Tag Archive | Medicaid

Well, finally got my medications. Medical frustrations and FMS


If you recall the meds I have been screaming about in prior posts .. well. finally, after literaly weeks of phone calls and personal harranges, I got them.

Now mind you, this was only after being so sharp with the staff, that one of them, hung up on me..  But she did do as she was told, which was trot her happy butt down to Medical records and demand some answers.

Seems they sent them off yesterday to my pharmacy. Now what is interesting about that, is the last information anyone was given by them, was .. send the faxes again .. no information from them to indicate they even had the the faxes ( twice over ) no one  even offered a guess at completion date, no notice in fact whatsoever, of what they were even doing or not doing about it.

As today, my ablity to tolerate this went through the floor and I was two cents over the line of even caring about being polite. As when I called on this for the umpteenth time, yet again the staff at my doctors office, were just reading off whats on the screen under my name in their office. Which of course, didnt say a dang thing about the medications, and has not, since the papers were first sent to them.

At no time has Medical records put in one word to the data base, or told anyone what they were up to and likely I am willing to bet, will not even record having sent them off for a week or more, as they seem to be as backward about data entry, as they are at handling the paperwork. Yet this data, is what my doctors staff, depends on.

Now, agreed, the staff should be able to depend on it, however, they cannot and NONE of them it seemed, were able to even understand the problem ! It is like, if it’s not in the computer, it doesn’t exist ?

I am suspicious that a good part of the problem, is due to the fact that most of the staff, has difficulty understanding English, and I do not mean that as an insult, I mean that literally.

As most of them, other than the Doctor herself, their accents are so thick, you can barely understand them when they speak. And it has been my personal experience that anyone who care barely speak the language, generally has trouble understanding it as well.

So what that has created is two fold, as the staff does know their jobs, however if presented with anything NOT on the screen, it seems they are lost, and furthermore, explain how you may, they just do NOT get it.

It was as plain as the nose on one’s face, that they just did not understand what I was saying to them and planned to do nothing about it but give me platitudes. Until I got downright rude about it !

This is not the first time that Medical records has done a major dance with paperwork of mine but it damn well had better be the last, or someone’s head, is gonna roll, as I have had it with them. Not just for myself alone, but for others as well. 

As it happens, the medications that needed some extra steps on their part, where not critical, in  that yes I could do without them for a few weeks. But what if I could not ? What if I were as my mate is and I was a Diabetic ? Or I had heart problems and NEEDED the medications, just to stay alive ?

As I firmly believe that it would make no difference to the paper pushers, at all. Anymore than they did for the paperwork for my bath chair and walking aid, the lack of either of which could have caused me great bodily harm if not death. They did not care.

I was at least, able to assure my pharmacist today as I have throughout all of this , that he was doing HIS job very well, as the man bent over backward to try and get this issue resolved for me.

He was very appreciative of the fact that I gave him a heads up, kept him in the loop at all times and that I assured him. that it was by no means his fault and I thanked him very much for his extraordinary efforts on my behalf. But he should not have had to make them.

Well, enough is enough, as I will find out who is in charge over Medical records ( as talking to them.. is pointless ) So far, no one wants to say who is really in charge of it, but I know where to find out. I plan to file formal complaints and if possible, charges against them for their negligence.

And no, I do not care at this point, if someone loses their job over it, in my view, given how poorly they are doing it, they should be booted right out the door, as they risk other peoples lives here and that cannot be condoned. If no one else will raise enough fuss to see it changed… I will !

Off to plan someone’s ultimate nightmare…

Advertisements

Medical frustration’s continue and day to day life with FMS


Gurrr.. had to call my doctors office.. yet again yesterday. No less than 3 of my medications have to have pre authorization now ( thanks to medicaid changes) and as yet, nothing had been done on them. In fact, when I called the woman was reciting requests that had already been completed, and only one of them that had been faxed. So had to have my pharmacy re fax the entire lot.

And get this, the woman insisted that anytime something like that comes in, they get on it right away. Well, if that is the case, why do you have only one in front of you, when 3 have been sent in the last week ? 

But, the good news is, the bath chair I FINALLY got, works like a charm. It is amazing the little things, that we did not even realize were such a pain, like washing ones feet, that suddenly one can so, without having to worry about falling down. It was very relaxing in point of fact, as up to this moment, I did not quite grasp, just how tense I was in the bath, just to keep from falling out of the thing. So score one for me.

The rollenator thing, is gonna take some getting used to but I think it will serve very well, when its time to do the marathon walk about, like at my doctors office for example. I never can just sit there, as my feet have to be up. But, as my mate pointed out, I could just as easily take the rollenator, put it in front of me and use IT to prop my feet on.  🙂

The heat is still trying to murder us all, and is zapping energy like crazy. As there is only so much AC can do, to handle triple digit heat indexes. The hurricane Irene ( blessings on all in her path ) brought us just a dash of rain and a few days of slightly cooler temps for a couple days. 

Just a minor side note: Our TV went out,  for no particular good reason, but thanks to Freecycle, we were able to get a replacement in pretty fast. I am not a huge TV buff, but two things. One we pay a good deal for that aspect bundled with our phone and internet and Two, it’s the only the thing that saves me from going right up the wall some nights when I cannot sleep or the pain is too great for the wimpy PK’s my doc gives me, to handle and I desperately need a distraction.

It’s the weekend again, which means I cannot do a thing about riding herd on the grasshoppers I am trying to direct in the medical profession, so I refuse to even bother my brain about it.. at least until Monday 🙂

More soon…

BB

Esta

Feeling half way human and running on empty. FMS


Feeling half way human today, for the frist time in weeks. It’s so odd, that we see a day where we are half way alright, as a good day ! I guess FM does one postive thing for us, in that it forces us to be appreciative of small victories, that we otherwise might ignore.

I have been running on sheer nerves and fumes for weeks now it seems, to the point of literally having a major flare with the “shakes” for at least the past week or so. If you have never experienced this one yet, count yourself blessed.

As it’s where the body and mind are so tired, that you find yourself having purpose tremors when you go to do things, often to the point where you cannot do them, at all, and your brain is so overloaded, that even a sudden noise is enough to make you jump out of your skin. You cannot think or process anything worth beans, and your confusion level skyrockets.

You bash into the walls, as your coordination has completely gone to hell. What little of it we have even on a good day. You do not sleep, as you literally cannot, as neither brain or body, will shut up long enough, to let you.

It almost goes without saying, but I will say it anyway, your temper gets more than a bit testy. As I am sure my Mate could attest to 🙂 I know damn well the people in the half a dozen medical dept’s I have either been in or talked to in the past weeks, know it for a fact, unless they are totally tuned out. ( I think some of them really are tuned out, but they are due a major wake up call and I plan on seeing to it, they get it )

This is a flare to the point of sheer flat out exhaustion. You are so tired, mind and body that you can barely function and things just start not to work, at all.

Now, I pride myself on the fact that most of the time, I can manage to work around most things FM throws at me. But between the extremes of weather and much added stress and strain, this time … not so much.

This time, just not enough reserves to deal with things outside of my direct control, my healthcare being a major one, and then to top it all off, have to step around the rocks that FM tends to toss in my path, at the same time, and I have tripped over a whole mess of them. I have the bruises to prove it !

But, finally, seeing a corner turned i think, ( crossing fingers ) and hoping I can regain the momentum, that normally keeps me going….

Welcome to my world 🙂

BB

Esta

At War with my HMO.. again !


Well, back to a war with my HMO. After taking two mts to bloody find me a Chiropractor, allowed 3 “office visits” only, which means no X rays, no therapy etc. Now they dare refuse to permit anymore as the file doesn’t show it’s medically necessary !

Now mind you, I have no doubt he would have dearly loved to X ray me up one side and down the other, but they would not have paid for that, so can hardly blame him for the lack. He did give me some minor treatments anyway, even though he was not really being paid for that. Yet when he asks for more… they say no, because no proof of need has been show.

This is a real cart before the horse situation here, in that they will NOT pay for the diagnostic workup, yet will deny me seeing him, for lack of it. So its war, yet again, from his end and mine. As the reason I was sent to him in the first place, was well documented.

I have already seen a nero doc about this, he said see the Vein specialists. OK, saw them.. they told me, nope not the blood flow, see a Chiropractor. Now I have to ask a stupid question here, how much more proof do they need ?  Almost a year I have been at this mind you and then after all that, they up and say, it doesn’t meet the “needs” test.

Ready to flat pull out my hair here !!!

BB

Esta

Stonewalled by Medical care and FMS


Well, I finally found out what the problem was with all the Chiropractics listed in my healthcare book and have basically set the dogs on em. They are all under contract to my health care plan, but are reneging on the deal they made with the Health care company.

So no, I am not crazy, they are under agreement with my health care provider, yet are trying to force anyone who wants to see them, to shift over to their MD, which is not the deal they made.

So heads are gonna roll, and she ( the specialist who deals with such things ) will, if needed find me a totally new Chiropractor in the local area, who she can talk into joining the health plan if she has to, and most of the ones on the list now, just might find they get no more business from my HMO.

Just goes to show, it pays to complain sometimes 🙂 And hopefully it will mean that the next person who needs such a doctor, will not have to run into being stonewalled, as I have been, so a win-win for everybody ( except perhaps the doctors currently on the list, but that is their problem, as they created that situation for themselves )

Anyway, so have been on the phone all day thus far, I did manage at least to finally get an appointment with the Vein specialist that was ordered over 6 mts ago but never followed up on, so at least one thing nailed down for the day.

Tomorrow I get to run the same issue with the GI people and hope, they do not tell me something like, an appointment, 2 mts from now. As I plan to be a total pain in the butt about it, and do some strong arming of my own if needed. It does not pay to be passive when it comes to healthcare and social systems. The tests I just went through, well prove that things need to be done and I plan to harp as much as needed, to see them done.

More soon…

BB

Esta

Medical care and red tape !


The red tape and hoops they make you go though, to get medical care is just insane ! I HAD an appointment with a doctor today, that according to the handbook I was given, I do not reed a referral to go see. Only to find out that yeah, I do.

Or worse, that I am supposed to change them to my Primary care doctor, which is even more insane ( given that the one I want to see, is a Chiropractor who could not BE my PCP ) And since it is again, Friday, I cannot do a thing about it, until Monday.

This is particularly irritating, as I just saw my PCP, a few days ago and could have gotten the referral from her, if  I had known that I needed one. She would have been more than happy to give it to me, as she agreed with the need to see the specialist, and get this.. even SHE did not know that a referral was needed.

Now, I consider myself an educated person, especially when it comes to medical care ( with FM you kinda have to be ) but Medicaid/Medicare, has got to be the most complex system, I have ever seen, as most of the write ups in their so called handbook, are incomplete and often, contradictory.

You almost have to be a doctor, or worse, a lawyer, to understand the things. And half the stuff that you need to know, is not in it, and you have to call them, to find out. Just bonkers, the bloody lot of it, to make a person wait and go through all this red tape, just to get an appointment … that they will pay for.

Health care should not be this complicated !  Going off to grump for a while, and re-read the damn manual, and tear their website apart again, and see if I can figure out, what I missed.

More soon

BB

Esta