I am so jackedoff right now

[skeets]

We just got a call from our health ins carrier telling here they will not approve her PET scan, asked WHY NOT, because of your lung cancer,,, she tells this guy I dont have lung cancer that was taken care of 2 years ago!
Well our records say you have it and there has been nothing done about it so the ins doc said it is not approved.
She says listen the lung cancer was 2 years ago and its gone, NOW the lymphoma that Im being treated for it through my whole body. Now why the hell are they disapproving the PET scan.
Like I said Ma'am ( hates being called Ma'am) because your lung cancer has not been treated for 2 years,, NO SHIT its gone radiated away as in ^^$#!^&@)_)(&^^%% gone.
OK Maam but it hasnt been treated ,,,,, IT FREEKIN HAS BEEN TREATED!!!!!
And the PET scan is for the lymphoma not lungs.
Well there is nothing I can do about it you have to take that up with the review board,,WTF!!!!
You can bet the phone lines will be burning up tomorrow and I dont think I would want to be on the receiving end of those calls

 

[sheepfarmer]

Oh lord love a duck, skeets, what a pain in the tailfeathers.

 

[RCW]

Geez skeets, I feel for you man. Health Insurance and the whole industry is out of hand.
My thoughts and prayers it's taken care of, for her sake.....
God speed, my friend.


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[workhorse]

Because ma'am, our bosses bosses boss needs to get rich while you go poor trying to stay alive... Can't they just be truthful !!

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[jryser]

Skeets - I'm in healthcare and this might help. Ask to speak to a supervisor because you want to be sure you are being heard and advocating for your wife. Stay as calm as you can (I know this is hard Bc I'm a patient too!). And if you don't like the answer ask to speak to their supervisor. Then ask to whom you would write about your concerns for patient satisfaction. Use those words; that usually gets things moving. I'll stay close to ur thread here.


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[sdk1968]

Geez skeets, I feel for you man. Health Insurance and the whole industry is out of hand.
My thoughts and prayers it's taken care of, for her sake.....
God speed, my friend.


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ditto on all fronts.

 

[Newlyme]

Hey Skeets,
My wife is a Nurse Practitioner and she deals with this all the time, in fact she got one of those today.
Your doctor needs to appeal the denial. He should have all necessary documentation and history necessary.
Insurance frequently denies expensive tests/procedures in hopes you'll say I've been denied, OK, Oh Well.
Keep appealing you'll get the test. The diagnosis is appropriate if it is for the lymphoma and not the lung cancer. If the doctor does an appeal or what is termed a peer to peer with the insurance company and provides the correct information they should approve it.
Sometimes it seems they are testing your stress and blood pressure!
Godspeed.
Best Wishes.

 

[Tooljunkie]

Oh what a world we live in. Insurance is like warranty,traing day one look for any excuse to refuse and with a little luck the consumer will accept it.

Dont give up!
You got some sensible advice,hope you can iron it out.

 

[tlefire]

Skeets - I'm in healthcare and this might help. Ask to speak to a supervisor because you want to be sure you are being heard and advocating for your wife. Stay as calm as you can (I know this is hard Bc I'm a patient too!). And if you don't like the answer ask to speak to their supervisor. Then ask to whom you would write about your concerns for patient satisfaction. Use those words; that usually gets things moving. I'll stay close to ur thread here.


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This ^^^

There's a old saying in the health care industry......those how can't, teach. With doctors, they work for insurance companies. It's amazing that one person, with no patient contact, can tell a physician what they can and can't do for their own patient.

 

[skeets]

Thanks everyone I just had to vent, and other than going out and kicking a tree or something this was my next best option ,, younz guys is the greatest

 

[helomech]

Sorry to hear buddy, hope all gets cleared up.

 

[wozza]

Don't know how true it is, but I heard that having your soul removed was part of the application process to work for an insurance company (of any type)

Best of luck. If you want, give me the address of their head office and I will post them some nasty ass critters from Oz.

 

[Newlyme]

Ok Skeets now that you've had some time to sleep on it call the Doc and get it taken care of. Then get some seat time on the tractor to relax.


And while you're at for God's sake fill in that hole! You know what you were thinking about doing to that insurance guy is illegal!

 

[bxray]

This scene from the "Incredibles" sums up the insurance company!
It is the stock holders they watch for!
https://youtu.be/mC_97F2Zn9k

Ray

 

[CaveCreekRay]

The message out west that conveys seriousness is, "I have a backhoe in the high country that can dig a hole no one will ever find."

May you get it resolved today sir.

 

[Flienlow]

Politically, I am pretty center right. However, in the US our health care is a for profit multi billion dollar industry and that truly makes me wonder if we should not have a Single Payer system. Not Obama Care, not the mess the GOP will make of it, but a true single payer system.
My mother in law just found out that the last resort cancer drug they can try to keep here a live will cost her $3150/month. What a complete crock of shit. 28 small white pills= $3150/month and that is just their portion. They couldnt afford it if it was $1150/month.

 

[bxray]

The message out west that conveys seriousness is, "I have a backhoe in the high country that can dig a hole no one will ever find."

May you get it resolved today sir.

My freind kids to his daughters dates.
I have a shot gun and a backhoe.

 

[Vacula]

Flienlow nailed it!
As long as the US healthcare is for MASS profit, the patient is the person screwed. As long as congress, administration and judicial systems do NOT have to use what we minions use, we as patients are screwed. As long as people who do NOT want to work for a living or never ever worked to earn the healthcare they are on, the whole healthcare system suffers. As long as attorneys and the courts are allowed to continue to go after doctors, hospitals and the drug industry with all these STUPID class action law suits, we all pay the price of that litigation. Many things are broken in our not so perfect democracy, but healthcare is probably the most serious issue we have and it needs fixed! Case in point. I pay over 450 dollars a month from my paycheck for my health insurance through my fortune 500 employer. (Double what I paid just 6 years ago). I needed a surgery to move a section of tendon from my arm to rebuild my thumb/index finger joint. Outpatient surgery! I paid $3500 dollars + out of pocket so far. (Low deductible/best coverage offered). I questioned three of the bills and "mistakes" in billing were corrected or it would have exceeded 4 grand.
In the mid 90's and in 2003, I had major back surgeries. I never paid a dime for either of those surgeries. Nor did I pay a dime for a knee surgery in the 2000's. The whole healthcare system is broken. Period. I feel for you Skeets. This should be a time for healing in stead of worry and frustration. Trouble is, if you own a mutual fund in your retirement portfolio, we own the very stocks that bi*#h on the phone is trying to save money for! Ironic isn't it?

 

[CaveCreekRay]

The Capitalist system is the sole driving force to innovation and discovery. Name another country where the government developed medicine or actually had a decent healthcare system. The Soviet Union? Cuba? Canada? (Ask Paul & Kathy Short!)

The old system that may have held up as the better one left about 30 million out of health care largely because they either didn't have a job offering healthcare or worked part time, thus not receiving benefits. After Obamacare, almost the same number of people are now uninsured but, at the middle of the income curve. Those people are paying for the original 30 million to have coverage by paying MASSIVE premiums. How is that right?

Based on history and people within the profession way smarter than me, we need to get the government OUT of the healthcare profession. Nothing the government does is in any way "efficient." Give a car wash to the government and they'll quadruple the cost and cut quality by a factor of ten.

Sean Hannity has interviewed a doctor in St Louis who has a booming business with several clinics offering Cadillac Care at Pinto prices. He has all the testing equipment in-house as well as labs and good tech people. If you need something, its covered. No questions. And the premiums are affordable. Why is Congress not looking at that type system? Because they would have NO CONTROL OVER IT. We have doctors in Congress who have great ideas. Health Care Savings Accounts are essential.

The comments about lawyers is dead on. I come from the world of aviation which has been priced off the chart thanks to idiotic law suits. When I was a kid, any blue collar guy interested in aviation could own a plane for the price of a good bass boat. Not today. The same has been done to the health care industry while doing nothing to increase safety for Americans. Its estimated a half million Americans still die each year due to drug interactions or mis-prescribed medications. Whats the government doing about that? Nothing.

My wife and I watched a Frontline show on health supplements and what a poor job the government is doing managing those. In Hawaii alone, several dozen did liver damage to the point of needing a liver transplant. Despite a doctor repeatedly calling the the Feds, nothing was done until the media got involved. The Fed interviewed on this show was about and smarmy and disgusting as you'd imagine a Fed would be. (He had a three day-old beard going on...) Having been under Fed scrutiny for decades while flying, I can honestly say some of the most incompetent and moronic people I ever came across in aviation were the Feds charged with "Keeping America's Skies Safe!" Riiiight.

I think single payer will be a disaster. We are faced with single payer by design. ObamaCare was designed to be so insanely complex and unworkable, that we would be driven to single-payer. Don't fall for it. Lets get back to something better than what we had before ObamaCare.

VOTE OUT the idiots who are standing in the way of true reform. ObamaCare is crashing and we sure don't want the government meddling in healthcare or we will get more of the same.

 

[skeets]

As bad as it is,, what do you think the single payer system will be like,,, Look to the UK, the courts will tell you if you life or die