Yesterday morning, Kelsea started coughing and had a slight fever. Night came and she still had fever ranging from 37.8-38.6. She’s still active but because of the news about the spread of dengue fever, we decided that we’ll bring Kelsea to the doctor for check-up in the morning.
Our current pediatrician Dra. Rosalinda Crespo of Asian Hospital and Medical Center (AHMC) is not accredited with any Health Maintenance Organization (HMO). She was Kelsea’s pedia since birth. So we shelved out money for consultations, vaccines and lab tests on Kelsea’s previous illnesses. She’s very accommodating, well-organized, can be contacted 24/7 thru her mobile and gives rewards to Kelsea every check-up.
We got Kelsea a Maxicare health card last November 2010. But we haven’t used it yet because as I have mentioned, our pedia is non-accredited. So the HMO card is a standby in case (knock on wood!) Kelsea needs to be hospitalized. But today, we decided to try to use it and consult with a Maxicare-accredited physician. In AHMC, the Maxicare office was transferred to the the 8th floor of Civic Place Bldg. which is across the hospital. I presented Kelsea’s HMO card and was given a consultation form for Dr. Eleanor Sia. I have already researched Maxicare’s website beforehand and knew that Dr. Sia has no schedule today. But the staff said that she’s available the whole day. Maybe their website is not updated. So I didn’t argue anymore. When we arrived in Rm 508, the clinic receptionist told us that Dr. Sia has no clinic today. Grrr! I’m disappointed on the Maxicare staff. I needed to go back again to the other building and have the consultation form changed to a different doctor. The staff apologized when I came back and referred a pedia named Dr. Normelita Zalamea. When Mark, Kelsea and I went to this pedia’s clinic, we were 6th on the line. We just waited on that small room which has 4 doctor’s clinics. So imagine the number of patients waiting inside and outside of the room. I told Mark this how it feels to consult an HMO accredited physician. We need to wait very long. Kelsea’s fever is getting high already and feeling sleepy. He just lightened up my mood by telling me that we didn’t have to pay any cent since Maxicare will handle the expenses. That made me loosen up a bit. After waiting for 2 hrs, the pedia just asked me what’s wrong with Kelsea, what were the medicines I’m giving her and checked her breathing and tonsils. She said Kelsea might have asthma because of the wheezing sound. She just prescribed a dosage of the meds I’m giving my daughter and nothing else. The doctor seemed in a hurry. Actually, we were her last patient. Wanting to get out already, I just asked her to make a request for CBC and NS1 (Dengue test). She made it and looked like she was eager to finish the consultation session. She’s not the pedia I’m looking for 🙁 So I went back to the Maxicare office AGAIN to ask for approval of the laboratory tests. The whole process required a lot of footwork. Before, Maxicare’s office was inside AHMC. I guess they transferred due to rental costs.
Before taking our lunch, we brought Kelsea to the outpatient laboratory for testing. Mark had her sit on his lap while I stood by their side and held Kelsea’s hand. She cried because of the fear of strangers (the nurses) holding her arm and not because of the hurt when the needle was inserted. I suggested they put kiddie stuff there to keep kids loosen up. The test results will be ready after 3 hrs. I was continuously praying that she’ll be negative in Dengue. I’m so afraid of it because it takes lives of its victims, especially kids, in a matter of 1-2 days when very critical.
Fortunately, when Mark came back for the results, he texted me that the result is negative. Praise God! But her monocytes are high. I searched for it in the internet and showed that it was caused by an infection. So we still need to consult a doctor about this so that Kelsea will be given proper medication. But for sure, I’ll ask for another Maxicare-accredited pedia. Maybe we’ll try Dr. Sia since she’s well-known and she’s also my cousin’s pedia. Or we might also try Dr. Arneil Suratos, a known pedia pulmonologist, so that he can better check Kelsea’s cough.
So now, we are currently looking for the best pedia for Kelsea. Will it be her pedia since birth but not HMO accredited OR a Maxicare-accredited pedia but we just yet to find the one for us? Suggestions and recommendations are welcome 🙂
UPDATE as of 5/4/2016: We are still with Maxicare and satisfied with their service. We’ve also found a Maxicare-accredited pedia for Kelsea that she also likes since she was 2 years old and that’s Dra. Elizabeth Morales 🙂
Maxicare Healthcare says
Hi Ma’am, I’m Mark, I’m a Maxicare agent. I am saddened to know that you were misinformed by our rep in Asian Hospital. Glad to know that you’re baby tested negative. My reply might seem late, but for referrals, you might want to consult the reps of Maxicare in Asian Hospital and ask them for referrals based not on availability but based on reputation. You might want to ask for maybe 3 doctors. Bring these names with you and ask the hospital receptionist, even the janitors or guards or even patients that you meet and ask them about the reputation of those doctors. You will most likely get an unbiased advice from them.
Hope everything goes well.
Mark
http://maxicareinquiry.blogspot.com
Mommy Erl says
Hi Mark,
Thanks for your reply. I’m a Maxicare agent as well but under a broker. I actually already have 3 doctors highly recommended by an online community, friends and relatives. Unfortunately, two of them are out-of-town while the other one is Dr. Sia. Overall, I like Maxicare’s service and benefits. I just hope they’ll have a bigger office and more staff to accommodate members requesting for LOA.
Carmela says
Hello…having worked in a bpo industry,I have had experienced using three different HMO..out of the three, maxicare by far provided the lousiest service. The information that you get from their call center is different from the reps in the actual hospital. The irony here is my company opted for a platinum coverage bundle from this HMO. I suggest you avail of other HMO provider. Maxicare and its accredited doctors totally sucks. I can’t even begin to tell you of the back and forth I’ve went through because of their ineptness.
Carmela says
To add, kelsea should have been referred to the emergency department because she had a fever and dengue is prevalent in our country. Referring you to a pedia amidst the long line just shows how unsympathetic maxicare people are.