Chronic Pain

A 51 year old female living and dealing with lumbar back pain and fibromyalgia. Sharing things I do for relief, reduce stress and control weight gain.

Monday, April 22, 2013

Frustrated

Do you ever just feel like if you want something done, just do it yourself?  If I could I would.  Friday I decided to call my insurance company to see where we stand with an approval of the reposition of IPG.  I hadn't heard from the surgery center or the insurance person at the PM clinic. My insurance company couldn't seem to find any claims for a pre certification pending or denied from either place. This made my anxiety kick in high gear.  I started not to wait 2 weeks but I figured it would take at least that long so no need to call before.  I was so frustrated and disappointed :-(

After this call I was left feeling very saddened at the fact that two weeks have gone by and according to BC/BS we are still at square one.  I just felt like it was an added two weeks of dealing with this issue that could be avoided.  I want so badly to get this over with and move on.  I know it's not true but I felt like no one really cared.  I called my PM clinic and of course got the answering machine for insurance professional.  I told her what I knew and to please call me back because my insurance company told me under the circumstances they can call in for an approval.  That's another thing that bugged me, I could have had an answer a week ago.  

Next I called the person at the surgery center who would be ordering the new IPG and making sure everything is good to go there.  He wasn't available either.  Good ol voice mail.  Next I vented to Mr. R.  He apparently made some calls and at least got to talk to someone.  He said the person at the surgery center was out of town this week and would be back on Monday.  Mr. R said he'd personally call him and have someone get back with me or he would.

I tried really hard this morning to be patient and just wait for a call.  Then at 11 am it dawned on me that I'd been patient for two weeks and apparently did me no good.  If you want something done, done right....do it yourself.  I called back to both places and voice mail for both.  That can really be frustrating when you've already called once and your call has not been returned.  I don't know what else I can do though.  I can't make them talk to me.  If I don't get a call at all today I plan to just show up there tomorrow.  It may make no difference at all but I will let Doc know about the entire situation.  I also plan to ask help from Mr. R again.  I know he has Doc personal number.  Maybe he can light a fire under someone.  

I guess it really bothers me more than most because I did the very same job when I was working in the dental field.  If we didn't have an answer for a patient we called and got one.  We were human and made mistakes some time but always owned up to it and bent over backward to fix it and make them happy somehow.  To not even acknowledge that I'm waiting for an answer kind of makes me feel like they are just annoyed by my "making work" for them.
I know whats going on, their waiting to call me when they have an answer.  That just don't sit with me.  Call me and tell me where we are and what you've done to get an answer.  

On Saturday D and I took P to the zoo.  He had a good time.  It was a beautiful day.  Sun shinning but nice and cool.  We saw a good part of it but I tired out pretty quick.  After we were back home and P was back with mom Nonna hit the recliner.  I had a pretty good rest then went for a walk.  I haven't been doing much of that with my IPG troubles.  I have been however riding my recumbent bike most nights.  Saturday I covered myself with cream, took a pain pill and jacked up the stimulator.  After a 30 minute walk I actually felt a little better.  Later that evening though I was right back down.  I don't know what bothers me most now.  The IPG or back.  They just blend all together. 



Poppa with P at the zoo!




At 2:30 this afternoon I received a call from person I needed to speak to at surgery center.  He explained he had faxed the pre cert to my insurance the same week I saw Dr. but had no idea they didn't receive it.  Last week when I called him he was in Boston and just got my message this morning.  So he has now resent and states he will call tomorrow and make sure they have it.  He said it shouldn't take more than a couple days to get an answer.  The strange part is he said he just got off the phone with Dr. G and got an update on what's going on with my IPG.  ( I guess that was delay in a return call today)  Why would he have to call the doctor to find out what to request from insurance company if he had already sent it once?  That's odd! Oh well at least I know it's being worked on now.

We leave for our long week end get away Friday.  I'm looking forward to being at the beach and hearing the sound of the waves rolling in.  Reading a good book too.  I just hope I can find a way to get comfortable.  Not looking forward to the drive either.  I have to pay to play though.  

My heart goes out to all the victims and their families in Boston and West, TX.
Praying for peace in their hearts and to not be afraid to go forward with their daily lives. 

Hanging in there....Theresa

God is not so concerned about what we do, but why we do it.

3 comments:

Unknown said...

I know what you are talking about insurance and DR office. I have been trying since September to have my third fusion surgery, my insurance denied four times, so I had no options left but to go with the SCS. It only took my insurance 4 days to approved the trial. It went so well I am now waiting for a surgery date and my insurance to approval. I am not too worry about the insurance, hopefully the surgery center and my DR can get a quick date. The trial SCS was so helpful with my pain, the faster the better.
When I was working with my insurance in the fall, I had days liked your that you had last week. I pulled every string I knew and still got no where. But I now know that insurance companies are not approving fusions surgery and it isn't just mine. I have tricare prime, it's with the government since I spend 20 years in the Army. Hope you have a great time this weekend.

Shauna said...

Dear T,

....."I know it's not true but I felt like no one really cared".

Oh how I understand that line!!! I waited over a year and a half to get into the correct hospital, doctor, etc., for the consultation for an IDDS trial. (Intrathecal Drug Delivery System) It was actually there that I received the results of my Thoracic CT scans showing the severe damage--it was the physician that would be implanting the pump that looked at me and told me how messed up my spine is. That was part of why I did not have the trial at the time, and there was also a question regarding the actual Hospital and the trial pump surgery costs, which should have been researched and dealt with previous to the appointment)

The waiting is always the hardest part. Think about the day of any surgery--doesn't it seem like HOURS to be taken into the OR? Or for a post-op pain shot? It even seems long if fasting is required the evening before. Moans and groans about how hungry we are and how great the coffee smells that ONE morning we can't have any.

Yet waiting weeks, months, into years for treatments/surgeries to be approved is common these days. Insurance type doesn't matter, it is all about following up on everything that others are being PAID to do, to make 100% sure we are taking care of ourselves.

Sad to say, yet the waiting for that pump appointment was due to insufficient staff at my old physician's office. I learned real quick in this continuing, daily life with pain, that no one else cares about my health as much as I do. I've spent hours of my time on the phone, the internet, and writing letters to speed up the process...but mainly to stay on top of those who are processing paperwork on my behalf. If I don't, no one else is going to.

Because if that ONE single piece of paper is not submitted/received when they tell us it was, what are we supposed to do as the patient when this occurs? Oh well, just wait some more, and patiently please.

Hang in there my friend (you never heard that before I bet) I know you have that special inner strength, God is so good honey, and I know you will surely get this taken care of....Kudos for being a 'very patient patient'!!!!

Gentle Hugs---<3

Unknown said...

That was really frustrating! Dealing with an insurance company is, sometimes, very difficult when you're doing your part, but they don't do the same to get things done faster. It may have helped you if you hired a lawyer for your legal representation so you wouldn’t have been that frustrated.
Maggie Malone @ Mastrangelo Law Offices