Friday, March 16, 2012

Medical Frustration

You know, it’s very frustrating when you are trying to “fix” your life and you have to hurry up and wait. In my last post, I talked about having seen my family doctor and discovered some issues which could be contributing to my weight and preventing me from being able to work on it as I would like. It’s ben close to 3 weeks and I’m still waiting. 

Actually, this morning I am going for an EKG and some blood work in preparation for my colonoscopy next week. Yes, that magic age of 50 brings with it certain rites of passage that I’m sure you, like me, can’t wait to experience. I have the bottles of magnesium citrate before me as I type – cherry flavored no less. And I have been given the gruesome horror stories of what my Monday will be like when I cannot really eat and have to “flush” my system out – forgive the pun, I couldn’t help it. 

This test is a screening test for those turning 50 so it is not an indicator that anything is wrong necessarily. However the other test – the one I want and need – the sleep study to determine if I have sleep apnea – that is on hold.
In their unfailing wisdom, the insurance company, Blue Cross Blue Shield, which I have through my husband’s employer, is questioning the need for this test. I received a letter from them requesting the following:
  • MD office notes and exam findings
  • Diagnostic testing results 
  •  Previously tried treatments and medications 
  •  Any other information that would support the request
I have 45 days to supply this information or the request can be denied.

HELLO!! They were sent the doctor’s notes and findings with the original request. The diagnostic test for determining sleep apnea IS A SLEEP STUDY!! There are no other tests that can diagnose the problem. There are no medications or treatments that can be given without the diagnosis.

So the following day I call my doctor’s office to find out what we can do. They received a copy of the letter as well. The doctor will write more detailed notes and resubmit the request, explaining all of the above. I wait a week and call the doctor to see if they have heard anything. The nurse calls the insurance provider and is told the documentation is under review. When asked how long it might be, the contact replied, ‘We don’t have a set review time. It will be whenever we get to it.

Meanwhile the heart-stopping snoring and general fatigue continue and there is nothing I can do about it except wait and look forward to the ‘cleansing experience ahead of me. Who knows, maybe I will lose a few pounds! lol


Joanne said...

UGH! I hope you get some answers soon!
Blessings, Joanne

Shawn S. Lealos said...

That has to be horribly frustrating. I use the same insurance through my wife's work but haven't had problems like this with them before.

Oh, and don't worry about the colonoscopy. They will put you under and you won't feel a thing. I had one done a few years back when they were trying to discover if I was a Celiac (which it turned out I was).

Lana Bandoim said...

So sorry Theresa. I hope they approve your request for the sleep study soon. It is ridiculous to make you wait.

Tamara McRill said...

I hate that you're getting the insurance runaround, Theresa. It as to be frustrating and scary to prolong getting help for something so serious. Hope everything gets worked out in your favor ASAP and that your tests went well.

Theresa Leschmann said...

Thanks everyone! Had the colonoscopy and got a clean bill of health there at least!

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