Tired of This Shit

I’m not sure how this month’s appointment with the WC doctors is gonna go. πŸ˜• I think I’m actually seeing Dr Walter this time, when it was the new guy that I had the in-depth discussion with about the state of my treatment last month. Regardless, since the WC insurer is coming at me with the shenanigans again, the conversation will have to revolve around that rather than the stuff that I started bringing up last month.

I’ve got to be careful, because it almost feels like a “trap” that WC could use against me, but this month I have to start discussing possible alternatives for the meds that I’m taking right now. Because if they are somehow able to weasel out of paying for what I’m currently taking, the cost of two of those medications would simply be too much for me to continue taking them long term. πŸ™ That’s where the “trap” part comes in.

When I start discussing more affordable potential alternatives for the meds I’m currently taking, I want it to be clear with my doctors and in my records that I have no desire or intention to make any changes now… and that the research and discussion is really just to act as my parachute if I get pushed out of the plane. But I can see where my fear of being forced to pay for my own meds, which has made me research cheaper (but likely less effective) alternatives, means that I nowΒ know that there are cheaper alternatives, so they’ll probably think that they have the right to force me to change to them – despite my preference to keep taking the ones that I’ve been taking. 😏 Heh… I know, that sounds a bit convoluted, but it basically make sense, no?

But until I’m able to discuss this with them, I know that I’m just taking barely-educated shots in the dark when it comes to what might or might not be suitable replacements. 🎯😎 I mean, even though I know that Lyrica has very specific actions – at its most basic level I know that it is considered an anti-seizure / anti-convulsant medication… so that’s where I start looking. πŸ€“πŸ“š And now I have four or five medications that I think could be good replacements… but for all I know, even though they’re anti-seizure, they may have totally different actions – and ones that aren’t even close to being applicable to my situation. πŸ˜’

So for now that’s all I can really do… look for “close” meds and make sure there are more positive side effects than negative. Then I’ll just hope that I’m actually on to something, and that information can be put in my back pocket until it is needed. Between now and then I just have to figure out how to condense all of this crap down into a tolerable three to four minutes. πŸ˜³β±πŸ‘¨πŸ»β€βš•οΈ Gotta impress the importance of this on him, while also not rambling so much that my point gets lost in the noise. I’m better at that than you’d think, actually… it just doesn’t seem that way here because I know I can go on and on about something and it doesn’t matter, since hardly anyone reads this blog anyway. πŸ˜πŸ€·πŸ»β€β™‚οΈ

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Mid-Day Rant

I decided to come over here to the blog so I can take a break from the infuriating insurance-related calls I’ve been making this morning. 😠 I still haven’t made it past the first thing on my “to do” list, because what should have been simple turned into a shit show. πŸ˜’ When I originally signed up for my dental plan, the guy on the phone said that both of the dentists in my current dental practice were covered by the plan – but that, for some reason, he wouldn’t be able to have those dentists’ names indicated on my insurance card, so I’d just need to call in once I got my card and they’d update my information in their system. 🀨

So that’s what “item one” was supposed to be today. As is typical with customer service these days, I called in and was immediately connected to a live human… but a live human that I couldn’t effing understand due to her thick accent. πŸ™‡πŸ» I think even she was aware of this though, because she spoke slowly enough that I could barely get enough information to figure out what she was trying to tell me. I told her why I was calling, gave her my information, gave her my dentists’ information, and was put on hold.

When she got back on the phone she told me that she “regretfully” wasn’t able to add those dentists to my coverage, because they were not participants in my plan. I explained to her that I was told, repeatedly, that my dentists were covered by this plan when it was being offered to me – and that I knew those enrollment calls were recorded. 😠 She put me on hold again, then returned saying that she had just spoken to her supervisor and that she was authorized to cancel my plan without any penalty.

Normally, as I was told when I signed up, there’s a minimum contract length of a year once you agree… but this call… it just seemed suspicious. πŸ€” She didn’t seem surprised that my dentist wasn’t entered into their system when I signed up. She didn’t seem surprised that I was told I’d be getting coverage that they would not be able to provide. She didn’t seem bothered when I mentioned the initial recorded call, and that I wanted to speak to someone above her. And the way she (allegedly) spoke to a “supervisor” herself and only a minute later came back to tell me that she would be able to cancel my plan without any penalty… it just really seemed like something she’s been through plenty of times before. And it definitely makes me wonder if that’s Humana Dental’s routine to sucker people in. πŸ˜’Β Signing up people who won’t complain and will just continue to pay for a year of something that’s essentially useless to them.

So, yeah, it’s good that I was able to get out of that plan… but I still ended up getting fucked, because we’re now outside of the Medicare enrollment window – and I can’t make any changes to my plan, including adding a different dental plan, until October of 2019. πŸ™„πŸ˜  In trying to find the positives of this situation… most of my major dental work has already been done, so new coverage wouldn’t make a huge difference at the moment, plus I do still have default preventative dental coverage… so x-rays, cleanings, diagnostic stuff… a lot of that stuff is at least partially (if not fully) covered.

I’m pissed, but totally not surprised. With all of the medical/insurance/legal shit that I’ve had to deal with over the years, my default condition is expecting shit to go south and me, gritting my teeth, trying not to shout at the poor shmuck on the other end of the line. 😐 Okay, I guess it’s time to move on to item number two…

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.)Β I mean, how many times have I bitched here myself about how nearly every damn monthΒ I have to make multipleΒ 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 theyΒ stillΒ 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.)

Insufficient Quantities

Another half-work / half-shlubbing-around weekend day. 😐 Cassi had the day off, so I went and got her so I’d have some company (and a helper) and so she could have time away from home. So, like the last time she was here, she’s been working on her stuff a little more and I’ve been working on my stuff more… using that bit of motivation that you get just from having someone hanging out. 😊

A couple different phone calls to the pharmacy this morning and they’re still having problems with getting any of my workers comp related medications approved. πŸ˜’ Ten minutes on the phone, then on hold, and then told that they were gonna have to make some calls to get things straightened out.Β  Haven’t heard anything back from them for the past couple of hours, so I’ll be calling again after I finish this entry. I’m not even trying to get them before last month’s supply ran out. πŸ€¦πŸ»β€β™‚οΈ

Heh… and as I’m writing this I got another text notification from the pharmacy saying that one item is on order, another is ready – but with a $12 charge, and no info about the third. πŸ˜• But this confirms the typical problems I have every month… because if there’s a charge on one of these, that meant it was run through my regular insurance instead of the one provided by workers comp. I guess twelve bucks won’t kill me though.

And even though it’s Saturday, I got an actual registered letter that I had to sign for, from that “home care” medical provider that I mentioned a few entries ago. It says that they’re letting me go as a patient (okay?)Β and that I need to find someone else… despite having never used their services and not knowing who this nurse is that supposedly tended to me a couple times. 😠 So I sent them another email, despite just talking to someone from there on the phone, telling them to knock it off with the bills and the mail. It’ll probably do as much good this time as it did last.

Meh… so that’s been the first half of the day. And yeah, I know that a lot of the entries in the blog lately have just been me bitching about the mundane and trivial, but believe it or not – some people do like keeping tabs on me and knowing how things are going, even people that aren’t relatives or close friends. It’s weird to have made what are essentially digital pen pals, from people who have found the blog and have then messaged me for one reason or another.

But I guess I better throw on some pants and head in town for the one script that I can pick up. πŸ™„ And like I told Cassi, the reason I go in there most of the time, and deal with this shit in person – it’s because people tend to work a littleΒ bit harder when you’re standing right there, telling them exactly how things are supposed to be, and nudging them in the right direction when needed.

Heh… this was quite a ramble for just some medical billing filling bullshit. 😏

“Customer Service”

Might as well continue my bitching into Tuesday.Β πŸ˜’ Had to get up really early for my appointment with Dr Walter… and everything was routine until he asked me if I would be willing to be seen by a new physicians’ assistant that they have added to the office. 😳😟 I think they actually added two other doctors as well… but like he and I were discussing, ever since the big changes that were made about six months ago they’ve been struggling to try and keep up with appointments, paperwork, insurance stuff, medicare stuff, workers comp stuff, etc.

So while I’m glad (for them) to see that they’ve added some auxiliary people that will help evenly distribute the workload, it’ll definitely take a while to get used to the new guy.Β πŸ™ Dr Walter isn’t going anywhere, so if my condition changes he’ll be able to handle it, but that was his point… my condition has been relatively stable for a long time now, so my appointments are really just about prescription refills rather than treatment.Β πŸ€• That’s why he felt like I was a good candidate to go to the new guy – freeing up Dr Walter (someone with a lot of seniority) to choose appointments with patients he still has a chance of repairing. 😏 And to be honest, it could be interesting to bounce ideas off of new guy – since on most days I still struggle to just reach “okay” … so fresh ears and eyes couldΒ help me in the long run.

After that, I didn’t really feel like going to the Social Security office to handle my insurance enrollment issues… so as soon as I got home I was on the phone again. 😐 I’m not sure why it took as long as it did, but just enrolling in the dental part of my Medicare Advantage plan took over a half hour. And for me, someone who gets super twitchy if I have to be on the phone for more than a few minutes, it may as well have been three or four hours. 😣

I ended up calling it a day around 3pm, even though there was still stuff that I couldΒ (should?) have made calls about. Couldn’t get through to the hospital again, despite definitely calling during business hours, and so far they haven’t returned my calls. 😠 That’s fine though… I’m fine just sitting here and waiting until another notice for those bills arrive, and another, and another. I mean, I’ll call again, but if they don’t seem interested in dealing with it, then I’m not gonna be terribly interested either.Β πŸ€·πŸ»β€β™‚οΈ

Strangely, despite twitching out over the obscene amount of time that I spent on the phone today, I’m still feeling enough of a burst of energy that I’m gonna try to work on a few things around the house. I’ve got a couple of friends who have been hinting heavily that they’d like to come over, so I feel kind of obliged to make it look less like the house of a single guy and his white cat that’s in the process of being groomed. 😳🐱 But mostly I’m doing this stuff for myself, because the more organized and calm this place is, the more organized and calm it makes me. 😌

But after these crap days starting the week, I think tomorrow I’ll take at least half of the day off… maybe get my cameras organized and charged up, get the C64 Mini all updated, set-up, and hooked up. I dunno… Monday and Tuesday have me pretty grrr, so I really need to make tomorrow different.

Mundane Monday

Today has been very Monday.Β πŸ˜• Ordered something online last night and woke up to a fraud alert on my phone, where the company – and it’s one of the main, big-name ones – had attempted to charge my card five times for the one order. 😧 So that was the first bit of “customer service” shit that I had to deal with. Just to be safe I had them cancel all of the charges, which allowed me to just create the order again from scratch. So far no alerts, so I guess that all got sorted.

Then I had to get online to sign up for new Medicare Advantage insurance, and of course I ran into glitches during the process. 😠 I swear, with the way that some sites seem cobbled together and barely hanging on to their functionality – it’s a wonder that big entities like this don’t collapse in on themselves in a flaming pile of data loss.Β πŸ”₯πŸ”₯πŸ–¨πŸ–₯πŸ’ΎπŸ”₯πŸ”₯Β I could have called to get this issue fixed, but you know how I am with phone calls… so “online chat” was the way I went.Β πŸ“žπŸ˜¬β˜Ž The lady was helpful, seemed to give only 50% (or so) canned responses, and despite not really fixing anything – she said everything that needed to be in their system was in their system, so there shouldn’t be any issues.

And the third thing, which I’m still in the process of dealing with, is getting these couple of rogue hospital bills figured out. One bill is for an appointment with my workers comp doctor, which are the same every thirty days and always billed to workers comp. 🧐 And then the other one, well, it’s a big enough amount that I need to investigate – to find out if that’s the amount due even after the financial aid has been applied, or if I just need to wait it out until it eventually goes away.Β πŸ₯πŸ‘¨πŸ»β€βš•οΈπŸ€•πŸ’Έ Still waiting on a call back from those folks.

So, I’ve been dealing with this crap pretty much from the moment I woke up.Β πŸ˜΄πŸ˜’ My brain hasn’t started getting twitchy about it (yet), mainly because everyone I’ve spoken to or chatted with – they’ve been helpful… and if not actually helpful, they’ve been nice and have given me confidence with their “Everything looks fine.” type shpeal.Β πŸ™‚ And since I’m somewhat in the flow of all this bullshit, there’s a couple other things that I need to tend to as well – so I’ve probably got just as many calls to make after this blog entry as I did before.Β πŸ€·πŸ»β€β™‚οΈ

Promising Start

Met my new doctor today… well, nurse practitioner, but it’s the same difference as far as visits like today, where I just needed tests to be ordered for something that I was already aware of. πŸ‘©πŸ»β€βš•οΈπŸ€·πŸ»β€β™‚οΈ But I do think that I’ll stick with her. Their other practice has mostly male doctors and nurses working with clients, and then the one that I go to has all female doctors and nurses – and at my last appointment they told me I could switch if I wanted. But like I told her, whenever something might be gross or embarrassing, it’s gonna be gross or embarrassing regardless of who’s seeing me. 😳🧐

I didn’t expect much sympathy, since I hadn’t been to their office in a couple of years, but I was pleasantly surprised. Not only did we take care of the main couple of things that I went in for, but she continued asking questions and let me ramble quite a bit about all of the somewhat lesser concerns that I’d like to eventually address as well. πŸ˜ƒ I told her to stop me when she had heard enough, since I was honestly expecting to be rushed in-and-out in about 10 minutes… so yeah, while she probably had to make this face after I left, she definitely sold me on staying at their office.

So now I have to go have blood drawn, wait for the hospital’s imaging department to call and schedule a test, while waiting for another call from another referral… so, yeah, the ball is now officially rolling. πŸ˜¬πŸ‘πŸ» A different practice might try to milk as many office visits as possible before digging into stuff, so the cheap part of me (which is all of me) approves. 😏 Now the fun part will be figuring out which stuff is covered by my insurance and which stuff will make my wallet and me cry.