Medical Dominoes

[anewbiewannabe]

I'm feeling really frustrated. In order to make the other big dominoes fall I need to get the medical dominoes to fall first.

It's October and my specialist ordered 2 MRIs in January. It took a couple months before one of them was approved and I'm still waiting for approval for the 2nd.

It took me 4 years to be able to go to a specialist. Long story I'm not going into. Anyhow I finally found one that takes my current insurance so I have to do what I can to keep him until my insurance changes and I won't be able to see him anymore.

That's where the rub is---the insurance person in his office is the main reason this hasn't been resolved. For months she never bothered to call except when I was in the office. (Yes, I'm sure of this.) The last time the blame was once again put on me because my file showed the MRI had been approved. Nobody called and told me. Her end of the conversation with the insurance company while I was in the office confirmed that it had not been approved---the company had no record of it being approved.

So, for whatever reason, she hasn't been doing her job. I risk losing my specialist if I say anything---both of us or just myself could be fired. His personality is the type that would shoot the messenger. I risk not being able to afford any treatment determined by the MRI if it doesn't get done soon. Changing specialists isn't a possibility because there isn't another one in my area other than the pill mill I went to once 4 years ago.

I'm beyond due for a spell of good luck. Anyhow, thanks for reading. Just venting because there's not really anything anyone could do or that I can do differently other than keep plugging away. I just want to be free to have more options in my life.

 

[coffeewitholiver]

Hi,
I wish I could say something helpful, but since I can't, I'll just say I wish you well and hope this resolves in a positive way for you!
Parker

 

[anewbiewannabe]

Thanks Parker. I appreciate it. Somehow, some way it will resolve. I just wish it was yesterday, or last month, or last year. LOL

 

[Cammalu]

I understand and really feel for you. The wheels turn very slowly at times.


Sent from my iPad using Tapatalk

 

[jimindenver]

anewbiwannabe

At least you have some hope. My "specialist" has already told me that she won't do surgery for the numbness, falling down and pain. It's been one shot, handfuls of pills and see me in 6 weeks. My back will never get better and she can collect forever.

 

[SternWake]

My father has been dealing with medical issues, and can't even get them to discuss the results of CT scans. There were a few comments at the time of the scan which has freaked us all out, but we have to wait another month before the Doc will even talk with him.

Part of the comments were the indicating same condition was building which landed him in the hospital ICU for 8 days loaded on painkillers, is recurring.

I am rather enraged. I get the impression he is not going to bother fighting and having to keep dealing with the whole medical establishment.

He is Seeking second opinions outside his insurance plan, as part of the issue seems to be a botched surgery that is not normally difficult or known for complications afterwards.

 

[jimindenver]

Any more if you want any care anytime soon, you go to the ER or Urgent care. It's the only way my folks could get care and they were near death when they went in. The other half needs a CT and all the Doctor could say is if the pain gets worse go in and they will do it right away.

The cross between profit and medical care is about as messed up as it gets.

 

[cyndi]

The stress of the BS that the health industry exacerbates any chronic condition.Sometimes I feellike it's part of their plan to keep us sick and paying. I'm not into conspiracy theories, AT ALL! But I can't think of any other reason why these people don't do their jobs!

I'm sorry your dealing with this.

 

[Queen]

I'm so sorry you're dealing with this! We ran into the same runaround in Florida... one of the big factors in us returning to Illinois was health insurance, there it was crap, here it is pure cadillac.

 

[ccbreder]

Hope things work out. I have had problems with front office personal. "Oh, I would have to make a phone call!"

 

[Gadget728]

ANW - I feel for you, the medical mediocrity in recent years is pitiful. All the older Dr.'s have retired or died, leaving us a bunch of younger Dr.'s that went to college in the partying 80's & 90's.
I can't afford obama care, so i went to a Dr. who you pay by the month, and she doesn't take insurance. After 5 months with my condition brought on by a tick bite, my words are still slurred and my hands still don't work very well. The last time I went in to see her, she wanted to send me to a specialist for speech & coordination therapy. I asked her once again for a name for my problem, and she still has no answer. I sat down in her waiting room and wrote her a final check with a required 30 day notice of me leaving her care. She acted surprised.

I hope you get taken care of soon, good luck to you. -gadget

 

[TrainChaser]

Call your state Board of Licensing and chat with them. You may also be able to go to their site and type in your doctor's name (first and last, not just last) and see if there are other complaints.

 

[GotSmart]

I guess I am lucky.  I am going to a teaching hospital that has everything online.  

I have instant access to all my charts.  

It still sucks not being able to remember what I am doing, but at least I can tell what the diagnosis is.  cerebrovascular disease.

 

[DannyB1954]

I am getting the medical runaround as well. Doctor authorizes a specialist, insurance sits on it then sends it to the specialist to sit on and approve, by that time the 4 month window for the referral has expired.
I bought the platinum plan. What I conclude is I would have been better served with a bare bones plan. Once yoiu give insurance your money, good luck getting them to release it back in your behalf.

 

[anewbiewannabe]

I had typed up something with individual responses only to discover I had lost my connection. When I got a connection again I went back to post it and discovered I had somehow deleted it in the meantime. Anyhow, taking a moment now to at least briefly respond my thanks in general to all since I haven't been up for more thought about the situation since.

JiminDenver, your comment about hope helped me realize something even though there isn't any hope. The silver lining to the situation with the MRI is that as long as it's put off and I can find a way to keep from getting a EMG then I don't have to worry about anyone wanting to poke me in the spine. A poke in the spine won't answer all the issues with my leg and any surgery is a risk. So, now I'm happy for all the delays. I can't afford to lose this specialist as he's the only one within driving distance.

Thanks everyone! Don't know if I'll get back to retype individual responses as I'd like to forget the whole damn mess I'm dealing with.

 

[Gunny]

I hope your physician gets their act together and you get treatment. I've never had an MRI, got a bit of metal in me, but have been CAT scanned aplenty. It's easy for me to type not to get discouraged but when you get the need for some support just check in here. Sometimes moral support is better than what the doctors prescribe.

All My Best, Rob

 

[TrainChaser]

People, you need to take control of your medical care.  Don't just sit there and nod; ask questions.

1.  If you're having trouble with your doctor, contact the State Board of Licensing, and ask how to file a complaint. Also ask how many other complaints he has had lodged against him/her.

2.  If  you're having trouble with your insurance company, contact your State Insurance Commissioner.  Your SIC decides which insurance companies operate in that state, and which don't.  You'll get a gumchewer receptionist when you call.  Distill your problem into about three sentences.  She will send you forms to fill out, and that's where you detail every single little thing.  Maintain a log of when you called (or visited), who you talked to, and what the gist of the conversation was. There is no harm in doing it in front of the person. *evil smile*

3.  If the witch in the office is ignoring you, call every day for a week.  If that doesn't work, talk to someone else in the office and ask what state office you should contact to file a complaint.

4.  Every time you ask someone (any above), ask WHEN the next step should take place.  Write it down. Follow it up.

5.  A doctor cannot FORCE a patient to do anything if that patient is competent to make medical decisions and refuses care.

 

[anewbiewannabe]

Everyone dealing with the medical establishment for themselves or loved ones, I wish you the best of luck, the best of treatment, the best of doctors and staff, and my prayers are with you.

Gunny, thanks.  There's not really anything for doctors to do except medicate. Whether orally or with injections in my spine.

TrainChaser, I agree with much of what you say and it's good information for people to consider and I highly recommend your suggestions.  There is a lot going on that I'm not sharing so I have to make my choices based on facts and information not in evidence here---I know that makes it harder for advice to be given, but I was venting not looking for advice.  I have no problem kicking a doctor to the curb as I fired one in the middle of a high risk pregnancy.  Boy was he shocked!!! Who ever heard of firing a doctor at that point?!?!?! LOL

As for me, I got too complacent with my last GP because he was the best I could find in a 13 year search after my wonderful GP passed away.  This last one at least met my basic needs, so I thought, while I tried to find treatment options.   Unfortunately, most of my records from him are missing so it's pretty pointless to report him. The ones I've seen since suck too.

Calling to fight the insurance companies myself for the MRI would just use energy I don't have to speed up the timeline on a procedure I don't want---there are other parties at play that could cause me problems if I refuse outright.

Like I've said though, I found a silver lining that I should have seen but missed until Jim's remark.  I know my conditions, I know there's not really anything that can be done other than to medicate a few.  One is progressive and debilitating and about 20 years early.  The new laws make it harder and harder to find the care I need, then add to that them having to be a provider under my insurance, and then whether they are accepting new patients, and it makes things more complicated. Our urgent care can't meet my needs except for if I have bronchitis as it's just a walk-in doctor office.

So, the perspective I've gained is that I need to go ahead and figure out my plans without the medical domino falling.  I need to get some things taken care of while I still have my specialist because I won't have access once I'm on the road.  The hope that I've found is that maybe I will actually be able to get out there before I'm no longer able.  That is what I'm working toward.

 

[jimindenver]

ANW

I understand how you feel. I have put off the surgeries I knew I needed worried I'd come out worse for it. Now with things going numb I'm worried if I don't get things fixed while I still can that I won't be able to. I did get a new specialist, my regular doctor wasn't to thrilled with the "will never do surgery" aspect especially after my neck MRI came back. The pills haven't been helping that either. That was a 2 hour initial consult today and we start the whole process over.

Believe me, I'd put it off longer if I could too.

 

[GotSmart]

ANW

I understand how you feel. I have put off the surgeries I knew I needed worried I'd come out worse for it. Now with things going numb I'm worried if I don't get things fixed while I still can that I won't be able to. I did get a new specialist, my regular doctor wasn't to thrilled with the "will never do surgery" aspect especially after my neck MRI came back. The pills haven't been helping that either. That was a 2 hour initial consult today and we start the whole process over.

Believe me, I'd put it off longer if I could too.

I have had two separate spinal surgeries,  1st they replaced the C3 & C4, That was in 2001,  then in 2014 they replaced C5, C6, and C7.  Each surgery took about 1 hour.  I was driving within a couple days (against orders)  I will not have my knees worked on, but the neck had a much better success rate.  Always ask for information about how many surgeries and the success rate for the recommended surgeon.