Wednesday, September 23, 2009

Anyone else want a piece of Mama Bear today?

Dewey has his stress test on Monday.

I spent some 45 mins on the phone with Blue Cross Blue Shield of TN discussing the authorization procedures for medical referrals. Joyful conversation, let me tell you.

BCBS of TN, as of January 2009, started outsourcing their authorizations to a company called Med Solutions. These 'board certified' medical professionals (aka: goons with pencils) review all medical procedures, files, record histories and referrals expected to be paid by BCBS of TN and allow or deny what they, in their infinite medical wisdom, deem necessary.

Penny pinching company boys is all they are.

I called Cardiology Associates and spent time discussing things with them as well. And, the doctor was with patients, so his poor nurse got the other chunk-o-mama today.

Bottom line is there is a 'standard' treadmill test and a 'nuclear' treadmill test with a cost variance of some $2500. We agreed with the doctor and cardiologist to go with Step A on the BCBS of TN ladder of medicial testing and do the cheaper standard treadmill.

Then I got to deal with the children's insurance coverageand the fact I received a denial letter because of whatever-such-and-such mumbo jumbo.

I'm tired. My headache was just a dull throb and now it's trying to wave up on me again. I don't play well with doctors and insurance folks so I've been rather vocally stretched today.

Anyone else want to test the waters around Mama Bear? I can go another round or two before my head splits in two I think. Wanna discuss politics? Sports? Religion?


Kimberly said...

I'm the same way, I don't play well with large corporations. I tend to remind the person that I'm speaking with that they are not a superior to me, and that I am in no way obligated to submit to them. My favorite line is "the (computer) system won't let me do that..."; and the really have a problem when I share that as CFO of this (corporation, i.e. family) that we have "rules" too. Some one once told me that our rules were invalid, I laughed. I've been hung up on many times, I just call back and get some one different, or Hubby calls, gets a female on the other end and the request is granted. (that one kind of annoys me, but as long as the injustice is fixed I'm OK with it) I also remind the person that if they were the customer in the situation, they would be doing the same thing. Keep on pushing and standing firm for your family.

LizBeth said...

Not a good day to bring up insanity and speech-making at the U.N., huh? Hope the headache cools down soon.

I won't tell you what the Word Verification is under this box, but a little Google humor is slipping through. But you'd laugh.

Lisa said...

I come bearing large chocolate bars and ice packs!

I hope things get better soon, and that all goes well with Dewey's testing.

I remember a totally frustrating call to my insurance company years ago, when they paid for a doctor to cut a suspicious mole out of the middle of my daughter's back but would pay to suture the hole closed! As if she could walk around with a gaping hole in her back?? Makes me think I'm trying to teach pigs to crow!


Jeremiah 6:16
Thus saith the LORD, Stand ye in the ways, and see, and ask for the old paths, where is the good way, and walk therein, and ye shall find rest for your souls.

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