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Hans update #4
KathiM
CSN Member Posts: 8,028 Member
WHEW! It's been a wild few weeks!
Hans is doing better and better. He is capable of functioning at 'normal' levels...the only thing missing is his incredible retention (he could quote you on something you said to him, 10 years ago, word for word). But, he is better. He ended up with a stress ulcer, and, after 4 failed attempts at filling a perscription (all denied for lack of pre-authorization),I found myself on the phone with Blue Cross, throwing myself on their mercy, asking what med, what strength, and what dosage I could have the doc that was standing by (who had called in the other, failed, scripts) call in to keep Hans out of the ER with a dilaudid IV drip.
I HATE the life of a caregiver...lol! But, at least now, he says 'Thank you' for my work...I think someone took him aside and shared with him how lucky he was to have me in there pitching...
Thank you all, again, for all of your thoughts and prayers...it is what made all the difference!!!
BIG hugs, Kathi
Hans is doing better and better. He is capable of functioning at 'normal' levels...the only thing missing is his incredible retention (he could quote you on something you said to him, 10 years ago, word for word). But, he is better. He ended up with a stress ulcer, and, after 4 failed attempts at filling a perscription (all denied for lack of pre-authorization),I found myself on the phone with Blue Cross, throwing myself on their mercy, asking what med, what strength, and what dosage I could have the doc that was standing by (who had called in the other, failed, scripts) call in to keep Hans out of the ER with a dilaudid IV drip.
I HATE the life of a caregiver...lol! But, at least now, he says 'Thank you' for my work...I think someone took him aside and shared with him how lucky he was to have me in there pitching...
Thank you all, again, for all of your thoughts and prayers...it is what made all the difference!!!
BIG hugs, Kathi
Comments
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Pre-Authorization?
Ok... my ignorance is showing here. Who is suppose to pre-authorize a prescription that a doctor writes??? I understand the policy of checking and possibly double checking that a prescription has been ordered by a legitimate doctor, but once that has been determined, who is undermining the doctor's authority?
If Han's doctor has filled out a prescription, what other doctor needs to "pre-authorize" it? I'm confused as to why you had to beg Blue Cross to tell you what med, what strength and what dosage you have to have the doc prescribe? Why would the insurance company be telling the doctor what to prescribe??
Am I missing something here? -
Nah, just ol' American Blue, White, and Red Tape...lol!CherylHutch said:Pre-Authorization?
Ok... my ignorance is showing here. Who is suppose to pre-authorize a prescription that a doctor writes??? I understand the policy of checking and possibly double checking that a prescription has been ordered by a legitimate doctor, but once that has been determined, who is undermining the doctor's authority?
If Han's doctor has filled out a prescription, what other doctor needs to "pre-authorize" it? I'm confused as to why you had to beg Blue Cross to tell you what med, what strength and what dosage you have to have the doc prescribe? Why would the insurance company be telling the doctor what to prescribe??
Am I missing something here?
Insurance companies have 'reasonable and customary' brands of drugs for each and every illness. These are the ones they cover. Within this is (I didn't know THIS) a 'reasonable and customary' strength and dosage...so, if it doesn't fit, the doctor MUST call first, and get authorization...I know, I know...crazy!!!!!
So that is why I threw myself on their mercy. And, it isn't just Blue Cross...my insurance, Healthnet, wouldn't cover the perscribed drug AT ALL, and recommended another within the same category, but that worked a bit differently...sigh...insurance companies playing doctor...VERY scary!!!!
Hugs, Kathi -
Thank you, my dear!!!!dianetavegia said:That's great, Kathi!
I prayed for you and Hans when I woke during the night. I'm so glad to see the update!
God bless,
Diane
I felt a great warmness and peace when I awoke in the night....must have been your prayers!!!
Hugs, Kathi -
what good news!
It is so good that Hans is darn near back to normal, and I am sure you are relieved, even if you HAVE had to fight with the insurance people. How well I know THAT nightmare! Also glad Hans has seen the light on how lucky he is to have you! Luckily I haven't had any issues with prescriptions outside of not being able to fill more than 2 Emend packets in a given 30 day period and nearly having to take a treatment without it! I learned to stock up after that! I pray that Hans continues to recover, and for continuing health for you as well! Stay strong, gal!
mary -
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