Me: Hello. I need to file an appeal for a claim that was
denied. Who do I send it to?
BCBS rep: To the
medical review board.
Me: (Pausing long
enough for the rep to give me a complete answer). Ah, yes, but who do I send it to?
BCBS rep: (Not
pausing at all and in a much clipped voice): You asked who to send it to, you
didn’t ask for the address.
Four long months of bizarre and disturbing diagnoses later,
we still have no answers to Rob’s issue with his tissue. We survived the physical and emotional stress
of experiencing some pretty dramatic side effects to medications various ones
had prescribed for him. We finally
called a halt to further “treatment” until we had a conclusive answer to what
indeed was being treated. We are over
$2,000 in the hole, and his condition is worse than when we started. We had
hopes that the fifth doctor that we were seeing would be the one to put us on
the right medical course. This is the
doctor whose claim was denied.
I do wish I knew then what I know now about the logic of the
medical insurance scheme. I would have
armed myself with more than my miserable grasp of Latin.
What I really want this to be about is the Power that is more
formidable that our current system. I
experience emotions largely. I go to
great heights with love and joy and experience dark depths with sadness and
injustices. That makes me sound rather
bi-polar, but truly I’m not – at least not until this all started! I do have a firm grasp on my senses. But after four months of this roller coaster
existence there was more darkness than light shining in my life. I crave a balance and this was putting me off
kilter. I was fighting off entering into
the depths of despair. I am concerned
about Rob, but I was learning through this foray into the netherworld of
insurance how this system is not there for our health benefits at all.
So, there I was, little Davey ready to duke it out with
Goliath. I read the 14 page manual on
how to appeal a claim. I withstood the
indignities of the call centers treating me like an idiot as I scrabbled to
compile all the documentation necessary.
I “pestered” the doctor’s office for hours. I got them to send me the secret notes they
write about you when you’re in their office. I put all the reasons for why this claim
should not be denied into a letter. I
gathered my arsenal of papers and letters and claims, clamped them to my
clipboard and went to town to talk to the doctor one more time and then pick up
something for dinner. I ran my errands
and came home to try and make a semblance of a normal day and put this ugly
mess aside for a while.
A few hours later Rob came home and asked me how my day
went. It was dinner time, so I told him
to join me in the kitchen while I made dinner and I’d tell him all about
it. My clipboard that I took into town
with me earlier also retains my shopping list and the week’s menus for our dinners. It is as valuable to me as my wallet. I never let it out of my sight. It was gone.
I had no fight left. I was officially in the depths of despair. My shopping list, my menus, my username and password to a specific website, not to mention all the original-only-copy of my retaliation to the MAN was lost! I had a solution though. Shoot me between my eyes. Quick thinking Rob thought that the first step should rather be that we look for the clipboard.
Like that was going to work.
I knew I left it at the grocery store.
I called – but nothing was turned in.
Rob grabbed me and the car keys and drove us, in stunned silence, to the
store. We searched the area where I had
parked. We searched a few lines of
carts. My brain is whimpering, “Futile. This is futility.” We wandered into the store,
peering at every cart we passed. I went
with Rob to the counter, summoning up the dregs of gumption I had left to ask
the clerk, again, if my beloved clipboard had been found.
And then it was all slow motion. For some
reason we turned to look behind us.
A clerk was handing my clipboard
to a manager, saying, “A customer just gave this to me. She didn’t know it was in her cart.”
