July 22, 2006
I have not posted for several days as I had an appointment with the Dr. that fills my intrathecal pump and while I was gone I had received a call from Minnesota finacial services dept. I knew immediately that something was wrong, it was too late however for me to reach anyone there.What was the issue that day and was resolved has now become a different issue. I personally believe that the file sat on someones desk too long and they are attempting to determine a way out of the approval that had been given previouslyI can assure you that I am pissed to no end, and am ready for what ever fight is to ensue. I knew that when I had approval for this surgery in 6 days that it went to well, especially for an insurance carrier that has denied routine hospital stays for dehydration. Believe me, this is not the first time they have denied medical procedures. When I had the j-tube inserted they would pay for the j-tube insertion but not the food " as nutritional supplements are not covered" give me a break. Anything I eat causes so much pain, I wouldn't begin to eat. That is why I lost 40lbs duh.I truly understand why people go "postal" I really do. There is only so much that one person can humanly take. I have gotten the plan book out and it discuss this type of transplant which is no different than a bone marrow transplant. There are other types of these transplants just I don't feel like listing them all. It basically boils down to they don't want to pay for it. I spoke with the lady from fianicial services at UM and she said " they have NEVER recieved authorization and then have taken away". Never. They have not cancelled the surgery, yet. Only time will tell how this will play out. I can tell you that they are aggressive looking for a way out. The HR person at my husbands work can't even say the name of the procedure and then told me that their so called insurance company pays a physician board to determine what classification it falls under. No they pay them to deny services, my husband works with a Dr. who once worked for an insurance co. and they would give them HUGE bonus' to deny surgeries anything to save them money and if they saved them enough then they would give them big incentives to continue to do so. She finally left because she knew they were killing people. I have honestly said " I was not looking forward to this surgery, I was afraid, but that I knew it was a means to and end" It is terribly difficult to see the light in the tunnel and now have the tunnel capped of to prevent you from seeing the light. If it doesn't happen, then I was willing to have it done. I even told the HR rep what kind of idiot am I that I would willingly let someone take out my pancreas, duodeum, spleen and 1/3rd of my stomach? Does that tell you how bad I feel that I am willing to let someone do something so radical to me, in hopes that it will work. I can no longer eat enough to sustain life, they have been told that without this surgery I will probably never eat another meal. So I guess they don't think that in the long run with all of the tube feeding supplies, and the pain meds, and the pump refills, and the surgery to replace the battery when it is dead ( in 2 years approx) that they would save any money. They don't look long term they look at what has to be paid out in one sum. It would be cheaper for them to pay for the surgery and be done with it, than to continue paying for all of the other stupid stuff I have to have. God is still on the throne he has left for one day and he isn't going to. God's will be done.