Tuesday, March 29, 2011

Ugh-- Can't Live With Them, Can't Live Without Them

Can I scream?
I think Charissa says it best, "Dealing with insurance companies gives me an almost-uncontrollable urge to swear!"

For the last week I have been on the phone for huge chunks at a time trying to get Dennis approved for his specialist appointments. Funny how no one else seems to be as concerned as me--yet they have so much to say without even knowing why I am calling them. Who should have known that Dennis needed a recent hearing test before he could be seen by the ENT? Am I overreacting to think that I wasted the last 20 minutes of my life on hold only to be told that he can't get an appointment until he has a new hearing test? How many months out sounds reasonable to you before I can get an appointment for my son? Three? What kind of plastic surgeon should Dennis see? Who knew there was more than one kind? Whose responsibility should it be to figure it out?

Yes, I have tried to get help from various state ran agencies, and no they won't help us because we have private insurance. No Dennis medical condition has not changed-- he still needs to wear a prosthetic. Medical care and insurance companies have gone a little crazy in the last five years if you ask me. Forget abot the mountains of paperwork they make you out and sign, they make it nearly impossible to maneuver through their automated service and when you do, if you are lucky they will put you on hold until you give up and hang up. I'm nearly convinced that is part of their plan. You almost need a degree to maneuver through the steps of being referred to a specialist-- no joke. And more often than not, I am left hanging, things unresolved only to be forgotten by every medical professional until I call to begin the process all over again the next day.

And this is not only the case for Dennis. Take my routine mammogram. I was referred to the hospital and yet I was the one who needed to make the call to initiate an appointment. I was a little miffed to find out that the soonest appointment was over a month away. "Oh you haven't been seen here before? Well I can get you in next week." I am still scratching my head with that one.

And don't get me started with prescription refills and recurring medical supplies. Getting Alex a new supply of catheters involved changing primary care physicians, and crying to the tech. What an ordeal that was.

Okay, I'm off my soapbox. Sorry. Sometimes I just have to vent.


  1. Man, I am exhausted just reading about all that. Sounds very aggravating.

  2. Sorry to hear that you are having a hard time with the insurance companies and the doctors that go along with it. Have you tried a regional childrens hospital? I'm sure you have, but just a thought. There is a great childrens hospital in Salt Lake City. (Primary Childrens Medical Center) Good luck, and our prayers are with you, hoping an answer will come for you. Keep the faith

  3. Insurance companies can be incredibly frustrating!! I love mine- but it is also state employee insurance so they pretty much let me see whomever I want [within reason}. I do know though, there are dozens of different types of plastic surgeons, depending on the type of reconstruction needed, and typically {or atleast how it works with my insurance} everything is run through my primary doctor.
    I had some reconstructive surgery done. And what kind of doctor I needed, who that would be, where it woud be, the interview of them, all of that was done there at my main doctors office and then she made the referrel on to the insurance agency for me. What kind of plastic surgeon Dennis will need can only be determined by the referring doctor not by the insurance company.
    One this for sure when you deal with a lot of health problems is it gets confusing and out of control quickly. I like to write everything down, and kind of create a map. And then when I get to over-whelmed with who does what, and who refers me to whom, I always go back to my map or my primary care doctor {my main doctor}, schedule a consulation appointment, and have them take care of it for me. As a patient you have that option as well!!
    Good Luck!!

  4. Christine, I will be praying for you as you continue to advocate for the needs of those sweet boys. It's so sad but insurance is beginning to rule our medical world, not our doctors and nurses and it's only going to get worse. I have been waiting over a week now for insurance to approve a stress test for chest pains, still no word. One really hopes that I don't have a heart attack or something while they hash out the why's and wherefores of paying for something my doctor has ordered.

    Just keep fighting and know that you are being lifted up in prayer!

  5. I know what you mean. I recently just GAVE UP and decided it would be easier to pay the bill than get Blue Cross to. The doctor made an error on the code, or something, and I can assure you - in trying to get that corrected, I already spent more time (several hours) than it was worth....

  6. We have all been there.... I am really tired of automatic phone service..

    Took 45 mins just to get to a customer service for a museum. So I had to smile when I read your post this am

  7. Yup that would give me an erge to say a few unkind things too. sorry you have to deal with this kind of mess. Praying for peace for your heart as you deal with all the stuff you need to get the appointments you need.

  8. Ugh! You too? At least we know we're in good company I guess!

  9. i hear you. we are working on approvals for jasmine's meds and her surgery next week.

  10. I totally agree with you! IT IS CRAZY! I have had a run around for the past month to see a specialist from the insurance company. On top of that, we just moved from Boston to Atlanta and we are new too and I called and some appointments could not be made until SEPTEMBER! Now this is not acceptable to me! I have serious medical issues that can't just be ignored until SEPTEMBER! (ie, kidney failure and skin cancer) It is a joke! We even pay for the "super" insurance! Something has to CHANGE! I know you probably are not a fan of Mike Moore but his movie on insurance companies and US medical care was very telling! (Sicko) I cried during the whole show. Sorry, you just got me going too!

  11. I can't imagine. We are so blessed in Canada..all that is covered under our child's disability. As for test for us..it's covered under our OHIP and we don't pay..the only thing we pay for is our prescriptions..but dh has coverage so we only pay 10%.
    .. It's a shame that it is so costly in the US and sad that they make it so difficult. I will keep you and your beautiful family in my prayers

  12. Does your husbands employer's insurance company have an advocate or liason that you can get involved? I've done that a few time and its very helpful to have someone familiar help out. take care

  13. Hi! Sometimes it is easier just to pay the bill myself then to wait and get a preapprovals. Sometimes I have waited so long for the preaapproval I did not need the specialist appointment after all my condition improved.Good luck Pat


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