INSURANCE RANT, YES AGAIN, BUT WITH A TWIST.....

When one is dealing with a severe blow to executive function, the ability to multi-task, has a To-Do list that never seems to get shorter,  the last thing needed is a group of people who should know, but don't know, resulting in the wasting of an entire afternoon. Four precious hours in which I could have accomplished, oh, I don't know, perhaps a task that in a pre-cancer body, would have taken 20 minutes. Or less.

So what exactly does that all mean??

Quite simply, this.

I am entering my doctor season. Follow up appointments with my plastic surgeon, my medical oncologist and the dermatologist. I'm down to three and the med onc isn't even a visit with the doctor. It's his PA.

Yes, it's unnerving. My balance seems to be off again and I had this back pain thing first on the left side of my back, then on the right. I went to my PCP over the weekend. Low-ish blood pressure, not dangerous low, just low-ish. No lower than in the past. He identified the pain in my back within a minute. It was a muscle strain but when that was preventing me from taking a deep breath, I already diagnosed myself with brain mets, lung mets and bone mets. My stomach was acting up too so I tossed the liver in just because, well, I KNOW you hear me.

I also know I have none of those things. Or, I'm reasonably certain at the moment, I have none of those things. Since it takes one billion cells to cluster together in order for a "thing" to be visible on an imaging test, can we ever really know what's happening? Cue the resounding, "NO!" Or at least, "Not yet."

But this isn't about that.

It's about the fact that I spoke with the doctor and his staff when I was in there on Saturday about getting my referrals for my follow up care. I was told and according to the policy, one referral to MSKCC was the only thing that was necessary. It is specialty care at a specialty facility. One referral. And they can bounce me around like a volleyball.

The PCP's office wasn't certain how to do that. They refer using physician ID numbers. I left the office on Saturday with a promise that I would call on Monday with the answers.

And that's how I wasted an entire afternoon.

First, I contacted my health insurance company. The initial response to my query was, "Hmmmmm, can I place you on a brief hold while I contact the department that handles this." I uttered my approval before insisting she take my phone number should we get disconnected. Instant eye roll on my part, along with the proverbial kicking oneself.

She DID get back on the phone. "I didn't get the answer I wanted, I'm going to try another department." Before she put me on hold, I did make sure she had my number to call me back just in case. When just in case happened, and the line went dead, I waited for about ten minutes before realizing I was an absolute idiot if I actually believed anyone would be calling me back.

Call number two was made to MSKCC. They deal with this all the time. However, they are on the receiving end of those referrals so I can't fault them for not having an answer that made me any too warm and fuzzy. They told me one referral to any doctor would suffice and cover all doctors. It wasn't sitting well with me so I tried my insurance company a second time. I followed all of the proper prompts, don't even get me started. My "representative" request was duly ignored. My backup, to put incorrect numbers in just to get to a person didn't work and somehow, I find myself lost in telephone prompt hell with the computer thinking I am a provider. And, the computer threatening to hang up unless I entered a number it could identify. And the computer giving me its rendition of See Ya, Loser.

I'm sure I said many horrible things to the phone. And then, I realized enough is enough and took my act to the place I like to go when I need to attract the attention of a company that is not being very helpful. I turned right to twitter. I found the parent company, a very large conglomerate that, for what it's worth, announced last week they will not be writing any more ACA policies once 2016 comes to an end. Yay, ACA (insert sarcasm emoji-I'd like one properly designed to be dripping with sarcasm). Don't even get me started. And no political commentary. Please. This isn't about that. That was an aside.

As expected, I received a message to please send them my phone number in a private message. I did and they called within two minutes. Score one for twitter and the customer service team that is monitoring their social media. Social media team transfers me to real customer care people who proceed to tell me, "Oh, that division in NY? We can't access those records. Unfortunately, they don't have a social media team. I'll reach out to them and someone will get back to you within -- wait for it -- Two.Business.Days."

I never got nasty, my tone was more in the incredulous zone. I explained that my first appointment was in 48 hours and I needed this resolved today. That I was tired of phone prompt hell and equally tired of being disconnected. When she said that was all she could offer and in typical robotic form enraged me with, "I'm happy to be of assistance, is there anything else I can do for you today?" I lost my shit. I simply said, "Thanks for nothing." In moments like these, I'd love to have an old fashioned phone because nothing says you suck with the same dramatic ending as the slamming of the phone.

I hung up the phone and yes, you may have guessed it. Right back to twitter. I sent a few tweets that were less than kind in their content but they were completely true of my experience. I was pretty irritated. I got back on the phone with the NY division of the insurance company. I specifically asked her to check about this MSK one referral thing. Then I directed her to the page in my policy that refers to specialty hospital care. "No. No. No. You need referrals for every doctor." She was urgent and persistent. whatEVER.....

Ok. I'm done fighting for the day. I had her look up all three doctors (actually four, I wanted the oncologist and his PA). I asked her to please give me their provider ID's as I was not going to check the website where there might be outdated information. Armed with four provider ID's I finally called the PCP's office. They are lovely. Jennifer was with a patient, "would you mind waiting?" Of course not. These people are the only ones doing anything helpful.

When Jennifer got on the line, she began to issue the electronic referrals one by one. This takes a little time. While this was going on, my call waiting was beeping incessantly. I saw it was the health insurance company but I was so over it, I was NOT putting Jennifer on hold. What? They wanted to make the social media thing go away? It took about 20 minutes for Jennifer to electronically submit the referrals. She printed copies just to make sure there would be no problem and then asked me for phone numbers in case I had any other problems. She would handle it from there.

I surrendered. They won. There are four referrals for six visits with each of the doctors which are good for the next six months. Stellar. Unless, of course I actually need all of those appointments. Then, not so much.

And upon hanging up the phone, there it was again. The insurance company. "HELLO?" I barked into the phone. How can you not love caller ID? On the other end of the phone was a kind male voice that seemed to be a bit remorseful. Yes, I could hear that in his tone when he asked if he could speak to me.

Turns out after the less than happy tweets, they bypassed the social media team and someone contacted the head of the resolution team. I told him I heard the beeps, but I was too busy collecting provider numbers and then having the referrals sent to be bothered to interrupt the process. I told him I had been at this situation for almost four hours and I wasn't about to interrupt any of it, not in the home stretch.

There was an awkward pause. Silence between people in real life can be a good thing. On a telephone with a stranger, definitely awkward. "I don't even know how to tell you this and I want to apologize first."

I had no idea what to expect. I thought it was going to be an apology for the dropped calls, the inconvenience ... I was confused. The voice was sincere without being patronizing.

"I can't get you back the amount of time you spent trying to get this organized but......." immediately followed by,  "When I saw the problem, I groaned...."    He groaned??!!      ".... because none of this should have happened at all."

HUH?

I see your groan and I'll raise you a dagger glare, a shrill shriek and a slammed phone receiver.

And he continued, "MSKCC has special exemption status. NO REFERRALS are needed for any policyholder of ours as long as MSK is an in-network provider." And MSK is in my network.

He apologized again, assured me he would be speaking with the people I spoke to, no one is in trouble, but everyone needs to know this. He kept apologizing for the time I lost. He promised this would never happen again with a guarantee. He sent me his contact information should I ever encounter a problem with anything in the future. I'm appreciative.

Ultimately, I realized this was an opportunity for me to share information. I asked him to please stop apologizing, "You know what, if my time is going to help others not have to go through this, then it was worth it."

And that's how I spent a day that I should have been working on a To-Do list that now has a few more things added, nothing subtracted but someone (hopefully a few someones) learned something, and I think that's really what matters most.


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