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Beyond Frustrating

August 29th, 2007 at 11:22 pm

I'm past my tantrum now, but this morning it took all my self control to not scream into the phone!

I was attempting to follow the discharge directions from the ER re; moms fall yesterday. Thought it shouldn't prove to be beyond my capabilities.....HA! Was I ever wrong.

First, called the specialist, whom she needs to get into on Friday. (this being Wed, it didn't seem impossible) Well, not so quick..... We could get an appointment, but it needed to have a referral from her primary care DR.

OK, a quick call to the primary people & speak to the referral dept. (who knew they had an entire dept to deal with just the referrals?) At this point, the logic of any conversation began to seep away fairly quickly....

The insurance co. had made an error on the last membership card, giving mom a brand new primary care DR. We had noticed it last week and called for a new corrected card. (was that ever a mistake...) New card won't be effective until Sept. 1st! (started tearing my hair out about this point)

So, the upshot of the deal is we need to go register as a new patient of the mistakenly listed DR, have an appointment and he will give us the referral.

Insurance co. would be willing to revoke our change of Dr's but that wouldn't help, it would still leave us with the brand new guy. No one seems to know where the difficulty began & I couldn't uncover a trail that led to the switch in the first place.

With almost no patience left, I gave up. I feel so sorry for anyone having to wade through this health care mess. I've just had no experience with this at all until I began working on moms medical with/for her. It is worse than the condition or accident I believe!

We are headed to the brand new Dr. tomorrow morning for a full fledged appointment with someone she has never met and will never see again. Being nice enough just until we get said referral in hand........we're out of there!! Then, we wait til Friday when we have to trek all the way downtown to Seattle (me who doesn't DO Seattle!) for the nose specialist appointment. With luck it will also be a one time deal & she will be on the road to good as new!

Note to self: I will be certain to double check all of the insurance cards coming in.....making sure the DR is the correct one.
Also plan to get all moms meds on a mail order situation, saving as much as possible on each prescription. I just found out there is a 'window' each year, if her total meds go over the line and until they reach the top line, she pays 100% of the costs. This is just so blinking complicated, it is hard for me to follow all the rules, no wonder she had difficulty and was just shoving the paperwork in a closet here!

Hoping for a better day tomorrow!

Posted in cranky | 8 Comments »

8 Responses to “Beyond Frustrating”

  1. JanH Says:
    August 30th, 2007 at 12:39 am 1188434353
    1188434353

    My mom had to keep notebooks and up to date information on her mother at all times while she was in the assisted living and then the nursing home. It sure does take a lot of paperwork and time to keep track of it all. I feel for you. I know that your mom appreciates it.

  2. mbkonef Says:
    August 30th, 2007 at 12:40 pm 1188477625
    1188477625

    I can sympathize with you on how frustrating the whole health care situation can be. Several years ago my oldest DD fell and broke her arm. It was in the evening. My DH took her to the local ER where they did X-rays, confirmed a break but could only put on a sling since they did not have an ortho on call at night! I Cclled a local ortho who was connected to the hospital first thing next morning for an appointment. They told me I should call whomever had treated her. I told her no one since there was no ortho on call at night. I had to argue with them before they would finally agree to squeeze her in at 4:30 that afternoon. If an ortho doesn't have room for emergencies, are we supposed to resort to scheduling our broken bones? The same group of ortho's did cast and treat her but made her keep the cast on for an extra week cause the doctor who put it on was on vacation the week it was scheduled to come off! I flipped out, gave them a piece of my mind and tell everyone who mentions needing an ortho about our experience with them.

  3. kashi Says:
    August 30th, 2007 at 03:17 pm 1188487038
    1188487038

    Have you seen Michael Moore's "Sicko"? If not, you should. After reading this post, I'm sure you'd appreciate it.

  4. Joan.of.the.Arch Says:
    August 30th, 2007 at 03:18 pm 1188487105
    1188487105

    Oh, my! I have had to deal with the insurance company when I was sick and I couldn't handle it. I ended up in tears and had to get someone else to make the calls for me. You are a godsend to your Mom. I say that from the point of view of someone who is normally competent, but can be beaten down by the insurance companies just at the time when I need their cooperation the most.

  5. fern Says:
    August 30th, 2007 at 03:56 pm 1188489360
    1188489360

    Ditto what kashi said, the health insurance system is a mess. If seemingly intelligent people like us get confused, imagine the situation for older people like your mom, or for a recent immigrant who many have a complete grasp of the english language.

  6. littlegopher Says:
    August 30th, 2007 at 06:16 pm 1188497803
    1188497803

    My family, too, has had our share of insurance craziness unfortunately. I also had to figure out, straighten out, and stay on top of my mom's medical care. Like JanH mentions above, keeping a notebook with all info from calls - names, date, even time of call, as well as what was discussed - is very helpful. With my mom, it plain took time, and lots of calls, to get everything straightened out...and eventually, managing her care got easier. Hope things will be better soon for you too. Best wishes!! (Glad your mom is doing well!)

  7. Frayed Buckeye Card Says:
    August 30th, 2007 at 07:15 pm 1188501344
    1188501344

    When I became a widow I followed the law and notified SSI
    of his demise. Not only was he declared dead but I was also. No income did I receive, but worse yet my health insurance was declared void. It took four months with SSI to prove I was not DEAD. United Health Care made me jump
    through hoops to prove I was alive. And some people want
    universal health care? No way!

  8. contrary1 Says:
    September 3rd, 2007 at 04:32 am 1188793934
    1188793934

    I'm starting a notebook and file system for mom, with almost a whole drawer devoted to this convoluted health plan.

    I agree with keeping detailed records, however I couldn't get the insurance co to agree with me about the primary DR even tho we had records of mom seeing the woman for over 10 years now. They kept telling me if I wanted mom to switch Dr's ..... No way would they see they had made an error on the silly membership card. Just a clerical error, but wow........what a mess it caused.

    I truly can't imagine how older people/couples manage if they don't have family assisting. This is HARD and I start doubting my abilities ......where I'm usually more than confidant!

    I'm learning more all the time.....and plan to make huge strides this week when I get to meet the primary DR. (the old original one) to see if we can tidy up the process, get the meds in order and save mom some money in the long run.

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