Re: Where do we draw the line?/Today Update

[Guest guest]

I agree with you. But stressfree day I didn't have read on and strangle when

you see how my day went today. I'm gonna be sick tomorrow because I got so upset

today i was shaking.

I called my surgeons office today to try and understand why my surgery was at

1:00 pm when I was told to be there at 6 am. Well when I finally got to speak

to someone who knew something I was told the following! " We are sorry to tell

you this but your Medicare refuses to pay for your operation and we have to have

a second doctor review your case because of this in order to appeal your case so

we are going to have to move the date of your procedure " A full fusion between

L-5 and S-1 " to the following morning Monday and just have you pending as we

don't know if we can get Medicare to pay for it.

Needless to say I lost it I said WHAT? And then I called my husband and

informed him as he had scheduled at his work to be off for two weeks in order to

be with me while I was in the hospital and to care for me once I got home. He

lost it too.

I then called the gentleman who sold me my Coventry " Medicare " Insurance package

to me as it's for low income families. When I told him what I knew he said I

will call you back don't worry about calling them I can get further than you

can. I said ok and hung up.

I then called my Medicaid case worker as I have both insurances and she told me

that she couldn't help me but told me I had to call them directly so I did, it

took over a half hour of being on hold to speak to someone they told me that

they could not help me without the procedure codes for my operation so I had to

hang up and then call the surgeons office again. I got the codes and called

Medicaid back. ALL of the codes were approved by my Medicaid except for one

that the lady didn't know even with speaking to her supervisor if that code was

paid for without prior authorization.

I then called my surgeon back and the lady who I needed to speak with was gone

so I have to wait another week to get any relief. She will have to call

Medicaid Monday or Tuesday and speak with the Medicaid officials and try to get

everything covered by Medicaid before the operation will be a definite go on the

following Monday!

Do you want to know why Medicare refused me? You'll think it's as insane as I

did….

They refused because their medical board said that due to my past two surgeries

that this one would not be of any use to me!!!!

Hello? I first operation was due to an injury and I had in 2000 and I had to

have it. The second surgery was because I had a build up of scar tissue at the

location of the first operation and was impinging a nerve.

This one is needed because my disc between L-5 and S-1 is completely gone and I

am bone on bone. Yes the primary nerve is being pinched again on the left side

but it's because of the disc disintegration! And without the operation I will

eventually loose the use of all the nerve action from the L-5 S-1 region which

means the use of my legs. So please tell me why I don't need this operation?

And yet they say that the operation to correct this which is removal of the

damaged disc and placing a new carbon cage in its place filled with my own bone

and two rods on either side of my back to hold my back in place won't relieve

the pain or the nerve impingement. Who the hell gave these idiots their medical

licenses? They didn't have copies of my medical charts from either my regular

doctor who said I needed the surgery and my surgeon who said it was a medical

necessity!

And to think our Taxes pay the wages for these idiots who claim that they know

my case well enough to make an informed decision. Where is our safety when you

can't rely upon the medical insurances that we pay for? And Obama wants all of

us to have medical insurance? Oh would I love him to suffer like I do just one

week, he definitely wouldn't be a happy camper and I know that there are others

out there that are in far worse shape than I am who have probably had the same

thing said to them by these idiots who don't have a full copy of medical records

for each patient and haven't read them even if they were able to get them.

And to think what would have happened if I had gone up to the hospital on my

surgery date unknowingly to the following situation… Would the surgeon's office

have gotten in touch with me soon enough to find out?

Ah update now your really gonna feel like a yoyo when you read this!

My surgeons office just called me at 4:45 pm right before they closed and said

that they had gotten the chance to get ahold of an outside physician to side

with my surgeon and that they were able to push Medicare into paying for my

operation now. So I'm back on for this Monday but that I will need to go in

later in the day due to all this B.S.

Can I scream NOW? I am so upset, stressed out and furious that medical insurance

companies have the power to put ill, and in pain recipients through this.

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> (((((Mist)))) Unfortunately there are rude individuals in every field. > Hope

you're having a less stressful and low pain day. Gentle hugs, Tami

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