It's no secret that I have been struggling with chest pain for a long time. Off and on for about four years now in fact; ever since my heart surgery in 2010. My first cardiologist told me it was part of the recovery process, my surgeon told me I was making it up and my current cardiologist has actually been trying to help me. It has been very slow going, but it seems that we are starting to narrow down the suspects.
We have tried all the usual tests and medications. I've had stress tests, EKG's, echo-cardiograms, chest x-rays and CT scans of the chest. All of which has always come back normal so we have never been able to pin down a reason for the chest pain. We have tried Ranexa, isosorbide di-nitrate and nitroglycerin tabs as well anti-inflammatory meds with mixed results. Some didn't work at all and some only worked for a short period of time before the chest pain returned and back to the doctor I went.
I suppose on the plus side I have already met my deductible and my out of pocket maximum for the year. And we're only half way through July.
The latest thing we have decided to try is a heart catheter. The reason my cardiologist wanted to put it off for so long is because of the invasive nature of the procedure. It's not normal for someone in their early thirties undergo such a procedure. But I also pointed out to him that it's not normal for healthy 29 year old women to have strokes. He concurred. During the heart cath, the doctor is looking for anything that could be causing the chest pain; scar tissue, heart disease and malformations of the heart. While we're hoping that there is no need for further surgery, I have been made aware that is a possibility, albeit a slim one.
So now I'm just in that place of limbo where obviously I don't want there to be anything wrong but I want there to finally be a solution to one of my problems. The sooner we can take care of this one, the sooner we can take care of the rest. Oh, how I hate saying that there is still more to work on...
Till next time my friends.
Showing posts with label insurance. Show all posts
Showing posts with label insurance. Show all posts
Wednesday, July 16, 2014
Tuesday, January 28, 2014
Let's Get Physical
I had a frank discussion with my neurologist about my physical well being. Over the last three years, my right side has progressively gotten weaker and weaker. Because of the neuro-pathic pain (a present from my stroke) that we just haven't been able to get a handle on, I have gotten less and less active. It can now be a struggle to do my daily activities due the pain and weakness I am experiencing.
It's a vicious cycle that I haven't figured out how to break. I try to work out and go for walks. In fact I walk my daughters to school on average about three times a week. The walk is one mile round trip. Granted, after half a mile, I am already ready to call it quits, but I try and fail and try again. Thus prompted the discussion with my doctor. Something has to change. I am on lifelong medication, some of which has made me gain weight, and I need to get more active to lose the weight to keep a healthy heart and reduce the risk of another stroke.
We decided on a round of physical and occupational therapy to help my body get back to where it needs to be. I had my first appointment last Thursday. It was my evaluation day. After that, the insurance company gets to decide whether or not to continue paying for the therapy. The evaluation went well. I have lost a lot of strength in my right side as well as range of motion. Cindy, my therapist, was great. She was knowledgeable and patient. She answered all of my questions. I honestly couldn't have asked for better.We didn't get to the occupational therapy, something I will have to address at my next appointment, but I was sent home with plenty of exercises to do everyday to help build my core strength and my balance back up.
All that's left is waiting to be sure there are no hiccups with the insurance company. I spoke to them on the phone to confirm my benefits and they gave no indication that there would be any refusal for treatment. The only reason it is even on my mind is because I was asked to fill out more paperwork to send off to them. I had physical, occupational and speech therapy right after my initial stroke in August of 2010. I was 29 years old at the time. I recovered remarkably well, considering. I am also worried because my occupation is "homemaker". It wasn't a job that was important enough to fill out the JOB section of the insurance company's questionnaire. Never mind the fact that the reason I have no job is stroke related.
It's the after effects of living with a stroke that seem to have done me in. The neuro-pathic pain, the seizures, memory loss and problems with retention have led me to quit school and my job. But I can't quit the most important job I have, that of raising my three kids. They are counting on me and I can't let them down. So even though it really hurts, you'll have to excuse me. I need to go do my exercises now.
E-mail your members of Congress and ask them to stop therapy caps for Medicare patients who have had a stroke.Without therapy, vital skills could be lost.
It's a vicious cycle that I haven't figured out how to break. I try to work out and go for walks. In fact I walk my daughters to school on average about three times a week. The walk is one mile round trip. Granted, after half a mile, I am already ready to call it quits, but I try and fail and try again. Thus prompted the discussion with my doctor. Something has to change. I am on lifelong medication, some of which has made me gain weight, and I need to get more active to lose the weight to keep a healthy heart and reduce the risk of another stroke.
We decided on a round of physical and occupational therapy to help my body get back to where it needs to be. I had my first appointment last Thursday. It was my evaluation day. After that, the insurance company gets to decide whether or not to continue paying for the therapy. The evaluation went well. I have lost a lot of strength in my right side as well as range of motion. Cindy, my therapist, was great. She was knowledgeable and patient. She answered all of my questions. I honestly couldn't have asked for better.We didn't get to the occupational therapy, something I will have to address at my next appointment, but I was sent home with plenty of exercises to do everyday to help build my core strength and my balance back up.
All that's left is waiting to be sure there are no hiccups with the insurance company. I spoke to them on the phone to confirm my benefits and they gave no indication that there would be any refusal for treatment. The only reason it is even on my mind is because I was asked to fill out more paperwork to send off to them. I had physical, occupational and speech therapy right after my initial stroke in August of 2010. I was 29 years old at the time. I recovered remarkably well, considering. I am also worried because my occupation is "homemaker". It wasn't a job that was important enough to fill out the JOB section of the insurance company's questionnaire. Never mind the fact that the reason I have no job is stroke related.
It's the after effects of living with a stroke that seem to have done me in. The neuro-pathic pain, the seizures, memory loss and problems with retention have led me to quit school and my job. But I can't quit the most important job I have, that of raising my three kids. They are counting on me and I can't let them down. So even though it really hurts, you'll have to excuse me. I need to go do my exercises now.
E-mail your members of Congress and ask them to stop therapy caps for Medicare patients who have had a stroke.Without therapy, vital skills could be lost.
Thursday, October 17, 2013
Making Plans
October 29 is World Stroke Day. I love telling people my story, but I still struggle with living with the aftermath of my stroke. Sometimes I don't know what's worse. Trying to explain myself to doctors that don't understand or being forced to explain myself to people that make me feel like I'm just giving excuses. This week has been a tough one on us. I say "us" because recovery is a family affair.
I had two of my seizure-like episodes (un-diagnosed but suspected to be a form of epilepsy) this week. After I have one, it takes me a few days to recover. I feel exhausted and drained for sometimes a week afterward. My seizures consist of periods of time in which I sort of just black out. Most of the time I remain conscious, but every once in a while I lose that time entirely. During these episodes I am unresponsive, dizzy and nauseous. After these episodes I am nauseous, I usually have a headache, I am tired and my right arm and leg hurt even more than usual. Sometimes I get angry and obstinate after these episodes with whomever is directly around me, but not always. I am not supposed to drive for six months after I have an episode. Even though they haven't been able to diagnose them as seizures, I have "periods of non-responsiveness" and am therefore not permitted to drive. I'm a liability.
This weekend I have volunteered my services for the annual Fall Festival at my children's elementary school. I felt so bad telling the PTO (of which I am a member) that I am happy to help out, but I cannot do much of anything. I need to have a job where I am sitting most of the time. I always feel like I am giving excuses when I have to say things like this. We had a hard time finding student volunteers this weekend because our Fall Festival coincided with the local high school's Homecoming Dance. And here I am saying, "Well, I'll help, but not that much." I'm in charge of tickets that day and I agreed to help with clean up. It's just the looks I get when I try to explain why I can't be on my feet all day, why I can't use my right hand, why I can't run multiple booths, why I can't carry anything too heavy... Excuses, excuses, excuses...
Next weekend we plan on taking the kids to the Renaissance Festival. My husband is so concerned about me and knows that I will do anything not to ruin my children's fun, including letting myself go through the day in pain, that he wants to rent me a wheelchair for the day. I think it's a good idea. I know that I can't go the entire day walking around without having to be flat on my back for the entire next week because of the pain it will cause in my right leg. My medication isn't working, something I need to call my neurologist about. Again. I don't know why she's so stuck on me taking Neurontin, but that's a different story. It has me wondering now if I can persuade my doctors to help me get a permanent wheelchair. We already know that I end up being housebound because I can't walk due to pain. I avoid day-long activities and outings because of it; have for three years now. I have even turned invitations down because of the physical exertion that it would take just to go out. To us it makes perfect sense, but I don't know that it will make sense to the medical community. I guess it doesn't hurt to ask. And it's not like I would take advantage of it. I would only need it so we could do all day outings like museums, fairs, festivals, concerts and such.
Stroke recovery is a never ending process. It has been quite a journey trying to find the right doctors, haggle with insurance and fight for my patient rights. It upsets me that I still have to deal with stares and ugly looks from perfect strangers when I park in a Handicap space. But I have finally found my voice. It took a stroke, but I feel I finally know who I am. Deal with it.
I had two of my seizure-like episodes (un-diagnosed but suspected to be a form of epilepsy) this week. After I have one, it takes me a few days to recover. I feel exhausted and drained for sometimes a week afterward. My seizures consist of periods of time in which I sort of just black out. Most of the time I remain conscious, but every once in a while I lose that time entirely. During these episodes I am unresponsive, dizzy and nauseous. After these episodes I am nauseous, I usually have a headache, I am tired and my right arm and leg hurt even more than usual. Sometimes I get angry and obstinate after these episodes with whomever is directly around me, but not always. I am not supposed to drive for six months after I have an episode. Even though they haven't been able to diagnose them as seizures, I have "periods of non-responsiveness" and am therefore not permitted to drive. I'm a liability.
This weekend I have volunteered my services for the annual Fall Festival at my children's elementary school. I felt so bad telling the PTO (of which I am a member) that I am happy to help out, but I cannot do much of anything. I need to have a job where I am sitting most of the time. I always feel like I am giving excuses when I have to say things like this. We had a hard time finding student volunteers this weekend because our Fall Festival coincided with the local high school's Homecoming Dance. And here I am saying, "Well, I'll help, but not that much." I'm in charge of tickets that day and I agreed to help with clean up. It's just the looks I get when I try to explain why I can't be on my feet all day, why I can't use my right hand, why I can't run multiple booths, why I can't carry anything too heavy... Excuses, excuses, excuses...
Next weekend we plan on taking the kids to the Renaissance Festival. My husband is so concerned about me and knows that I will do anything not to ruin my children's fun, including letting myself go through the day in pain, that he wants to rent me a wheelchair for the day. I think it's a good idea. I know that I can't go the entire day walking around without having to be flat on my back for the entire next week because of the pain it will cause in my right leg. My medication isn't working, something I need to call my neurologist about. Again. I don't know why she's so stuck on me taking Neurontin, but that's a different story. It has me wondering now if I can persuade my doctors to help me get a permanent wheelchair. We already know that I end up being housebound because I can't walk due to pain. I avoid day-long activities and outings because of it; have for three years now. I have even turned invitations down because of the physical exertion that it would take just to go out. To us it makes perfect sense, but I don't know that it will make sense to the medical community. I guess it doesn't hurt to ask. And it's not like I would take advantage of it. I would only need it so we could do all day outings like museums, fairs, festivals, concerts and such.
Stroke recovery is a never ending process. It has been quite a journey trying to find the right doctors, haggle with insurance and fight for my patient rights. It upsets me that I still have to deal with stares and ugly looks from perfect strangers when I park in a Handicap space. But I have finally found my voice. It took a stroke, but I feel I finally know who I am. Deal with it.
Thursday, October 3, 2013
Bad Medicine (One Week and Counting...)
It is no secret that I have been a big proponent of Botox for migraines. It was the only thing that helped me control my migraines when they got so bad that I was suffering from them on an almost daily basis. Unfortunately, I only received one round of Botox for migraines before my insurance lapsed due to a job change. I am currently awaiting approval for the treatment to restart under our current insurance plan; but let me tell you a little story about what happens when your insurance company takes the liberty to charge you for a treatment you never received.
In June of 2012 I received my first Botox treatment and it was meant to be re-administered every three months. Late August of 2012 I called the doctor's office and requested the reorder. I knew at the time that my husband would be changing jobs and that our insurance would be lapsing on October 15. I informed the doctor's office of this. I called the office every week through mid October to inquire about the Botox order and was told that it had either not yet been ordered or had not approved by the insurance company. By the last conversation, I told them it was too late and the order would have to be cancelled.
Many months later I began to get bills from Optum Rx (previously Prescription Solutions) for $105. I had never used Optum Rx, so I never opened most of the letters I got from this company. I didn't know at the time that they were previously Prescription Solutions. By the time I opened the letters, the debt was in internal collections. Well, unfortunately for me, my new insurance company, in their infinite wisdom, has chosen Optum Rx as their mail order provider for all my convenient prescription needs. And now Optum Rx has placed a hold on my account because of this $105 debt.
I called Optum Rx and very clearly stated that I am NOT validating this debt, but I am inquiring to find out what it is about. Guess what? It was about the Botox treatment I never received. Say what? I told the lady on the phone the whole story, but she could have cared less because, after all, she has a designated script to stick to. She has to get me off the phone to get to the next caller. She said because the Botox was under my name and was shipped to my doctor, it was my responsibility. End of story.
Two Problems with that:
1) I cancelled the order.
2) Prescription Solutions had a policy that they had to have my verbal permission to act on my behalf in order to ship a controlled substance. How do I know this? Because I had already been through the procedure once before. AND because they called me exactly one time to try to get my permission for said shipment. I missed the call and it had gone to my voice mail. That prompted me to call my doctor's office to reiterate that I no longer had insurance and to cancel the order. Why do I remember this? Because I went off on them about having had two months to do their job and having done it very poorly.
The Optum Rx lady suggested I call the doctor's office clear up my debt but that the hold on my account would still stand. So I told her that I would never choose by my own free will to ever use Optum Rx as a mail order prescription company. I hate mail order services and much prefer my local Walgreens. Yeah, I said that.
So I called the doctor's office and they called me back the next day. She was very nice and genuinely sounded concerned, especially after I told her the story about they had dropped the ball and that I was now seeing someone else (it not me, it's you). She read my file notes to me. According to what the insurance company told them, they tried to contact me multiple times and due to nonpayment from the patient (me), they were unable to ship the Botox.
What?!?! Hold the phone.
If you consider calling me once and leaving me one voice mail, contacting me multiple times, then yes, you contacted me multiple times. In June of 2012, when I had my first Botox treatment, I paid for it happily. Of course, I also recall giving the company handling this controlled substance my verbal permission to act on my behalf. It was procedure because the FDA regulates Botox shipments. I also remember Optum Rx (then Prescription Solutions) leaving me that one message seeking my permission to ship the Botox. They never got my permission to ship anything. It may have my name on it and may have been shipped to my doctor, but I never gave them my permission. So it is really my responsibility? And here's the kicker.
Wait for it...
My doctor's office never received a shipment of Botox with my name on it. What they did receive were a bunch of nasty notes from Optum Rx saying that I am a patient that refuses to pay for services.
Services Optum Rx claims to have rendered. Services I never received. Services my doctor's office can prove they never provided me. Not to mention a now missing box of Botox. I bet the FDA would love to hear that.
So to update my little story, Optum Rx requested my contact information on Friday, October 4, 2013 for customer service to be able to reach me. They haven't reached me yet... I'll let you know how it goes when they do. Till then, I'll keep posting Bad Medicine if you'll keep sharing it because as a stroke patient, I know how important it is to keep to my medication supply in stock.
In June of 2012 I received my first Botox treatment and it was meant to be re-administered every three months. Late August of 2012 I called the doctor's office and requested the reorder. I knew at the time that my husband would be changing jobs and that our insurance would be lapsing on October 15. I informed the doctor's office of this. I called the office every week through mid October to inquire about the Botox order and was told that it had either not yet been ordered or had not approved by the insurance company. By the last conversation, I told them it was too late and the order would have to be cancelled.
Many months later I began to get bills from Optum Rx (previously Prescription Solutions) for $105. I had never used Optum Rx, so I never opened most of the letters I got from this company. I didn't know at the time that they were previously Prescription Solutions. By the time I opened the letters, the debt was in internal collections. Well, unfortunately for me, my new insurance company, in their infinite wisdom, has chosen Optum Rx as their mail order provider for all my convenient prescription needs. And now Optum Rx has placed a hold on my account because of this $105 debt.
I called Optum Rx and very clearly stated that I am NOT validating this debt, but I am inquiring to find out what it is about. Guess what? It was about the Botox treatment I never received. Say what? I told the lady on the phone the whole story, but she could have cared less because, after all, she has a designated script to stick to. She has to get me off the phone to get to the next caller. She said because the Botox was under my name and was shipped to my doctor, it was my responsibility. End of story.
Two Problems with that:
1) I cancelled the order.
2) Prescription Solutions had a policy that they had to have my verbal permission to act on my behalf in order to ship a controlled substance. How do I know this? Because I had already been through the procedure once before. AND because they called me exactly one time to try to get my permission for said shipment. I missed the call and it had gone to my voice mail. That prompted me to call my doctor's office to reiterate that I no longer had insurance and to cancel the order. Why do I remember this? Because I went off on them about having had two months to do their job and having done it very poorly.
The Optum Rx lady suggested I call the doctor's office clear up my debt but that the hold on my account would still stand. So I told her that I would never choose by my own free will to ever use Optum Rx as a mail order prescription company. I hate mail order services and much prefer my local Walgreens. Yeah, I said that.
So I called the doctor's office and they called me back the next day. She was very nice and genuinely sounded concerned, especially after I told her the story about they had dropped the ball and that I was now seeing someone else (it not me, it's you). She read my file notes to me. According to what the insurance company told them, they tried to contact me multiple times and due to nonpayment from the patient (me), they were unable to ship the Botox.
What?!?! Hold the phone.
If you consider calling me once and leaving me one voice mail, contacting me multiple times, then yes, you contacted me multiple times. In June of 2012, when I had my first Botox treatment, I paid for it happily. Of course, I also recall giving the company handling this controlled substance my verbal permission to act on my behalf. It was procedure because the FDA regulates Botox shipments. I also remember Optum Rx (then Prescription Solutions) leaving me that one message seeking my permission to ship the Botox. They never got my permission to ship anything. It may have my name on it and may have been shipped to my doctor, but I never gave them my permission. So it is really my responsibility? And here's the kicker.
Wait for it...
My doctor's office never received a shipment of Botox with my name on it. What they did receive were a bunch of nasty notes from Optum Rx saying that I am a patient that refuses to pay for services.
Services Optum Rx claims to have rendered. Services I never received. Services my doctor's office can prove they never provided me. Not to mention a now missing box of Botox. I bet the FDA would love to hear that.
So to update my little story, Optum Rx requested my contact information on Friday, October 4, 2013 for customer service to be able to reach me. They haven't reached me yet... I'll let you know how it goes when they do. Till then, I'll keep posting Bad Medicine if you'll keep sharing it because as a stroke patient, I know how important it is to keep to my medication supply in stock.
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