Don't it just figure

[kitanzi]

Oh, wheeeee. The insurance company pulled the plug on the surgery, until I get an additional 4-6 weeks of physical therapy. What the hell that's supposed to do for a bone spur I have no clue. ACat talked to his HR people, I talked to his HR people (since I'm on his insurance), they gave me a phone number and explained that my doctor would have to make any appeal on this. I called my doctor and left a voice mail. I got a voice mail back from his nurse - he got some sort of faxed note from the insurance company and apparently said "Fine, she needs therapy." So, he's useless for any appeal. Maybe I do, maybe he just doesn't want to be bothered. ACat suggests that maybe he knows the insurance company well enough to know it's pointless.

So, no surgery for a while at least. When I talked to the nurse (I've lost track of which phone call this was, lots of calls and voice mails back and forth, I'm sure she detests the sound of my voice by now) she told me that I should call them after the therapy was done and she'd make me a appointment for the surgery right away. I think she meant to be kind, and let me know that they'd try and get me a quick appointment rather than make me wait, but to me it sounds like she just doesn't expect the therapy to do anything useful. I asked her as much and she backpedaled quickly, but...

So, at least another month to a month and a half on pills and ice packs, chronically short on sleep and at war with my own body over such ambitious things as combing my hair or wiping my mouth and with no real faith that I'm doing anything but wasting my time to placate the insurance company.

I was outraged. I was furious. Right now, I'm just out of energy.

EDIT: The phone number I got for the PT clinic doesn't work, which seems about par for the course. Another back and forth on voicemail, and I have a new number. I also have an appointment on Tuesday bright and early for a cortisone shot, which gave some temporary relief last time. It's something.

Comments

[madfilkentist]

Doctors vs. insurance companies ... not fun. I had a small does of the same when a fax from the insurance company, claiming a form had been filled out wrong, went awry. As a result, my prescription was held up for over a week. My medical provider, Dartmouth-Hitchcock, didn't want to do anything but wait for the reply from the insurance company to magically appear. When I said that was unacceptable, they gave me the number of a person who supposedly deals with resolving issues; she told me, "I don't know what to do." I suggested that making them talk to the insurance company was what she should do.

Eventually I did get the prescription approved, but only after repeatedly nagging several people, and after paying for a week of pills out of my own pocket. Even then, they didn't apologize or offer to reimburse me.

Nagging is a good idea, though. Have the doctor explain exactly why physical therapy is sufficient treatment for your pain. If he's useless for an appeal, he's useless as a doctor.

[kitanzi.livejournal.com]

I may well do that. Kyttn had a number of specific suggestions along those lines, and she deals with this kind of thing a lot. I just have to scrape up some more cope, since I'm temporarily out. Maybe tomorrow.