Aug 20, 2008
I found out late last week that the insurance company is canceling my Rocephin (IV antibiotic) and home care (picc maintenance) as of the 23rd. That's THIS SATURDAY, folks! If I don't find some way to get them to change their minds by then, I have to have the picc pulled. If I have it pulled any later than the 23rd, I have to do it at my own expense.
I was originally approved for 4 months of treatment, with a review of my case every 28 days. Now they're saying 28 days is enough. Something ain't right!
So anyway, the dr's office called and said the doc wants me to continue on the IV treatment if I can afford to pay for it out of pocket, otherwise I should have the picc pulled. HELL NO! I don't know anyone who can afford to pay $1200-1400 a week, plus supplies and nursing costs.
Talked with the insurance company yesterday. The reason for the denial was the diagnosis the doc's office sent doesn't meet the insurance company's criteria for coverage (which makes me wonder why they approved it in the first place, but that's another wasp nest I'm not going to kick right now). The ins co has authorized a peer-to-peer review of my case which means either the doc or the PA has to call them and justify further treatment.
Since the doc says he wants me to continue treatment out-of-pocket, he can sure as blazes find some kind of justification to present to the insurance company.
Rocephin is the only antibiotic I've been on so far that's done anything for me. When I was on oral antibiotics, my symptoms were getting substantially worse. That's why I'm fighting so hard to stay on this treatment.
I tried calling the dr's office on Friday with the info and, guess what? They were closed already! 15 minutes early! So, their current hours are 9am to 4pm, with an hour and a half for lunch. And then they're late turning on the phones in the morning and after lunch and they turn them off early. Must be nice. There's no answering machine or service for leaving messages after hours. Just a pager number to contact whoever's on call in case of emergency. Called them again yesterday and left a message asking them to call me, no matter if they're going to help me fight this or not. No return call so far.
In the meantime, just in case, I'm arranging to have the picc pulled on Friday afternoon after my last dose of meds. I'm so hoping someone pulls a miracle out of their butt and it doesn't come to this.
I'm freaking out! A decision has to be made by this Friday or the picc comes out and I'm forever done with IV meds. Suck!