Not sure how to make a 'new entry' yet w/out starting another blog so I'll just carry on in the comments - keep it simple.
So 3:00 am finds me again - ugh. I guess this will be part of the new norm for a bit, but I was really hoping I could have stuck it out a few more hours. I felt as if I were double dreaming which was really strange. I guess with all that's on my mind it's not surprising. Part of it was about my treatments, nothing bad but just feeling like I had already gone today and came home to realize HA! Jokes on you it was just a dream! And the other part was about while at the center they happen to run out of A/C (since mine at home gets fixed today) and how they were charging us extra to sit near a window unit while waiting and charging our insurance for it. Just kind of the crazy stuff. Next thing I know I'm staring at my darn clock.
Speaking of insurance and knowing how to be your own patient advocate. Again, being a part of the health ins. biz we see a lot of messed up stuff as far as how the business end runs. Again never ever mistake anything medical or insurance wise for charity because in the end it all comes down to the mighty dollar - PEROID!! Standard protocol for certain things is to DENY, DENY and DENY even if there is no reason to DENY. For example - this 'Pill' that I am supposed to take was DENIED. I received a ROBO call from the pharmacy yesterday saying there was an 'issue with my insurance and my medication denied.' Well I KNEW exactly WHY they denied it and immediately contacted my Dr's to explain this 'conflict of interest' between the pharmacy and my ins. co. and the Dr's where very thankful that they did not have to do any extra leg work of calling around to figure out WHY or HOW a life saving/changing pill would be denied?!!
Without giving out too much detail this is all I can say. Any time companies merge to where a pharmaceutical co. is now running an insurance co. is a great conflict of interest. Naturally all other pharmacies become NON-PAR as this 'new' co. basically forces you to use them and them only which is not always 'ideal' for the member/patient/dr's. But again it's the nature of the beast. We get many complaints from our OWN EMPLOYEES as well as members about how they are out of the certain medications constantly and making people wait to have them filled.
Well the average Joe not knowing the ends and outs stresses and frets and waits not realizing or knowing that by law they can only pull that crap once. After that there is a number you can call and they HAVE to 'pre-cert' certain meds to another pharmacy at the PAR RATE! However again, unless you know the ends and outs - you wont really know. And it's sad. Going through what I am facing and hearing PT scan denied/meds denied/MRI etc is frustrating enough because I KNOW it's all BS. So as a member advocate I beg you all to please READ YOUR POLICIES all the way down to the very fine print with the largest microscope you have!!! When your ins. co tells you NO - KEEP PUSHING! DO NOT ACCEPT THAT NO AT FACE VALUE. Another tip - anytime you go to a PAR Dr. or facility it is ILLEGAL for them to try and balance bill you for ANYTHING as they are paid at a CONTRACTED RATE!!!! Even if you insurance denies them something simple as a lab test - THEY CAN NOT BILL YOU UNLESS YOU SIGN A WAIVER!! Be very, very careful regarding these 'waivers'.
Another great tip - WAIT FOR YOU EOB FROM YOUR INS CO. BEFORE STRESSING ABOUT A BILL. I received my 'ER' Observation bill stating I owed over $1500.00 even though my deductible and out of pocket are fully met, par facility, not signing your waiver go stick it up your ARSE!! And of course on a closer look at the 'bill' found they had not even submitted he claim to my ins. co yet. Sneaky bastards. So when I did get my EOB it turns out that all was approved at their CONTRACTED FLAT DRG RATE - meaning you get what your contract states and not one penny more! If for some reason w/in that 31 day period I have to be readmitted it all still follows under that one flat rate and not a dime more. Sorry - I just had to get this off my chest DEADPOOL STYLE simply because a lot of the times the 'powers that be' literally tie your hands and I just can not and will not follow those misguided un-ethics.
So now that those tips are out of the way - this AM I will drive myself alone for the 1st time to and from treatment. Since my dx my Dr's keep asking 'AND YOU'VE NEVER HAD A SEIZURE' WTH? So just that word has made me a bit cautious as if I'm going to have a seizure! And the LAST PLACE you want something like that to happen is behind the wheel of a car!! Well after a few weeks of being on steroids and my 1st few treatments and finding my new legs I would test myself and go the back way to the store or just up the road driving like a little old lady lol. Yesterday I drove to treatment and had my mom with me just in case. I did fine - radio off, phone off - no distractions as school has just started back and I pass one elementary school way under the 15 mile per hour limit. Just better safe than sorry.
But now that they have cut back on the steroid intake and let me know the treatments are doing their job has brought some calm in that area. If they thought something like that was a possibility now they would have not started to wean me off them. But I still plan on being very, very cautious especially with my crazy sleep patterns.
So Team Deadpool is going solo tomorrow for a bit. I think this is a good thing for me another step/fear to over come!! Another good thing with the A/C people coming out is I will sort of be forced to do nothing but rest and recharge. But I need it!! It will give me a chance to break out some of my puzzle books or those Adult coloring books that I haven't had a chance to really dive into and get creative - stop buzzing around the house like sally homemaker for a bit so to speak. Wait - Deadpool doing house chores? Shut the front door!! LOL.
But in all seriousness because I get to keep my mask - I'm painting it as DEADPOOL and I'm going to hang that sucker on my wall as a daily reminder to never give up, never give in and do everything with a special style and flair and wicked sense of humor behind it!!