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Saturday, December 22, 2012

Phone calls, paperwork, phone calls, paperwork, phone calls.....and then you get stuck in the elevator....

The other day, I told Bob he needed a Business Manager. Seems like all I've been doing this past week is filling out paperwork and making umpteen phone calls and there's no time for anything else.

It's bad enough having to switch Bob's Medicare Plan over to another company because of the big dispute between the hospital and United Health Care (and yes, still no rehab for Bob, so much for "continuation of care") but slogging through those multiple different plans, Medicare A B C and D, and if you've ever done that, you know what I mean. It's confusing as all get-out to me, especially when your dealing with seven different doctors and 16 different prescriptions and you need to find a plan that covers them all... And our government expects our elderly population to figure this stuff out? I finally got him signed up with a Blue Cross plan, only to find out this week that the lab they use does not do home draws.

Now Bob has been having a home draw weekly. This is where a lab technician comes to the house and draws his blood for testing. I guess I've gotten pampered by this service, because I just cannot imagine carting him off to a lab once week, arranging for transport and all that involves, wasting an entire afternoon for a procedure that takes about 5 minutes... And you know, the transport company will not wait at the door for you. They have to drop you off and come back later, with another "45 minute pick up window". Which is why such a trip will take all over afternoon. Not to mention the expense of the transport ride.

So I spent a good deal of time trying to figure a way out of this situation and keep our home draws coming. I was told, at first, the only way to get a home draw was to use an "out of network" lab and that meant paying a 40% co-pay (figure about $36.00/weekly) which we just cannot afford. Our home draws right now are free. So after making many phone calls, someone suggested to call a home health agency who may be able to send a nurse out to do a home draw.

Now, home health care has a zero co-pay, so this is a good idea. I call and get it all arranged, except I have to now get a doctor's prescription/referral to the agency. So Bob and I go to see his primary care doctor, who that day has an emergency and is out of the office, and we have to see a substitute doctor, who I ask for the prescription for home health care and also a referral to get Bob back into Rehab with the new insurance after the first of the year.

Afterward, I have to go to the referral department to pick up the paperwork, but lo and behold, she's only got the order for rehab not home health care. So after waiting and waiting, and Bob getting very antsy, finally a nurse comes out and tells me that she cancelled the referral because they cannot refer Bob to home health care because he is "too mobile". She says if he can get to Outpatient Rehab and he can get to a doctor's appointment, he does not qualify for home care.

I can't believe it. Is she nuts? I tell her to look at him, look at Bob, for crying out loud, the only reason he is sitting in that office is because I hauled him there and we took the wheelchair transport, and the only reason he will get to Outpatient Rehab is because I will push him there, six whole blocks mind you, but no, she says, the insurance will not approve home care for someone as "mobile" as Bob. So, I say, what am I supposed to do? She says, take him weekly for lab draws. (Easy for her to say. Is she trying to kill me? Maybe she'd like to come pick him up? And bring him home?) Or, she says, call the insurance company.

We leave the doctor's office, and I am very upset, and we're rushing to get to the transport on time, and then, just then, Bob's wheelchair front wheel gets stuck in the elevator door. You know, the little open space on the floor where the elevator door closes? His front wheel gets stuck in that, and I'm trying to pushing him through and damn doors are closing on us! GA! So here we are, both Bob and I screaming "Help!" and finally a security guard comes to the rescue. The guard has the gaul to tell me to "back the wheelchair" into the elevator from now on, then I wont have this problem, but um, the reason he's coming out front forward is because I backed him in upstairs and there was no room in this tiny elevator to turn the chair around.... grrr...

So the next day, I am back on the phone with the insurance company for nearly two hours, talking to various people, because no one seems to know the answer to my problem. Finally, I do get connected to someone who tells me that if the doctor orders a home draw from home health care and rehab, well that's the doctor's discretion (not the nurse's) and they will cover it.... Jeepers, and thank-you-very-much, and I hope she is right. So, I finally get it all set in motion, a home care account set up for Bob and request for referral sent to the doctor and I call that nurse who put a kabosh on the home care referral and tell the insurance says we can do this....and we'll see what happens after the 1st....

And I won't even tell you about-- how I've been trying order a new mattress overlay for Bob's bed and having been trying to order this darn thing since September. He needs the overlay to prevent bedsores, but his bed is a "tall" hospital bed and no one seems to carry a "tall" overlay, or I should say, the companies that take his insurance do not seem to carry the "tall" overlay. Every time I think I've found the right overlay, they either deliver one the wrong size and I have to send it back or they call me to tell me there some darn reason they cannot get it in. I am on my sixth medical supply company, who is now trying to special order one for us....

Or about spending a week filling out government "recertification" forms for the end of the year...

Or about trying to order some medical supplies on-line and the "checkout" keeps telling me my zip code is wrong and throwing me back into my "shopping cart"...

Or about trying to e-mail some attachments to the attorney and my browser keeps failing...

Or that I still need to fill out a new financial aid application for 2013 so that Bob's rehab co-pays will be hopefully covered again...

And add all this on top of what I normally do. And everyone else is out there preparing for the holidays, while I'm just trying to keep Bob's care continuing into the New Year.

I will tell you this: I need a raise! ha! And a new job title. "Caregiver" just doesn't cut it. How about Care Coordinator? Or Medical Manager? Or Master Juggler of the Universe? Or.... ? Any ideas?





1 comment:

Anonymous said...

I don't know how they arranged the home blood draw, but when I used Home Health Services (social services) through our local hospital for my wife's blood draws and urine samples, they took care of all the paper work, draws, insurance, and phone calls to get everything covered. I didn't have to do a thing except tell the nurse what I wanted done. I don't know if that service is via local, state, or federal services, but do check them out. I had to work through her doctor to get Social Services involved, but once done, it was a God send in what they could do for us.

Hugs, Dan