Friday, August 1, 2008

Exercise in Futility

There are so many things in my life that I have no control over and because of that I like to troubleshoot potential problems before they happen. Yesterday, I checked my calendar to see if I had any doctors' appointments next week and saw that I had two. I then went to my health insurance company's web site to make sure that all of my referrals and authorizations were up-to-date. I discovered that the authorization to fill my Baclofen pump had expired, so I called that doctor's office to let them know . At this point, I should explain that most patients wouldn't take the time or even know how to check something like this.

Anyway, I called my doctor's office and explained my problem. I quickly realized that the person on the other end of the line had no idea what I was talking about. She told me that I would need to get a new referral from my primary care physician. I responded that she was wrong; the specialist's office needs to get authorization for a particular procedure. I added that I had been going through this process since my pump was implanted back in 2002. It was challenging, but I stood my ground while keeping my cool. In the end, that phone call accomplished nothing but I had come up with a strategy.

My next call was to my insurance company. Once again, I explained the situation and included the conversation that I had just had with the office. The member services representative I spoke with confirmed that I was right; the office needed to call for authorization to do the refill. Since there was no way I was calling those people again, I asked the man who was helping me to call on my behalf. He agreed and offered to do it right then if I didn't mind holding. Since being on hold is a large part of my existence, I had no problem saying "fine." The poor guy ended up leaving a message for the person who handles insurance and he promised to follow up with them in the afternoon. I should be okay because my appointment is not until next Wednesday.

It's times like these that remind me why I no longer work. I cannot imagine having to make all these phone calls on my lunch break or having them returned while I am trying to concentrate on something else. I must have spent at least an hour this morning trying to sort this out and I'll probably have to spend more time next week on the same issue. I read that there are growing number of companies and individuals specializing in patient advocacy. For a fee, someone will keep track of your insurance and medical billing to make sure that everything works smoothly. I don't know how much they charge, but if they have to deal with people like me that it's hard earned money.

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