Rumors of this blog's demise have been greatly exaggerated.
I made what I thought was an April Fool's joke funee, and found out some of my readers took it seriously, which wouldn't have been so bad, except I promptly entered one of those phases where blogging became next to impossible, so it really did look like I'd packed up and gone away. That'll learn me, as my dad used to say, not to joke about serious stuff like blog network hopping.
Anyway, I am still, in theory, blogging at Scientopia. It's just been the usual life madness. A picture being worth a thousand words, here's what I've been doing lately.
This morning, the phone rang a little after 9 a.m. It was the person from my neurologist's office who they've hired to work full time on dealing with insurance companies solely on the issue of getting approval for botox treatment for migraine. She was calling to tell me that she has left numerous messages for my insurance company's rep and has not gotten a reply, and now it's my turn to try and roust them. The insurance company has denied my request for coverage, claiming there is insufficient evidence to show that I've failed three alternative treatment options. The neurologist's office says they've sent them the information. The insurance company rep says they would be happy to talk with the doctor's office, and the doctor's office rep says they would be happy to talk with the insurance company. This game has been going on since I got the rejection letter sent out on April 16. I have until June 16 to get my appeal completed. I am not optimistic. I feel like I am swimming in molasses. I will never reach the shore, and will drown in this sticky morass of everyone saying they are happy to help me if only the other person would do x, and the other person saying they have done x, and would be happy to help me but the other person needs to do y, which is what the first person said they can't do until the second person does x, which their office shows no record of it ever having been done, but if I could call them and ask them to fax x over, and the second person says we faxed mini-x and it's their own fault if it isn't sufficient because they wouldn't let us send more than mini-x and the first person says the second person should know that we need x and the second person says I can't get the first person on the phone and the first person says just ask the second person to call us and...and my head hurts. It hurts a lot.
Five minutes after I got off the phone with the neurologist's office, my phone rang again. It was someone from the endocrinologist's office. They filed a claim with my insurance company for my visit a month ago. The insurance company has refused to pay until they receive an explanation of benefits form from my Medicare insurance. I don't have Medicare insurance. The kind woman on the phone tells me "they are doing this to a lot of people. You'll have to call and tell them you don't have Medicare, and ask them if they can reprocess the claim or if we have to refile, and then call me back and let me know."
I haven't even had a cup of coffee yet, and I have at least three health insurance phone calls to make. Plus a form I need to fill out for my in-laws. Plus the usual paperwork for Z-mom. I look at the cat curled up on the bed and want to crawl back under the covers and sleep till noon.
A few weeks ago I called the toll-free number Mr. Z's company provides for its employees, for a health advocate service. The person I first spoke to was very enthusiastic and sure they could sort out the mess and help me get coverage for my botox treatments. She then transferred me to a nurse who listened for a few minutes and then told me that I should not be calling the health advocates, I needed to file an appeal on my own, and ask my doctor to write a letter for me, and if my appeal failed, then I should come back to the health advocates and maybe they could help me then. A week later the nice person I first spoke with followed up by email to ask why I had not filled out the paperwork she sent me and I told her about my conversation with the nurse. Oh no, she said, we can surely help you out! Who am I supposed to believe, the phone screener, or the nurse who essentially told me to get lost? What does this health advocate service actually do?
What good does it do for my neurologist to employ someone full time to work with the insurance companies on trying to get approval for botox coverage, if that person doesn't even know anything about the patients on whose behalf she is working? When I first talked to this person, she didn't know that I'd had a migrainous stroke, and she seemed unaware that my previous insurance company had paid for my botox treatments. When I tried to explain what I did to get approval from my previous insurance company and offered to help in any way with putting together my file for this insurance company, she was uninterested. I feel like, I am just a patient, what could I possibly know.
What good does it do for the FDA to approve botox treatment for chronic migraine, if all the insurance companies then just drag their feet and stonewall as much as they possibly can to prevent anyone from actually getting coverage? It's not like they didn't know this was coming. I'm sure they all knew well before the FDA decision that it was likely to be approved, and the approval was issued in October last year. And as of the first of this year, the insurance companies were all still claiming that they hadn't figured out how they were going to cover botox, what kind of coverage they were going to offer. Seriously? That's how you run your business? You wait till the last minute and make it up on the fly? Pardon me if I don't believe that. That $1200 I had to pay out of pocket in February is a crime.
And I just can't afford it anymore. So until the paperwork nightmare gets sorted out, no botox for me. I just have to deal with the increasing pain and fatigue. And I just have to hope that I can manage to get it sorted out by June 16.
Or maybe my non-existent Medicare will pay for it.
I guess I'd better stop ranting and get going on those phone calls. The best health insurance in the WORLD! doesn't work itself out on its own.