Aa
Marched into the Lobby of ins company
I Have to go to hospital overnight for transfusion. 10 more phone calls at WORK! So I drove straight from school n asked to speak w supervisor in charge of appeals. I've made 2 now. It was a 1 1/2 hour meeting n I rambled n ranted n cried out my whole story. I don't know what good will come. But I didn't ride a horse in there. Haha! Feel better anyway. I WANT MY PROCRIT!!!! (:O Karen
Insurance companies, a rude awakening for me. I went to my HR dept and complained. I had nothing but trouble with getting auth for my initial treatment and every single step since. Now I've been assigned an escalation specialist with Aetna pharmacy. It's much better but it took may weeks of fighting. I think it only get worse in the future as healthcare costs are climbing as doctors and insurance companies get rich and the regular working folks pay the price.
The lesson I've learned is when I'm Medicare age I will never sign up with an HMO or any medicare replacement. I am sick and tired of insurance companies playing with my life.
The lesson I've learned is when I'm Medicare age I will never sign up with an HMO or any medicare replacement. I am sick and tired of insurance companies playing with my life.
i hope you feel better after this transfusion!! i feel so wrong complaining after reading this... i feel horrible in the 10s and bitter about my riba reduction... i should be grateful that i'm in my 10s and not fighting in front of an appeals board just to be able to remain standing... best of luck with you... i'll keep you in my thoughts and prayers!!
The "bucket" line did it for me. You just hit me perfectly off center and boy that laugh felt so good. Thanx
Karen, you must feel like your'e driving a runaway freight train with all the high horses I and other concerned not so silent witnesses feeling your pain have trumpeted forth. I feel we collectively enfold you in our hovering wings and bid you peace of heart this night.
Karen, you must feel like your'e driving a runaway freight train with all the high horses I and other concerned not so silent witnesses feeling your pain have trumpeted forth. I feel we collectively enfold you in our hovering wings and bid you peace of heart this night.
Jus got settled into. Ny girl you shud see my phone bill. I have asked for every kind of advocate, supervisor, I literally have called the manufacture. What I didn't do was as my surgeon how to word the appeal. I'm going there Monday... Thnx.
Frijole I did fall in the classroom. And I've always had weekly CBC differential and even Vit levels weekly.
I think it was a combo of things: changing ins, Dr out of the country for a couple of weeks. Me not being assertive enough. Not expecting the appeal n deny process. My doc has not dealt with repeated appeals.
I've got 24 hrs in bed n shud feel betta. So I'm gonna be reading n considering my next step. Thanks guys. Level fot down to 7... I'm gonna feel so honking good! Karen ;)
Frijole I did fall in the classroom. And I've always had weekly CBC differential and even Vit levels weekly.
I think it was a combo of things: changing ins, Dr out of the country for a couple of weeks. Me not being assertive enough. Not expecting the appeal n deny process. My doc has not dealt with repeated appeals.
I've got 24 hrs in bed n shud feel betta. So I'm gonna be reading n considering my next step. Thanks guys. Level fot down to 7... I'm gonna feel so honking good! Karen ;)
My pharma tried to pull that this month. Said I didn't have the labs for the procrit. I told them they sent me two deliveries already and i have 5 refills left. Just check and I'm sure the labs are there or I never would have gotten the procrit for the last two weeks. She just said OK and set up my delivery day with the procrit included. I'll tell you though, I'm not sure how well the procrit really is. I think it's better with then without, but I'm not getting any extra energy from it. Just finished up incivek 24 hours now. Itch seems to finally be subsiding, but it is taking a while and not much more energetic but I've been eating real food and it feels great. With an appetite no less. I have new lab results next week to see hgb. Maybe a good tranfusion is just want you need now karen before you start the procrit.
screaming 48 - what a visual - you are too funny but I sure can relate. Tonight is my sci fi and shot night. What a combo!
frijole
frijole
I hope things get better for you! I have bluecross blueshield of Texas, I have not had any problems at all getting anything I need. Epogen just came in the mail and just finished reading all about those side effects that will now go along with the others I already have. Wish they would knock me out for 48 weeks hang me from the ceiling like in a sci fi movie put a bucket under my butt, feed me fat and give me my meds then when the 48 is up wake me up and send me home, its a thought anyway.
I have said this before, but I will say this again. I think you need to go to a hemotologist. Please ask your doctor for a referral. He is not doing a good job of monitoting your blood and a lot of doctors do pass this part off to a blood specialist. Believe me, those of us who hvae used hemotologists have CBCs every week and get our results within a half an hour and consult with the nurse immediately on the timing of the procrit shots. This should not be happening. I still think he needs to use a different code on the request. What is happening is dangerous and could have significant consequences.
I am afraid for your long term treatment. How soon is it before you fall to the floor in front of your students? This is getting ridiculous. Thank goodness you will get transfusions, but if you don't get the epo, you can be doing this again in a month.
frijole
I am afraid for your long term treatment. How soon is it before you fall to the floor in front of your students? This is getting ridiculous. Thank goodness you will get transfusions, but if you don't get the epo, you can be doing this again in a month.
frijole
Did you ask the insurance specialist at your doctors or pharmacists to help try to get this through? I couldn't get Procrit but they did approve epogen after the pharmacist put it in several different ways, I think instead of b the month they put it in by week.....and finally it went through.
Dont give up!
Dont give up!
Dear Karen,
I tossed and turned thinking about your dilemma. I am so concerned that your already difficult fight is being compremised and it makes me afraid that if you can be treated so inconsiderately then what should the rest of us expect? You are our canary in the mine shaft and they are hurting instead of helping.
Why don't we shine a light on these companies that hold our futures in their bank accounts. Please name the company that won't give you Procrit?
I will begin by reporting "Humana" that I had only one month thinking I would do better during such a long treatment. Humana fought me the entire time except when I was signing up. They denied everything twice, even after my doctor sent the infor they requested. Humana was messing me up with my dctor never having the same person to deal with and every other representative acted like they were better doctors than my own.
Humana ***** - returned to Wellcare just for meds with no holdups.
Karen, I want you to teach my children and grandchildren. I want you and your amazing energy to be part of a better future without being dragged through systems that are disconnected from humanity.
Please people chime in - what companys work or don't?
I tossed and turned thinking about your dilemma. I am so concerned that your already difficult fight is being compremised and it makes me afraid that if you can be treated so inconsiderately then what should the rest of us expect? You are our canary in the mine shaft and they are hurting instead of helping.
Why don't we shine a light on these companies that hold our futures in their bank accounts. Please name the company that won't give you Procrit?
I will begin by reporting "Humana" that I had only one month thinking I would do better during such a long treatment. Humana fought me the entire time except when I was signing up. They denied everything twice, even after my doctor sent the infor they requested. Humana was messing me up with my dctor never having the same person to deal with and every other representative acted like they were better doctors than my own.
Humana ***** - returned to Wellcare just for meds with no holdups.
Karen, I want you to teach my children and grandchildren. I want you and your amazing energy to be part of a better future without being dragged through systems that are disconnected from humanity.
Please people chime in - what companys work or don't?
Their story was they needed more labs n history. Dr sent em. They wanted more. He sent em. I think there was a 10 day lapse... My angel nurse assistant who texts me at home n has been my hero just graduated from college n took a position w another hospital.
Lol. Gotta break in a new girl. You're absolutely right, the Dr office can wield power. It didn't help that I changed ins midstream. But I wanted transplant coverage n had to. You know I'm gonna be all up in the bed reading ur stories. Lol
Lol. Gotta break in a new girl. You're absolutely right, the Dr office can wield power. It didn't help that I changed ins midstream. But I wanted transplant coverage n had to. You know I'm gonna be all up in the bed reading ur stories. Lol
Karen, your fight and determination is amazing. I hope your appeal was heard loud and clear. Given that they spent 1.5 hours with you say something. I hope it brings quick results for you. I'm guessing that horse you were riding took a huge dump in the lobby of the ins co before you galloped off. ;)
Karen, WHY isnt your doctors office fighting with you ???? I ordered my second months of meds on Monday after I took my third shot. Wednesday I was supposed to have had my meds delivered. However to my surprise after calling the pharmacy co, they told me I was denied. LOL ! Yeah right ! Right in the middle of treatment ! Everything was approved but the Incivek, so I got on the phone and called Humana and they gave me some crazy story. Anyway, I called my GI's office and got my ARNP and let her go after them and Poof, it was some rediculous reason because they didnt have my 4 week labs yet. Well I am not even on week 4 yet. Anyway the doctor got it approved. Maybe your Insurance is needing lab work ??? I am praying for you girl, this isnt fair, and for them to pull this right in the middle of treatment is horrible. xoxo
I'm lol. Thanks guys. Had to sleep in the parking lot for 45 before I could drive. Oh. And I got REAL dirty. I showed em pics. Of my family. Remember that old lifeboat ethics scenario? Who deserves to live? Yeah. Brought that up too. Thanks for support. I'm gonna post a ? For advice tho. Karen :)
And you're a union member (assuming you are in a teachers union). I would think you would have pretty good insurance. This just is so wrong !
Hope you get you EPO.
Hope you get you EPO.
Couldn't have said it better than Mykids247!!!!
Karen -- I am so proud of you! That is way cool you went down there. I'm glad I don't work there though.....just sayin'! LOL :) That makes no sense to push someone into having a transfusion over giving them a rescue drug. That's like not fixing a leak in the tub for $20, then leaking to the unit below and having to cough up thousands of dollars to fix their damaged floors and walls. Really backasswards. Praying for you tomorrow girl.
Karen -- I am so proud of you! That is way cool you went down there. I'm glad I don't work there though.....just sayin'! LOL :) That makes no sense to push someone into having a transfusion over giving them a rescue drug. That's like not fixing a leak in the tub for $20, then leaking to the unit below and having to cough up thousands of dollars to fix their damaged floors and walls. Really backasswards. Praying for you tomorrow girl.
I cant imagin that a hospital stay and blood transfusion is LESS expensive for the &^%$# insurance companys than a shot of proctit!!!!!!!! It's imoral and just inhumane!!!!!!!!!! Really pisses me off that they get away with treating people like that. How long have you been paying for insurance??? How many $$$$$$ have you given them? NOW when YOU need something! Just makes me soooooo mad! Tell the hospital to charge them double. Stupid bureaucrats! Wonder if it was there family member? All fired up go get em Girl!
Karen,
I hope you get the meds you need and deserve, it is a shame you have to go through this. Treatment is hard enough without all of this added stress. Sending positive thoughts your way!!!
I hope you get the meds you need and deserve, it is a shame you have to go through this. Treatment is hard enough without all of this added stress. Sending positive thoughts your way!!!
Karen, I was visualizing you riding a horse into the lobby dressed as Annie Oakley, which maybe should be your ace in the hole, considering the problems your ins co is giving you. I will keep you in my prayers-you go girl!
What a mess, but thank God you got their attention. They should be be supportive while you are dealing with this!!!! I so hope you fee, better once you have the transfusion.
Take care...will be thinking about you!
Take care...will be thinking about you!
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