Push Through It

I thought I might have better luck if I went in to the pharmacy rather than calling them, but nope. 😒 Tomorrow’s technically a holiday, so I’m gonna wait until Tuesday before I go back in and make them go through any kind of fuss, in case they need to call the insurer or my doctor to get things moving.

Next stop was Walmart, since about a week ago I went ahead and ordered a second pair of glasses from them. I was originally just gonna grab my prescription and send it off to somewhere online so I could get a cheap pair of distance-only lenses and frames, but I was able to order a pair from Walmart for only $68 so I figured that was good enough. 🤓

After that I made it out to see Dad for a while. 🙂 We were gonna watch some of the Daytona 500, but weather came and put it on a rain delay. I wouldn’t have been able to stay through the whole thing anyway though. 😕 My neck was still pretty locked up through my whole trip out, but towards the end of my visit with Dad my shoulder started shaking and being uncooperative again, so I headed home to get it back in front of the space heater.

Oh great… speaking of meds. I just now got a text from the pharmacy that says “We are contacting your doctor for an alternative med for Rx Metaxalone. We will text when ready.” 😳 No idea what that’s all about, but if my doctor wanted me to be taking something different he would prescribe me something different. 😣 Oy… looks like I’ll be calling the pharmacy in the morning to find out what’s going on, and then my doctor’s office to let them know there’s some new sort of nonsense that they might be getting a call about.

I swear, man… 😒 it’s almost 7p on a Sunday before a holiday – and I’m still getting hassled. Meh… no sense in worrying tonight since I can’t do anything about it anyway. You see how this stuff goes though? 😟 I went in and tried to get that situation settled, I wasn’t able to, so I was trying to put it out of my thoughts… so the situation reached out and poked me, like “Hey, don’t forget about me. Here’s something confusing for you to ponder all night… and you might wanna get up stupid early to make even more phone calls tomorrow. Sleep tight.”

Awesome Timing, Thanks

I went and saw the new “physician’s assistant” fella yesterday. He first confirmed that Dr Walter is still my doctor of record and that everything will still go through him… but hopefully after this initial “getting to know each other” appointment (for which I’m sure he’ll have to confer with Dr Walter at least this time) he’ll be able to handle most everything while leaving Dr Walter’s time free to help patients that can actually still be helped, patched up, or even repaired. That’s where his time should go.

Thankfully though, I really like this guy. Dr Walter and I have a decade of history from me going to that clinic for the same problem… so, obviously, even starting to get new guy on the same page as us would be impossible in one visit. But that didn’t stop him from intently listening to everything I said, as well as already offering his preliminary thoughts and ideas about my condition and treatment. I don’t want to get ahead of myself, but the positive vibes were a pleasant surprise. I mean, it was really a crap shoot (what type of doctor I could have ended up with) but I should have known that their office wouldn’t hire a jackass when not a single one of them already there acts that way.

Okay, so that was the good part of the visit. Nothing has changed yet, but I told him that I appreciated having “new eyes” looking at the situation, and letting him know that I am willing to try changing some things up if he, Dr Walter, and I think that it could help with the problems which have slowly been getting worse over the months and years. I then began the walk to the front of the office to make my next appointment and hit the road, when I was told that Laura, the workers’ comp “saint” of the practice, needed to see me before I left.

She told me that my case manager contacted them and told them that I was non-compliant with my scheduled appointments, and that I was also non-compliant with getting my medications filled each month. Now, Laura has been there since the beginning with me, so she (like me) knew that what the case worker was saying was complete bunk. Before I could even say anything, Laura told me that she had already faxed more than sixty pages worth of documentation to them, to let them know that they are either full of crap and are trying to jerk me around again, or that they are incompetent. (My words, not hers.) I mean, how many times have I bitched here myself about how nearly every damn month I have to make multiple calls, multiple visits to the pharmacy, and often still I’m not “allowed” my medications until days after they’ve forced me to run out?

Based on what they are claiming, they are now only willing to pay for one doctor visit every three months – while certain medications that I take require me to be seen every thirty days. (And it sure sounds like their eventual goal may be to straight up “kick me out” or void their obligation to me.) So, this is what I have to deal with now. And I really need some dumb shit like this, right now, when my plate is already overflowing with stuff that is pushing my health and emotions to their limits.

But that’s what I’ll be doing tomorrow, gathering up all of the current information about whoever is my acting case manager, figuring out which of my attorneys handles this type of issue, and probably trying to figure out how to get records from my pharmacy – and maybe a statement from the pharmacy techs who know how I regularly get the runaround – and get everything in some kind of order, to where I can start making calls on Friday.

I had a good day today, and I do want to blog about it at some point, but I’m still furious about this. Yes, it’s all easily, easily refutable… and there’s absolutely no way that I won’t win if this gets forced into another IC hearing or actual court case… but the fact that I have to do it at all, and that they still seem determined to deny me as much of my treatment as they can. I don’t understand how any human could or would take a job like that, where if they complete their task or reach their goal, a person’s life is ruined.

If I keep talking about it I’m not going to be able to sleep again tonight, but that’s the gist of how my Wednesday went. I’m glad Genesee is still in town, because today I had to just pretend that yesterday didn’t happen… just for this one day, so that my brain wouldn’t have a meltdown from immediately trying to fix all of this. I already spent the entirety of Tuesday night through dawn on Wednesday wide-awake, sitting in bed with my phone, looking up countless things regarding my case and treatment, and sending them to the printer so I could compile and highlight them later.

When there is a reliable, well-documented, years-long pattern of delaying or denying a patient’s medication or treatment, when multiple hearings and court cases have already made it clear that the patient is legally entitled to all of it… even if it’s done in a way that technically isn’t in violation of their obligation – you’d still think it might reach a point where a judge would see that it’s nothing less than harassment, and I have to believe that one of that patient’s litigating attorneys would smell blood in the water at that point, so to speak. I’m not a squeaky wheel. Why do they want to push it to that point?

(Okay, tomorrow’s entry will be a positive one. I just had to let this out, for better or worse.)

Oh, You Need These?

Four straight days of talking to my doctor, talking to the pharmacy, going in to the pharmacy, them making calls… all trying to get my meds approved. The same meds that I’ve taken regularly for years. 🤔 This is starting to smell.

I paid for one of the prescriptions with my own insurance today (the other isn’t covered, so I’m not sure what to do about that one yet) and had them print me out the refusal – along with two different numbers that I can call tomorrow to try and find out what the hell the problem is. 😠 I’ll start off being nice, but if I can tell that I’m not going to get any results that way then I’ll be happy to adjust my attitude to reflect my frustration.

I’m also going to call and leave a message with my attorneys tonight, letting them know about this nonsense. And since there’s a court appearance coming up soon, I’m sure the judge will also find it interesting that all of the sudden I’m unable to get the medications that they’re legally required to provide for me. 🤨 I’m still hoping this is just an error, a coincidence… because I don’t wanna believe that somewhere, someone’s job is to just refuse to pay for meds that they technically can’t refuse to pay for. 😒