With todays healthcare issues, many of you may experience frustration with co-pays, out of pocket expenses and just the basic run around from insurance and healthcare providers. I hope this story warms the cockels of your heart as it did mine!
Many of you may know, I have an IV infusion every 8 weeks of a medicine called Remicade, which controls my Crohn's Disease and keeps it in remission. With my current insurance, I am liable for about $400 each treatment out of my pocket. I recently qualified for a program through the manufacturer which will pay for about 90% of that $400. God Bless the drug companies for starting those types of programs!
Unfortunately, I only recently found out about that $400 charge (which over the past year has totalled $1960). I came to find out that the "billing department" was negligent in sending out any statements. Evidently, that has been remedied by sending everyone to collections. So, I figured, nothing ventured, nothing gained. I faxed a letter today to Healix (the collections company for the doctor) and cc'd the doctor's office.
In the letter, plead my case for writing off the balance by stating that the doctor was currently receiving 58% of the billable amount and that once the new program kicked in, he would get 68% of what they billed out for each infusion. I also stated that in these economic times, they couldn't expect someone to come up with $2K on the fly and if it was not written off, they would have to accept payments of $100 over a period of 2 years.
I just got a call from the doctor who asked for the detailed itemized statement so he could review the history of the account. I am hoping that the doctor is kind hearted and wipes out the debt. Keep your fingers crossed.
If they are unwilling to work with me, I have found a facility that will do the infusion and accept what the insurance company pays and write off the rest...so the first doctor will lose approximately $6,900 of income every 8 weeks. I will play that card if needed.
Also, I recently had some procedures at a facility that stated that it was "in network" with BC/BS. When I received the Explanation of Benefits, it stated that they were "out of network" and my portion was $1,451. ARE YOU KIDDING ME. So, I got in "smack down" mode and called the facility to find out who I would speak with to get this charge written off. They told me that they treat all patients as if they are "in network" and my portion is only $162 and would be receiving a bill shortly. She also said that it was more important to them to keep me as a patient than it was to receive that money. WOW!
So, for those of you who get discouraged with those insurance companies and healthcare providers...be persistant and don't be afraid to plead your case...In these economic times, physicians are becoming aware that it is more beneficial to work with patients than it is to try to collect blood from a stone (no pun intended)
I know this is long (and perhaps boring) but it should give some hope and encouragement for those who struggle with issues like these. With this financial crisis, it looks like the "little guy" has some leverage...FINALLY!
Good for you for sticking up for yourself! Glad the drug company is helping too. And thankful that you found a treatment that works! A young friend of mine was just diagnosed with rheumatiod arthritis, and is waiting to hear about her remicade being covered. Blessings back!
For those of you who know Marty and Aimee Pickup...
Aimee's dad, Pete Cotton, passed away today around 1:00 p.m. after a long struggle with Esophogeal cancer.
In his sermon on the hope of eternal life on Sunday, Marty told the story of how Mr. Pete had been unable to swallow anything for the past 6 months or so. He said to the family the other day that he was ready to go and hoped that God would give him a big drink of water to quench his thirst.
...I am the Alpha and Omega, the beginning and the end, I will give unto him that is athirst of the fountain of the water of life freely... (Rev. 21: 6)...sometimes hearing those life experiences can really make a passage come alive.
I know Mr. Pete is in no more pain and drinking freely from that fountain!!!!!
Please Keep Aimee, her sister Julie, their mom Carol and their extended families in your prayers through this difficult time.
I know the normal Thanksgiving meal is turkey, dressing, mashed potatoes, some type of veggie, cranberry and pumpkin pie...but who said my family was normal?
We have never been huge turkey lovers and one year, mom asked me what my favoriate meal was...of course I said beef stroganoff. (she has a really good recipie). And that started the tradition of Beef stroganoff for our Thanksgiving meal.
We also have a pilgrim hat that someone has to wear every year and usually do some type of silly thanksgiving poem or riddle or game or something. You would think we had a bunch of kids here, but no, its just us old people. hehe
This year, Cami and the family will be in Tennessee for Thanksgiving so it will just be me, dad and aunt betty. I've also invited a few young people from church who aren't going to get to go home for the holiday. If they like beef stroganoff, they are welcome.
We're not all that crazy about turkey, either. Since I've been selling Honeybaked Ham certificates for the last 5 years for fundraisers, we've decided HBH is a REALLY superior protein!
I guess Caroline is the exception, she'd love to eat a turkey leg, medieval style, any day!
Although we stole the idea, we give the turkey it's last flight around the house before it goes into the oven. This is especially fun if there are sleeping college age kids you can wake up in the process
I love the story about the last flight of the turkey! waxtadpole has a description of making mincemeat pie that is rather disgusting. Ruth thinks all of the Krumrei traditions are quirky, I don't see it myself. Ooo you want to make Stroganoff with Gopher? No silly, the terrafin not the rodent, they taste like beef. I went "gopher" hunting once many moons ago.
Yea, ben was here they year we DID have turkey and to make him feel at home, I flew the turkey around the house before putting it in the oven. I don't think it had the same effect since it was just a turkey breast.
Actually, turkey dinner is our families' favorite meal! We don't have any quirky traditions, though. Maybe I should start one? Have a great holiday! I think you should make up a story about the first Thanksgiving, and how beef stroganoff came to be the traditional meal.
I know you all expected a gloomy post after reading that title, but...
Do you ever have one of those days that:
- you wake up with the alarm and don't feel the need to hit the snooze button 6 times
- You don't mind the hour drive to work (even with the traffic)
- As you're crossing the 7 mile bridge over beautiful Tampa Bay you hear a song with the lyrics, "today is the day he has made...I will rejoice and be glad in it" and you wholeheartedly agree.
- you look outside and see the cloud cover and drizzly rain but are still glad to be alive, awake and at work
- You receive an email from your boss asking you to work on another HUGE project that will consume much of your time, but you are greatful to have a job
- You receive an Explanation of Benefits from your insurance company saying that you owe another $1,456 because the facility that did your colonoscopy and endoscopy was a "non-participating" facility...but you're just happy that the test results were good.
- You think about your family and are so thankful that they are all healthy and happy...and you're glad that they belong to you.
Well, that's the day I'm having. I just thought I'd savor the moment and jot down my thoughts so when I'm having a "not so positive" day, I can look back and count my blessings.
After struggling with paypal for the last 40 minutes, having a son who broke his foot and may not be able to keep up in this last month before finals, and having a husband that has been out of work since 9/19, I'm TRYING to keep a positive spin on things. I know it could be much, much worse!
So I should just look at it -that I have I job and not be upset the Brenda peed her pants twice today, and she didn't have anymore clean clothes and I had to put boy underwear on her, and she said hey these panties have a pocket;p
Hi, Cindy! I linked to your pleo from his pleo. I met you when Showtime was on the Salem SenateAires show, how many years ago? I grew up with Todd Limburg in Salem, and I think I got to sing tenor with y'all on something? My name is Kathi Mitts, and your post is a great reminder to be thankful, no matter what! Could I add you to my friend list?
Challenge the insurance. I got that same notice once, and the insurance agency itself had sent me to that particular radiation clinic. They just needed to adjust their Tax ID number or some such business. otherwise, congrats on having such a positive attitude. It makes for happy times!
Here's to the glass half full attitude. Remember the story about the preacher walking whistling and carefree, and someone commented "you look like you rule the world" his response was "no but my Father does".
Our gospel meeting ended tonight. What a great and uplifting week. Shane Scott from Nashville TN spoke and his focus was The Glory of God. Great lessons we all needed to hear.
Sad to see it end and Shane go home but our loss is Nashville's gain.
On the bright side. I now have a fully functioning tire and an oil change to boot.
