Totally Frustrated!

[Nairek]

Well, it took my OS's secretary over a week to call me back to schedule my ADR surgery. I have a tentative date set for July 12th but after speaking with her, I'm not so sure how rock solid that date is.

I was injured (again) in an MVA back in 2002 & am dealing with No-Fault. When I spoke with her over 2 weeks ago, there was the issue of how much insurance I had left. She told me flat out that my primary health insurance (Empire BC/BS) would deny a pre-certification. I told her that it couldn't hurt to try to get the pre-cert. Who knows, maybe someone at BC/BS might be in a generous mood. Then she went on about different costs for the surgery & all that jazz. I left her 2 messages last week, asking her if she heard anything from BC/BS & she finally calls me today & says "I know flat out that BC/BS won't pay". Nothing was said about a denial letter & I never received anything in the mail about a denial. So I guess it's safe to say that she never bothered to look into it like I asked. Then she tells me "well I can tell you what the surgeons fee is but I don't know about any of the other fees associated with the pre-surgical testing, surgery & hospitalization". Ugh! I was so upset when I got off the phone with her. She was of no help at all. Now I have to try & find out this info on my own so that I don't get screwed (pardon me). With the luck that I have, No-Fault won't cover any of the surgery & I'm looking at a $70K + or - bill. Now I know why people go to Germany to have this surgery! Thank you for allowing me to vent. On a positive note, I graduate this Thursday. Yay!

[Justin]

Karin,

Sorry for getting the run around. You shouldn't have to do the digging for the other costs associated with the surgery--they should at least have ballpark figures from previous surgeries.

Oh yeah, here is an early CONGRATS on graduating!!

Justin

[Harrison]

Sorry Karin. I can recall the frustrations I had 2 years ago when I appealed BCBS' (Blue Corpse Blue Sled) ruling. By the way, my appeal was successful.

Maybe this week's news about Medicare covering ADR (people under 60) will help move the scales of health justice the other way, so patients have more say regarding their care.

On a happier note, congraduations!

[Dale S]

Karin,

Boy do I understand your frustration. Getting some doctors or their staff to return phone calls requires a monumental effort. Then getting straight answers is almost impossible. Some surgeons are only interested in you as a surgical patient and their staff behaves like the doctor. They know the answers if they've been doing it long enough... and why you have to get frustrated????? I asked a doctor if he found waiting months for a return phone call was acceptable. He was humble for the moment but nothing has changed.


I wish you good luck, whatever you decide.

Congrats on graduating, Dale