Okay, so you all know the saga of my gallbladder adventures. It continues! NO!!! you say! Well, the good news is I'm feeling a little better every day. Though by the evening I'm really exhaused and hurting. Thursday is/was THE DAY. I went and had blood drawn this morning for tests before THE surgery. Took care of some business that I needed to get done. One of them was go to the dr.'s office to find out why the paper work I'd submitted for work hadn't been filled out. (I faxed them and apparently they are now charging $15 to fill them out, so they were waiting on my to come in and pay. Never mind there isn't a notice and noone called, it's been over a week!) Got that straightened out. Got by the safety deposit box to retrieve adoption papers so DS#1 could get his learners permit changed over to his adopted name and renewed. (I'll eventually need a chauffer after all! LOL ) Got home from letting him drive nearly 30 minutes from the state police headquarters. At 4:30 the phone rings, it's the surgeons office.
It appears that my insurance company (which isn't an insurance company but a "benefit management company") has denied approval for my gallbladder to be removed. Seems I don't "meet the criteria". I was stunned. Even worse, the "medical director" has to talk to the surgeon before he can approve it, the "medical director" won't be back in his office until JUNE 6TH!!!!! In the mean time, I'm burning sick leave, need to have this thing out, something else looked at (that I'm really concerned about) This is sooo typical. I tried to call the department Chief to see if he had any bright ideas or could get the city finance guy (whom I believe sits on the board of our "benefit management company") to pull some strings for me, but he'd left for the day. (it was done shortly after I hired on and my DS #2 needed surgery but had a "pre-existing condition". One phone call by one of our captains that was friends with the finiance guy and all was paid for) So tomorrow......
I plan to camp out at the firehouse our Union President is assigned to in the morning. I will have a cup of coffee ready for him so I can butter him up. Our "prez" knows alot of "people" so maybe he can make some phone calls and move this along. I am so fit to be tied! I was furious when I first got the call. Though completely out of character, I was very nice to the lady that called me, part of the don't shoot the messenger policy. Now it's almost, almost amusing. It's so the story of my life! Nothing is easy! In
1994 I was having female problems. Turned out to be a cyst on my left ovary that was hemorrhaging. I didn't meet the "criteria" for the surgery. The dr. pushed the issue and it was approved. 10 months later, more female problems, they approved an emergency exploratory surgery. Nothing found. Two months after that low and behold I have more cysts on the other ovary, hemorrhaging. I didn't meet the "criteria" for more surgery, never mind I was at the ER every couple of days doubled over in pain, vomiting from the pain, never mind I was bleeding to death. Dr. again pushed the issue it was approved, oh guess what? The "ovary" they were looking at wasn't an ovary it was a cyst that had a cyst on it that was hemorrhaging. The ovary had gotten twisted behind my uterus, which somehow had gotten inverted, covered with cysts. They approved not one but two sleep studies for me. When the Dr. prescribed a CPAP machine because I stopped breathing over 100 times an hour while sleeping I once again didn't meet the "criteria". This Dr. wrote a nasty letter, magically it was approved.I would love to know how a Doctor, someone who has actually seen the patient can prescribe a treatment and be over-ridden by someone behind a desk reading guidelines. Makes no sense to me! ARRHHHHHHHHH!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
Thanks for letting me rant/vent! I'm sooo frustrated. I'm going to bed now.....