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Hospital stay update

So, I figured I would give you girls an update, since it's been a while and several have asked.

I was supposed to be admitted on the 28th.  And then again yesterday on the 7th.  But, I was not admitted.

We talked to the lawyer today, and he said that the court ruling is for everything up to that date and including the surgery, but they have the right to contest anything after that.  He said he doesn't think they will because they will look like idiots, given how strongly in favor of my case the board's ruling was, both for the stim surgery and the diagnosis as well as any future necessary procedures.  He said that they would look like idiots if they tried to take me back to court again, and that they might even be fined for wasting the boards and courts time (or something like that).

But, he said, they are allowed to take a certain amount of time to respond to requests for procedures and such- I can't remember if it's 30 days or 45 days.  They also have the right to request records and such, and if the doctor's office takes forever, that tacks on time too. 

Basically, the worker's comp is taking forever to approve it.  They haven't denied it, but they haven't approved it either.  They requested records from the Philly doctor, Dr. J, and then we just heard that they requested records from my doctor in DE, Dr. C.  They also have the right to review any new med requests- which has been a problem (see below).

Now, if they feel that the procedure is out of line or grossly over-exaggerated, they can question that and say no on those grounds- but that is mostly used when they feel that other avenues have not been tried/exhausted.  This is one of the reasons that we love both my doctors, because they are very, very thorough and do every conservative step first, including this time around. 

On top of the worker's comp, we have had TONS of issues with Dr. J's office staff.  We have talked about going to another doctor, but Dr. J is very widely recognized and respected, and we like him too much to lose the doctor.  But they have really made this process that much more difficult.

When we found out after the doctor's office booked and got authorization for the wrong procedure the Thursday before the 28th (when I was supposed to go in the first time), they were not helpful at all.  When I told the the hospital staff called and that something wasn't right- I knew the procedure I was supposed to be getting, and that wasn't what the hospital told me I was getting- the office girl told me "well, I don't care what you think you know- what you were told you are getting is what you are getting". 

Lovely, huh?  Especially considering when DH called back in and spoke to a different girl, Dr. J was standing right there and told us/the girl that I was right and what was in the system was wrong.

It's been downhill from there.  The Office Manager, Sue, got smart with Brian when she heard me crying in the background because she has just told him, and then him me, that I wasn't getting the procedure, and that her office staff had done nothing wrong, blah blah blah.  He told her basically that we don't care who made the mistake- whether it was the girl booked it wrong and got the wrong auth, or the doctor wrote down the wrong code- we go to Lankenau Pain Center, not to Dr. J and then walk to a different office to see you.  It took quite a while, and Brian dumbing to down, for her to get why I was upset.

This week has been no better.  We have left messages for different people, trying to figure out what we need to do, who we need to talk to, etc, and no one ever calls us back, and if they do, it's not until Thursday or Friday.  By that point in the week, you can't get anything done! 

The kicker was Wed.  We had scheduled an appt to see Dr. J, but he had said to call in on Wed to see if we were approved, because if we were then there was no reason to see him.  So we did- and the girl who answered told us that Sue and the scheduling girl were both out, but that she was 99% sure that the approval went through and we could cancel.  We asked her repeatedly if she was sure, and she said yes, so we canceled, and breathed a sigh of relief that things were moving forward.  She tells us Sue will call us in the morning.

Then Sue calls the next day- and proceeds to tell us that not only are we not approved and not doing this next week (yesterday), but that we were never approved, and there is no clue as to when we will be approved. 

Of course, I was hysterical- I have been counting on this infusion for so long, and literally holding onto it for hope.  Brian is pissed- I don't remember, but there may have been some choice words for Sue and her office at that point.  She told him that she would find out who it was who had us cancel, and get back to us, but we haven't heard from her (surprised, we are not). 

At this point, Dr. J calls us when he learns what has been going on, and Brian called Dr. C.  They talk, and decide to put me on an anti-anxiety med (to help me relax, so i won't be tense and my pain level will go down), as well as a sleep aid (Trazadone, which is non habit forming and has worked well for me in the past; with my pain levels so high, I can't sleep, and when I don't get enough rest, my pain goes up, so it's a vicious cycle).

Well, since I have not been on these meds before (for RSD), the insurance company decides they need to talk to the doctor and find out more, and put a hold on filling them.  That was 5 days ago- Dr. C called the scripts in last Thursday.  I called the worker's comp insurance and they told me they need info from the pharmacy as well as info from the doctor- and apparently I have to get it.  Or at least that's what I understood from the heavily accented woman on the phone who made no sense at all to the point that I conference called Brian into the conversation.

Luckily, my mom went through our stash of meds and found some of the same med they had prescribed from when I had panic attacks from crowd anxiety.  There aren't many, but hopefully it will tide me over.  What pisses me off is that these meds are commonly prescribed for people with RSD- every person with RSD I know is on one or both!  Grrrrr.

So, we sit and wait.  We don't know when they will approve it.  I am frustrated beyond belief.  At this point, I am not living.  I am existing.  I can't go to church, I have missed several coffee dates with people...there are days I don't go to the bathroom until Brian gets home, because I am in so much pain I can't get out of bed.  I am tired of not living- why have a life if you have nothing to look forward to?

Anyway, I thought I would give you all an update.  If you could just please, say a few prayers that this will get taken care of, and fast, that would be wonderful and so gratefully appreciated.  I just want to feel better.

Re: Hospital stay update

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    edited December 2011
    That's total bull.  I hope it gets cleared up soon.. T&P coming your way big time. 
    Paprika: I like it when you burp in my ear. It really turns me on.

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    FutureMrsTCTFutureMrsTCT member
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    edited December 2011
    T&P are coming your way. I hate that this crappola keeps you from getting the surgery you need to feel better!
    *~~*The Future Mrs. Coulter-Thurley*~~*
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