Sunday, January 19, 2014

' My Doctor saved my life this week' vs 'The Insurance Co wants to Randomly deny my CT Scan'



I had some pain the other day, a real stabbing constant pain in the right lower section of my gut. Mike said, that's where your appendix is...

So since the next day was 'day two' of morning four day seminar I had paid for I made an appointment for late afternoon - 4:30.

The pain was pretty constant and annoying but really didn't bring me to my knees or anything so I made it through the day ok.

When I got to the appointment lo and behold my new insurance plan didn't have my doctor as my Primary provider. (Despite me calling numerous times to have it changed and having someone tell me from Florida Blue that he had been changed to my PCP (Primary Care Provider)

So they weren't going to see me. They called Blue and the lady said that is the way it is and wouldn't let them put me on the phone.

So I got on the phone and sat on hold for MANY minutes...Meanwhile I asked them for another phone and the phone number of the primary care provider that was assigned to me so I could try to get in. AND I told them I thought I may have appendicitis.

30 minutes later, (Still on hold with Fl Blue) I had made an appointment with the other PCP for 8am the next morning...and the Office manager came over and said that my Dr. - Doctor Fern would in fact see me. On his time and not bill for the appointment (since he couldn't) and check me out...

So laying on the table with Dr. Fern examining me the person FINALLY picks up from Florida Blue and said he would switch me to my preferred PCP but guess what... couldn't in fact do it....

Put me on hold again for about ten minutes in which Dr. Fern went to see his other final patients for the day.

When he came back I am still on the table but he starts to examine me again and the Fl Blue guy comes back on again. This time he asks if I am at Dr Fern's office and asks to speak to someone from the office.

Dr. Fern gets on the phone and took down the confirmation number and verified that he would be able to order a STAT CT scan as it appears I have appendicitis. He said that was a first...to get on the phone himself with an insurance company WHILE examining his patient.

Then I go to the front desk and the lady calls gets DENIED from FL Blue for my procedure.

You know what she tells me? Oh don't worry I just have to call again...they randomly deny tests all of the time.

RANDOMLY DENY COVERAGE OF TESTS ALL OF THE TIME?? WTF??? WHAT IS WRONG WITH THIS PICTURE??

So my Dr. kept his practice open WELL after six to get this done for me and they gave me some sort of disgusting thick barium banana flavored drink to drink on the way to the ER.

At the ER since my doctor's office had pre-cleared the test and sent my stuff I am taken in to the Scan department, I am told I have to drink more goop and wait for 2 hours. They give me warm blankets and a quiet place to hang out while I wait for my gut for to be ready for the scan.

They took my appendix out at 1am rhat night. What could have happened if my Dr didn't see me that night? I could have gone home and it could have burst that's what.

I don't understand why Health Insurance companies still have so much power over our health and life and can still be so inept.

I get that they were overwhelmed with the whole ACA thing, so HIRE MORE PEOPLE! Insurance companies are one of the richest types of companies doing business in our country. Their offices are annointed with such splendor with rolling hills, statues, lakes and gated entrances that they look like country clubs.

Anyway today I am grateful for Dr. Fern. A Doctor who does the right thing and sees a patient despite the lack of correct policy in place and knows above all else 'To do no Harm'.

I just wish the Insurance companies had to follow that credo.


Thursday, January 9, 2014

Changing Routers or Modems is always such a hassle!

Our cable provider has been sending us these helpful reminders that we need to update our Modem. Mike called last week (one of the things I begged him to do during the vacation, you know Honey Do's).

So we got the new modem this week and he got it completely installed today.

Well I am ADDICTED to an online game which is a version of Settlers of Catan. The version I play is on an independent site with no advertising revenue or pop-ups and it's called Asobrain. A couple of guys in the Netherlands designed and built this site for their friends and several years later they have thousands of users and it's terrific.

Anyway I play it EVERY DAY and today I tried to log in after my work day and after I cooked dinner today.

It was a No-Go. Mike tried to come to my rescue but didn't listen to me when I said it was because of the new modem installation. He tried to download and update Java which is the program that the site uses. It was still a No-Go.

Meanwhile I logged onto his laptop and my daughters desktop and it wasn't working on any of the computers.

He was getting very frustrated and we had words. He departed into the den in a bit of a huff.

Fifteen minutes later he came up and handed my laptop with a smile.

Yup 'Tech'* figured it out. It was the firewall. It was blocking Java.

I think we may have gone down this road before the last time we replaced a router.

So I thought I would write a post about it. So we would hopefully remember the next time.

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*I call my husband 'Tech' as in "Tech I can't get the printer to work" or "Tech why does this pop up keep coming up?" or "Tech which remote do I press to get Netflicks to come on?"

Wednesday, January 8, 2014

Obamacare Update - People Matter!

Well I got signed up through the website and got a pretty good plan for $387/month. I am being subsidized about $115/month. The plan I was looking at Michaels' job was over $550/month for me so I am pleased.

I also am going to continue to use 'Obamacare' when referring to this life changing initiative. I want to give him credit for helping the citizens of this country to get care.

So many who are much poorer than Mike and I can get subsidized much more, even to the point of the coverage being free for them. A family of three that makes under $78,120 is eligible for a subsidy, a family of four under $94,200. http://obamacarefacts.com/obamacare-subsidies.php

And there is the rub.

Some don't thing the government should subsidize anything.

Don't have enough for an apartment or a house? Rent a room in some fleabag hotel!

Don't have enough for nutritional food for your kids? Give them Peanut butter and crackers.

And don't let us seeing you use your food stamps for anything like a (HORRORS) a birthday cake for your kid!

Don't have enough to keep your heat on? Wear sweaters and hats indoors.

My mom lived in subsidized housing her last five years on earth.

She had a very small apartment but it was affordable. I think it was costing her about a third of her Social security income - about $300/month. She couldn't have had a secure place to live without that apartment. They had group events like cards and bingo. They had a courtyard in the center near the laundry area where the (mostly lady) residents would gather and talk and laugh. They allowed pets, even small dogs so Mom could keep her cat. She loved that cat and I think that having Kiwi there really was a comfort to her. Kiwi died 10 days after she did. I just think that is such a testimony to the love they had for each other. They also had a buzzer all of the older residents were to buzz each morning by 10 am to let them know they were ok. Her not buzzing that buzzer led to the discovery that she had died in her sleep that night last May.

And I lived on Unemployment twice in my life. Yes I have been working since I was fifteen but had about 18 months 'on the dole'. And I am not ashamed of it. We work in this country and we pay for Unemployment insurance for a reason.

We need to allow people some dignity when they need a helping hand.

We need to take care of our citizens in this country. Not just the corporations that have money matter.

Obama care matters. People matter.

Sick Day again

Jamie was diagnosed with Strep throat on Monday. She had a sudden Sore throat Saturday and a very high fever on Sunday (Up to 103.3!!) I was pretty freaked out because she also mentioned that her neck hurt.

Anyway it's Strep again. She has had it a couple times the last year or so. And I had it once along with the flu about a year ago.

So combined with the Strep, and the horrendous cold weather even we in Florida have experienced this week we stayed home Monday and Tuesday. She still had a very slight fever yesterday but today it's gone.

I kept her home anyway. I know bad Mommy. To tell the truth I didn't want to 'Get back out there' myself.

We got up late - my alarm didn't go off - so we took another day. But you know what I am glad. Glad that I am a realtor and can do this without guilt and suspicion from my employer. Glad that I don't have to push my girl back into the swing of things so soon after being so sick.

So there- I have said my peace about that - How was your Christmas and Happy New Year!