the medications or any street drugs being used by these folks it is so sad we are sterotyped by others behavior!@algosdoc there has been alot of studies that have been done on alot of things that are NOT solid as you say!!!I agree the paper work is a nightmare for the offices but also agree thats what the people that work there are paid to do!Do the Dr.'s not care anymore what happens to a person or is it all about money?This world has become a very sad place with all the greed..I personally think healthcare should go back to the way it used to be when your family Dr. took care of everything !Instead they had to make all these speciality Dr.'s so everyone could have a peice of the pie and frankly I think there should be limits as to what they are allowed to charge it has all gotten out of hand and your right only the rich can afford to pay those prices!If either of you find a Dr that accepts this insurance please reply and if i have any luck I will let the 2 of you know.
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replied December 28th, 2011
I have lived in Alabama most of my life. Born & raised here. & I too am on Medicaid. I have had 55 surgeries, 38 spinal & 5 brain. I am on disability as well. I am now looking for another pain management doc. The one I had in Birmingham quit taking Medicaid. Medicare is my primary & Medicaid is secondary. I am looking at trying to find one in Cullman but only found 1 & his reviews are not very good. So guessing its back to Birmingham to UAB's pain clinic. They do take Medicaid even if its your only insurance. There number is 205-930-8966. Good Luck. I have to say stereotyping everyone who has Medicaid into a drug abuser category is the same as saying all Afro-Americans are thugs or all American-Indians are alcoholics. Neither is true. Because some people behave in such a way doesn't mean all or the majority behave the same.
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