The second thing on my list
is really really frustrating really
To do list experts (yes they are a thing no I am not going to cite sources,) say to being each list with small wins. I was so committed to this strategy that I used to put “brush teeth” and “get up” on my list until there were days that I couldn’t cross those off and it was very depressing. Meta.
Today’s list is pretty tight. Things that are immovable (MD call), important (ankle brace for H), and scary as hell (check on insurance appeal.) I am leaving tomorrow for 4 weeks so a few of the Denver based activities that I might have been able to push have already been pushed to their final pushing point. They are on the precipice of toppling “to do cliff.” The little known but most terrifying cliff of any average day.
The first thing on today’s to dos is “post.” Which is this. Which is short. Because the second thing is MD $ paperwork. One acronym, one special character, one word. It would be an acceptable password for most apps. It is a daunting task for most people. I have an ongoing appeal for $5,500. which I am likely to win if I can pass through level four of our battle and go on to beat the big Boss. of Aetna waits for customer to call them on ignoring the appeal. I have already triumphed over:
Aetna denies coverage for false reason or “mistakenly” determining things are out of network. These denials are not itemized, they can sneakily hide them between approvals, to be teased out only in long phone calls with Donna, my most beloved customer advocate.
Patient needs to enlist testimony from medical team
Patient needs to work with “patient advocate” (ha) to put together medical testimony and patient testimony and file appeal.
Patient needs to continually harangue advocate and customer service until advocate no longer wants to advocate and service no longer wants to serve. (Assuming they did.(And Donna did, but I might have broken her.) Me: I know you probably can’t answer this but do you see A LOT of “mis-labeling” of procedures as “out of network” that are in network. Donna: “I won’t say that I don’t see that.”
BIG BOSS. Appeal the denial of the appeal.
I am 14ish hours in and launching challenge 4 this morning. It Monday. Time to scream and cry. Donna works on Mondays.
The problem is I had ignored the mail for part of last week and when I went to gather my tools- mail, notes, screen shots of doctor chats in portals that I can magically navigate, at least six colored pens, MD letters, my ReMarkable tablet and its stylus which rolls into crevices I never knew my bag had- I found more envelopes. A second letter denying this appeal, and four more denials of coverage for two different family members. One, not the most expensive, is the low hanging fruit. It is $900 for a ferritin test that my MD ordered. One vial, one minute, $900. I am only able to figure out the details of the ferritin test by comparing this statement to two other statements that I have annotated in different colors. As of this mornings “not a bills” I have another 4,300 (ish) incorrect denails. Whilst we have ALREADY MET OUR DEDUCTIBLE.
Let me now say the thing that both keeps me sane and makes me more angry. I read English. I can translate these bills (and “not a bills” that they hope you recycle without reading because then the “yes a bills” are unintelligible from code into language with careful cross-referencing. I have time to sit on the phone because I don’t need to work three jobs to get this shit done.
Grateful: my means and skills
Furious: the system, the victims of the system and their resultant debt.
So with a to-do cliff looming I will try to practice deep breathing through my hold time and try not to cry when I realize Donna’s direct number no longer works, probably because for a time she was a patient and effective advocate and thus Anthem has sent her to a sub-basement.
Wish me luck.
Watch this actually sort of uplifting piece from John Oliver about medical debt.
Tell me stories about beating this boss. Or losing and living to tell the tale.
Ugh yes. I am in a mood today. Andi just sent me an article about how CPAs are overwhelmed and can't get taxes done on time. So instead of people getting their own money back from the government, they are automatically getting an extension. My dad was a tax accountant. And as someone that had to take over my father's affairs, I would see the emails that he'd get basically rallying the accountants to keep taxes complicated so that we the non-accountants would have to keep paying them. Well, now because of all the recent changes taxes are too hard for them to keep up with. Well done. We all lose, again. Getting my dad on medicaid was a nightmare. Weeks of my life battling with people on the phone, over email, etc., all to get something that he was 'entitled' too. Naturally I had to pay an attorney hefty fees to help me with the process. They too have craftily secured their positions as guides through an opaque cloud that they have a hand in creating and no desire to see lift. I have pretty much given up on my own health insurance battles. Paying out of pocket for a colonoscopy that my doctor ordered because my sister has colon cancer. (And I was at least 45 y.o. at the time.) Bullshit fees on everything. The government just now finally pretends to care about after people can't get Taylor Swift tickets. The common theme? All things that people in other relatively civilized countries don't have to put up with. I asked my German friends how long they had to deal with paperwork and phone calls after a visit to the hospital... they just stared at me like they didn't understand the question before they answered "none." Am I putting the rose colored glasses on? Am I over simplifying things and leaving out nuance? Am I ranting? Should I be grateful about what I do have? Yes. Yes. Yes. Yes. But is there a better way? Hell yes. And to all the professionals out there who 'help' me out- I get it, it's a game. Don't hate the player and all that. So I guess we all go down together. I guess I should say something nice. The sun is shining today.
I'm so sorry Anna, that sounds incredibly stressful. Wishing you the best of luck with everything - I hope you defeat the big bosses.