OK...I've had a day to calm down...but I am so disappointed that I still have a pending surgery...ugh! I want 2011 behind me and to go into 2012 healthy. I fought my battle and won...I deserve this.
Doctor "McC" called to inform me that the reason my insurance company declined the request for surgery was because they were under the assumption (based on coding) that Dr. McC. was performing plastic surgery on my abdomen. This is also the reason why my insurance company requested photos of my abdomen when they declined the surgery. I know that no one is perfect...and I am certainly not asking people to be....but if my doctor's office had submitted my surgical request in a timely fashion...even 24 hours earlier, all of this would have been resolved PRIOR TO ME BEING NAKED ON A GURNEY WAITING FOR SURGERY!
My surgery is rescheduled for Tuesday, December 20th. Dr. McC. asks if "N" can phone me later in the day with the time or would I prefer that she phone me personally? I appreciated Dr. McC. offering to call later with the time but being the reasonable person I am (amazing I know after the last 24 hours...grin) I tell her that it would be fine for "N" to call. Just a few hours later "N" calls and we are scheduled for Tuesday, December 20th at 10:00am for surgery.
Saturday, December 24, 2011
December 12, 2011 - It Just Keeps Getting Better
Being diagnosed with cancer is the last thing anyone wants to hear. When you are given the news you have no idea of the journey you are about to embark on and just how much of a role you are going to have to play in order to manage your health care. Even though you and your insurance company are going to be paying out thousands and thousands of dollars to be treated...you had better be on your "A" game.
On December 1st I had a follow up appointment with Dr. McC. to go over the results of my CT scan (getting the scan scheduled was a challenge in itself). The CT scan was ordered to get an inside look (literally inside) as to what is going on in my "port from hell" area. The scar tissue that has developed from the chemo fluid that leaked inside my body continues to grow and keep me in pain daily...it needs to come out. I know that, and Dr. McC. knows that. When I am done with Dr. McC. I go down the hall to talk with "N" who schedules Dr. McC. surgeries. We check Dr. McC. schedule and we choose Monday, December 12th for my surgery date. "N" promptly gets on the phone with the hospital to reserve an operating room and determine a time. After several minutes on hold "N" asks if I would like to head home and she will call me later with the actual time of my surgery. I am happy to do that since I am tired, feel crappy and as usual, I am in pain. The following Wednesday, December 7th when I hadn't heard back I called "N" to find out if in fact she had secured an operating room and what time my surgery was. I suppose it was foolish of me to think that I might have received an apology from "N" when I said...I hadn't heard back from you so I'm calling to confirm that I am scheduled for surgery on Monday and that you received an approval from my insurance company. "N" informed me that surgery was scheduled for Monday, December 12th at 2:30pm and that I needed to be at the hospital at 12:30pm. I asked about pre-surgical procedures (ie., fasting, meds, etc.). "N" referred me to the hospital for my pre-surgical instructions and said that I would need to speak with Jamie (the office manager) to determine if my surgery had been approved by my insurance company. Well then, upward and onward to speak with the hospital and with Jamie. It appears that if I want surgery on Monday I am going to need to be an active participant in getting things lined up. Remember...today is Wednesday, December 7th. When I spoke with Jamie I told her that I needed to be certain that my insurance company approve my surgery or that we could not move forward. I was also concerned that because it was already Wednesday and that surgery was scheduled for Monday. I asked how long the approval process takes...she told me that they usually have an answer within 24 hours and if there is an issue, which she didn't anticipate, she would contact me.
Monday, December 12th. I am nervous this morning in anticipation of my surgery. This is not the norm for me. Maybe it's just because I don't want have another surgery. Even though I am very anxious to get all of this scar tissue and whatever else lurks in there out of me and off of the pain meds that have become a part of my daily life. I also feel yucky each and every day and am curious to see if this toxic ball of chemo fluid, scar tissue, aliens who have taken up residence, etc. is contributing to that feeling.
I arrive at the hospital, fill out my paperwork and wait to be called back to the pre-surgical area. It's a short wait and I'm called back. I am greeted by my nurse ("L" is wonderful...efficient, kind, caring) I disrobe as instructed, slip on the lovely designer gown that snaps on the shoulders and ties in the back and begin pre-surgical prep. Tinkle in a cup, get my IV in place (damn-a-ramma that hurts...my veins are shot from all the chemo), blood draw, EKG, work through a questionnaire with my nurse and she is ready to send me downstairs for a chest x-ray before the anesthesiologist comes in for a meet and greet and to roll me off to surgery. Mind you it is 1:30pm and my surgery is scheduled for 2:30pm and the folks in radiology are calling wondering where I am. Just as we are getting ready to roll me down to radiology the phone in my room rings...the nurse answers it and it's "N" from Dr. McC. office who is calling to tell me that my insurance company just called (as in one hour before my surgery time) and has decline the authorization for surgery. What? Hello? What? Seriously? "N" was explaining that we could move ahead telling me that Dr. McC. would appeal it but, they could still decline it but, it was unlikely that they would...(after that all I heard was the teacher in the Charlie Brown cartoons...wah, wah, wah...). I couldn't believe it...seriously, really? I finally asked "N" if we move forward and they don't approve it who is financially responsible? Of course I knew the answer...you are she said. I asked "N" if Dr. McC. was at the hospital. She said no, but would I like her to call me. Why yes I would (arghMcC. I basically had the same conversation with her that I had with "N." My insurance company had just contacted them to decline the request for surgery...blah...blah...blah. Dr. McC. told me that my insurance company was requesting photos and a peer to peer discussion (Dr. McC. and a doctor from my insurance company would talk). I told D. McC. to cancel the surgery as I could not move forward without an approval. She said that she would speak with my insurance company and get back with me.
By the time I got home I was pissed beyond belief. How can this happen one hour before surgery? First I called my insurance company. I wanted to know exactly when they received the request from my doctor's office. The representative that I spoke with told me that all requests are time and date stamped and that mine was received on Friday, December 9th at 3:40pm. What the hell? My doctors office requested approval from my insurance company less that 24 hours prior to a planned surgery when they had known for just under two weeks? Next...I called Dr. McC. office and asked that she phone me. They explained that she wasn't in...I explained that I knew she wasn't in...that I had already spoken with her earlier and that she needed to call me today. About ten minutes later my phone rang and it was Dr. McC. who was very apologetic. I told her in no uncertain terms that something like this should never happen, that there certainly must be procedures in place to ensure that everyone involved; the insurance company, doctor, hospital, patient, etc. are ready to go (approvals, paperwork, etc.) well in advance of the patients scheduled surgery date...let alone one hour before surgery time. I won't bore you with the rest of our conversation...ultimately Dr. McC. informed me that she would personally contact me once she had spoken with my insurance company and received approval. Somehow I think she knew how pissed I was.
On December 1st I had a follow up appointment with Dr. McC. to go over the results of my CT scan (getting the scan scheduled was a challenge in itself). The CT scan was ordered to get an inside look (literally inside) as to what is going on in my "port from hell" area. The scar tissue that has developed from the chemo fluid that leaked inside my body continues to grow and keep me in pain daily...it needs to come out. I know that, and Dr. McC. knows that. When I am done with Dr. McC. I go down the hall to talk with "N" who schedules Dr. McC. surgeries. We check Dr. McC. schedule and we choose Monday, December 12th for my surgery date. "N" promptly gets on the phone with the hospital to reserve an operating room and determine a time. After several minutes on hold "N" asks if I would like to head home and she will call me later with the actual time of my surgery. I am happy to do that since I am tired, feel crappy and as usual, I am in pain. The following Wednesday, December 7th when I hadn't heard back I called "N" to find out if in fact she had secured an operating room and what time my surgery was. I suppose it was foolish of me to think that I might have received an apology from "N" when I said...I hadn't heard back from you so I'm calling to confirm that I am scheduled for surgery on Monday and that you received an approval from my insurance company. "N" informed me that surgery was scheduled for Monday, December 12th at 2:30pm and that I needed to be at the hospital at 12:30pm. I asked about pre-surgical procedures (ie., fasting, meds, etc.). "N" referred me to the hospital for my pre-surgical instructions and said that I would need to speak with Jamie (the office manager) to determine if my surgery had been approved by my insurance company. Well then, upward and onward to speak with the hospital and with Jamie. It appears that if I want surgery on Monday I am going to need to be an active participant in getting things lined up. Remember...today is Wednesday, December 7th. When I spoke with Jamie I told her that I needed to be certain that my insurance company approve my surgery or that we could not move forward. I was also concerned that because it was already Wednesday and that surgery was scheduled for Monday. I asked how long the approval process takes...she told me that they usually have an answer within 24 hours and if there is an issue, which she didn't anticipate, she would contact me.
Monday, December 12th. I am nervous this morning in anticipation of my surgery. This is not the norm for me. Maybe it's just because I don't want have another surgery. Even though I am very anxious to get all of this scar tissue and whatever else lurks in there out of me and off of the pain meds that have become a part of my daily life. I also feel yucky each and every day and am curious to see if this toxic ball of chemo fluid, scar tissue, aliens who have taken up residence, etc. is contributing to that feeling.
I arrive at the hospital, fill out my paperwork and wait to be called back to the pre-surgical area. It's a short wait and I'm called back. I am greeted by my nurse ("L" is wonderful...efficient, kind, caring) I disrobe as instructed, slip on the lovely designer gown that snaps on the shoulders and ties in the back and begin pre-surgical prep. Tinkle in a cup, get my IV in place (damn-a-ramma that hurts...my veins are shot from all the chemo), blood draw, EKG, work through a questionnaire with my nurse and she is ready to send me downstairs for a chest x-ray before the anesthesiologist comes in for a meet and greet and to roll me off to surgery. Mind you it is 1:30pm and my surgery is scheduled for 2:30pm and the folks in radiology are calling wondering where I am. Just as we are getting ready to roll me down to radiology the phone in my room rings...the nurse answers it and it's "N" from Dr. McC. office who is calling to tell me that my insurance company just called (as in one hour before my surgery time) and has decline the authorization for surgery. What? Hello? What? Seriously? "N" was explaining that we could move ahead telling me that Dr. McC. would appeal it but, they could still decline it but, it was unlikely that they would...(after that all I heard was the teacher in the Charlie Brown cartoons...wah, wah, wah...). I couldn't believe it...seriously, really? I finally asked "N" if we move forward and they don't approve it who is financially responsible? Of course I knew the answer...you are she said. I asked "N" if Dr. McC. was at the hospital. She said no, but would I like her to call me. Why yes I would (arghMcC. I basically had the same conversation with her that I had with "N." My insurance company had just contacted them to decline the request for surgery...blah...blah...blah. Dr. McC. told me that my insurance company was requesting photos and a peer to peer discussion (Dr. McC. and a doctor from my insurance company would talk). I told D. McC. to cancel the surgery as I could not move forward without an approval. She said that she would speak with my insurance company and get back with me.
By the time I got home I was pissed beyond belief. How can this happen one hour before surgery? First I called my insurance company. I wanted to know exactly when they received the request from my doctor's office. The representative that I spoke with told me that all requests are time and date stamped and that mine was received on Friday, December 9th at 3:40pm. What the hell? My doctors office requested approval from my insurance company less that 24 hours prior to a planned surgery when they had known for just under two weeks? Next...I called Dr. McC. office and asked that she phone me. They explained that she wasn't in...I explained that I knew she wasn't in...that I had already spoken with her earlier and that she needed to call me today. About ten minutes later my phone rang and it was Dr. McC. who was very apologetic. I told her in no uncertain terms that something like this should never happen, that there certainly must be procedures in place to ensure that everyone involved; the insurance company, doctor, hospital, patient, etc. are ready to go (approvals, paperwork, etc.) well in advance of the patients scheduled surgery date...let alone one hour before surgery time. I won't bore you with the rest of our conversation...ultimately Dr. McC. informed me that she would personally contact me once she had spoken with my insurance company and received approval. Somehow I think she knew how pissed I was.
Wednesday, December 7, 2011
Port From Hell Update
Remember when my IP port leaked chemo fluid underneath my skin? Me too. It's been a pain in my side, literally, since the day it happened. The scar tissue that formed as a result of the chemo fluid that leaked continues to grow, but not for long...I am scheduled for surgery on Monday to have it removed. I don't want to have a third surgery, but, I have to have a resolution to the constant pain that I am in each and every day. A girl can only take so many Percocet.
On a very positive note...Dr. McC. sent me for a CT scan last week so she could get a good look at what was going on inside. In addition to getting a visual of what is going on in my stomach and port area we received an added bonus...Dr. McC. was able to visually confirm that I am clean. Not that we thought anything was going on...but it was nice to get a visual confirmation that there isn't anything in there that shouldn't be. Remember the creepy lady from poltergeist who says: this house is clean? This girl is clean!
On a very positive note...Dr. McC. sent me for a CT scan last week so she could get a good look at what was going on inside. In addition to getting a visual of what is going on in my stomach and port area we received an added bonus...Dr. McC. was able to visually confirm that I am clean. Not that we thought anything was going on...but it was nice to get a visual confirmation that there isn't anything in there that shouldn't be. Remember the creepy lady from poltergeist who says: this house is clean? This girl is clean!
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