Services at Guadalupe Valley Hospital/Guadalupe Regional Medical Center (GRMC) for people with military CHAMPUS/TRICARE have not changed over the years. This facility has failed my military family over the years and now it does it again.

My complaint is not with the actual GRMC medical services provided or services provided clerical services personnel but rather with administrative procedures that have been established “by the powers to be” over the years regarding CHAMPUS/TRICARE. There have been problems almost every occasion that we have tried to utilize GRMC and here are only a couple of examples due to article word limit.

Several years back while still on active duty, we took our son into the Emergency Room for a sport injury that occurred at SHS. They would not treat him until I paid money up front, which I did because I was concerned for my son. Well, the hospital ended up filing a claim and also collecting from government. The hospital collected twice and I had a difficult time trying to get my money back until I informed them that I was going to turn them in for fraud. After they agreed to return my money, they delayed the refund again because they supposedly only issued checks on a certain day of the week/month.

Most recently, my spouse was issued a referral by SAMMC (BAMC) to seek physical therapy through community sources that accepted TRICARE and MEDICARE. We contacted the GRMC on April 27th and they said that they did accept TRICARE & MEDICARE but that the first available appointment was May 7th. We provided the referral form issued by SAMMC as instructed. The people at the Physical Therapy office indicated that they needed a fax from the SAMMC because the referral form was issued/dated April 4th and it would be more than 30 days to the first available appointment of May 7th. I contacted the SAMMC referral office and they said they would fax a form to the GRMC but they didn’t understand why the referral was not acceptable. We notified the GRMC of the forthcoming fax and they promised to call us as soon as they got the fax. GRMC never called us so we stopped by on May 1st and GRMC confirmed receipt of a fax on April 29th. The fax plainly indicated that the Referral Authorization End Date was April 11, 2020. The GRMC receptionist and others at the Physical Therapy office still declined services to my spouse based on the referral as written. There were polite about the situation but insisted that the procedures established by the GRMC “higher ups” prevented acceptance of the referral because the date on the referral was more than thirty days from the first available physical therapy appointment date even though the referral clearly showed a Referral Authorization End Date of April 11, 2020.

Guess what? We immediately contacted SAMMC to inform them about GRMC refusal to accept the referral as written. They were surprised to say the least. We then went to another local physical therapy services office in Seguin and they accepted the same referral as written.

It’s amazing how the GRMC bureaucracy affects certain people.

 

Paulino Soto is a resident of Seguin.

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