Don’t forget we moved!
https://brandmu.day/
RL Peeves
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After a series of unexpected health bills and all that stuff our second car died when we really need to have more than 1 car to juggle 5 working adult schedules. I feel ill. Its not worth to fix the 2nd car bc its a 2000 civic and so the cost to tow it and have it evaluated will cost more than the car is worth. This has been such a shitty week for so many different reasons I just kind of wish the ground would swallow me up right now.
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@mietze god, I’m sorry.
We recently bought a car and basically got scammed with it. The cabin lights don’t work, the throttle position sensor keeps going out, so I will suddenly not be able to accelerate while on the highway, and the battery keeps dying, which killed the a/c somehow.
We’re at this point where we don’t even know what to do with it. Do we sell at a massive loss because of all the problems? Or do we fight the warranty company to get them to fix it? “Oh it didn’t do it wit us, so we don’t know what’s wrong”.
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(And it’s not like we can afford the loss on the car, it was supposed to be an investment so I could work more… but it’s just been a pain.)
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Dear Dr. X -
I am asking you to cancel my appointment for Tuesday, March 7.
Based on the fact that a caveat that you do not test for <medical condition> was not only included in, but emphasized in bold in the email that I just received from you, I would assume that this is a recurring issue. I would strongly suggest that your office communicate this more clearly to your network of nearby referring offices, as well as to your own employees.
Please note that prior to making this appointment, I was advised that your office does test for <medical condition> by my referring doctor and specifically indicated to your receptionist that I was seeking testing for <medical condition> when I called in December to schedule this appointment and was told that I needed to fill out a battery of forms (which I should note I then didn’t receive for a week) before they would place me on your schedule. I specified it again in January when I called to confirm that I had completed and submitted them, but hadn’t heard back from your office, and was advised that your next available appointment wasn’t for several months.
If your staff had been able to communicate this the first time I spoke to them, it would have saved me multiple phone calls, clearing my schedule for a full day for a battery of testing, rearranging several financial payments to accommodate the nearly $2,000 that I would owe after my insurance coverage, and months of waiting only to find out now, three days before my appointment, that your office would not be able to help me with diagnosis or treatment at all.
It certainly would have saved your team this unkind, though not undeserved message.
Sincerely,
AriaI went through another round of this same situation this week, this time yelling at my insurance company. In the four months since this posting, I’ve discovered:
- My insurance company does not appear to have any doctors who are in network that provide this diagnostic screening for adults, only for children.
- Every doctor that conducts this diagnostic screening for adults does not work with insurance companies because they are a massive pain in the ass.
- My insurance company does cover out of network doctors at 60%, rather than 80%, but requires precertification for both.
This essentially means that the best case scenario is that I’m on the hook for as much as an extra $1,000 for “choosing” to go out of network, when I have no in network options, if I can somehow convince doctors who don’t deal with insurance to help me deal with insurance. Hahaha. Yeah, right. The more likely scenario will be that my choices are between paying as much as $5,000 out of pocket because I wasn’t able to jump through impossible bureaucratic hoops or just not get a diagnosis and treatment at all.
'MURICA! BEST COUNTY IN THE WORLD!!! WE DON’T WANT NONE OF THAT SOCIALIST-COMMUNIST-NAZI MEDICINE HERE!!
Please excuse me while I scream into the void.
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@Aria It is possible for you to get what is called an ‘in network exception’ where you can use an out of network doctor and they’ll be treated as in network. Not every insurance company is okay with that and some are easier to deal with than others but it’s definitely an option you should explore.
Call your insurance company and ask what is the way to get an in network exception because no in network doctor offers what your PCP says you need. If the first phone rep can’t/won’t help you, ask for a supervisor.
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^ this, but also @Aria your PCP can advocate for you here. I would suggest this only if you have a good relationship with your regular doctor. You can ask them to write a letter of medical necessity (specifically use those words). This can underscore the importance of the condition and its assessment and eventual treatment if it is found to be medically significant.
It will still come down to the underwriter and staff reviewer, so you need to be your own advocate with your insurer as well. That’s so difficult and I’m sorry you’re going through this. I hope you’re able to find some resolution and you have a good RL support network in your corner.
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Thanks for the advice, guys. I literally broke down in tears in a conference room today about this and someone just being nice to me about it instead of an unhelpful, faceless bureaucrat reciting policy is a relief.
@Aria It is possible for you to get what is called an ‘in network exception’ where you can use an out of network doctor and they’ll be treated as in network. Not every insurance company is okay with that and some are easier to deal with than others but it’s definitely an option you should explore.
This is my hope because I spent 45 minutes on the phone yesterday with a rep at the insurer who only handles claims from my company. I was like, “Give me a doctor, any doctor, within two hours that does this, is taking patients, and in network.”
They literally could not find a single one after 45 minutes of digging through their own database.
Apparently my company also has advocates in our HR office whose only job is to help us navigate these bullshit Byzantine rules and I’m like, “So maybe if we have three people at our office whose only job is helping employees deal with this insurance company, the insurance company is kind of shit? Just a thought.”
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@Aria I have nothing at all useful to offer in terms of solutions or helping you to navigate this situation. But I absolutely see your struggle and additional stress amidst what is already a terrible situation. I’m so, so sorry that you’re dealing with the bureaucratic nonsense amidst obvious medical need. I hope you’re able to come to affordable and reasonable solutions. We’re here to hold space for you and to offer support in the interim. I’m sorry that your ‘coverage’ makes things all the worse rather than making things better. It sucks so, so much.
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My rheumatologist suggested for a degenerative condition, that is causing me debilitating pain, physical therapy and a nerve block. Which are not things that can actually stop the degeneration of my body. Thanks, doc.
Cobalt@Under the Stars
cob.alt@Discord
Cobalt#[email protected] -
@Cobalt I swear. Sometimes I think we have the same damned rheumatologist. WHY is that specialty so shitty to non-elderly patients? I’m so sorry that yours is sucking extra hard lately.
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My rheumatologist suggested for a degenerative condition, that is causing me debilitating pain, physical therapy and a nerve block. Which are not things that can actually stop the degeneration of my body. Thanks, doc.
I’ve reached a point of strongly recommending that more patients (especially female patients) look their doctors in the eye and go “What the fuck is wrong with you?”
Like, just say it. Just say it outloud.
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@Aria I’m headed to my primary Monday to get a second opinion and probably argue for a surgery that I don’t want but know from family members with the same condition that if I don’t have it I’ll have permanent nerve damage which I might already have some because I’ve been having pain for ten years only the last two it has gotten to the point where I can’t function anymore.
And yeah, I really wanted to be like: “Do you think I like being like this? Do you think I want to be disabled and stuck in my house 24/7?”
My doctor was like “you know I see a lot of people who can’t work but just fill their time with travel and hobbies, and that’s no disability.”
Hobbies? Heh! I can’t even manage being active in a hobby that only requires me to sit at a computer and type! I wish I had hobbies.
Cobalt@Under the Stars
cob.alt@Discord
Cobalt#[email protected] -
My doctor was like “you know I see a lot of people who can’t work but just fill their time with travel and hobbies, and that’s no disability.”
Seriously. These people. Do they just not hear themselves when they talk?
I once went to a gynecologist who - after telling me he would do nothing to treat the minor and easy to address issue that was causing me debilitating pain when walking - assured me that I shouldn’t worry, because it was still safe for me to have sex! A question which, notably, I didn’t fucking ask him.
I’m glad you’re working with your PCP, but I really do think the healthcare system would be better served by patients looking their doctors right in the face and asking them if they’re this stupid all the time or putting extra effort into it today.
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I’ve reached a point of strongly recommending that more patients (especially female patients) look their doctors in the eye and go “What the fuck is wrong with you?”
Last year, I started having breathing problems. My O2 saturation was going down to high seventies; most people get delirious in the eighties, but apparently I have stern lungs. Good for me. Anyway, I went to my PCP, told him my symptoms, and he said, without conducting any tests, “Oh, you’re just too fat to breathe. You need to lose weight.”
Later that week things got worse, so I went to Urgent Care. In ten minutes they diagnosed me with bronchitis. They gave me half a week’s worth of steroids and the problem went away.
I never got up the courage to ask my PCP what the fuck is wrong with him, but I did ask to be transferred to another doctor.
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@GF Medical fat phobia kills people. I’m so sorry that happened to you.
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…but I did ask to be transferred to another doctor.
I’m a little confused about this part (though good, you definitely should get rid of that one). Is it an outside the US thing that you need to request a new doctor? I pick my own and so long as they’re in network, the insurance covers it. I could change designated PCPs every day.
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@TNP My PCP works at a clinic. They assigned him to me at random when I joined. I asked to have a different doctor.
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@GF Ah. You should also file a complaint. Sounds like malpractice to me.
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I’ve reached a point of strongly recommending that more patients (especially female patients) look their doctors in the eye and go “What the fuck is wrong with you?”
Last year, I started having breathing problems. My O2 saturation was going down to high seventies; most people get delirious in the eighties, but apparently I have stern lungs. Good for me. Anyway, I went to my PCP, told him my symptoms, and he said, without conducting any tests, “Oh, you’re just too fat to breathe. You need to lose weight.”
I definitely feel this. Earlier this yeae I had a some light headedness, some wheezing, a cough, with difficulty breathing. He did my weight and got my BMI (as bullshit as that metric is). I’m pretty short (5’5") and my BMI came up as 30.1. I was told that I was having bad acid reflux due to weight, which can cause a cough. I pointed out that my daughter had a similar cough about a week prior and that I thought there were other kids at her daycare who were ill. No change to the prognosis. He prescribed me rx strength Prilosec.
Anyway so I wound up in urgent care because I had COVID.
they/them
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@somasatori just wtf. You’re so scrawny tho???
Cobalt@Under the Stars
cob.alt@Discord
Cobalt#[email protected] -
@Cobalt a mix of grad school stress eating and weight lifting because it’s a quick way to do exercise without having to go somewhere.
they/them
