Thursday, April 2, 2009

He's Home

I have not developed a habit of reading my daily horoscope and I have very few feelings about their value one way or the other. But I do find them at times amusing while at other times eerily accurate. They also seem to appear in almost any type of written material that one finds at a hospital. And where have I been biding my time lately?

Today, one of the horoscopes I ran across seemed to be talking to me about the struggle with insurance that we ran into, once again, today. Let's see what you think:

Your ability to be clever under pressure might just save the day for you, but you'll need to carefully watch every step you take today so you don't make a critical mistake. Taskmaster Saturn forms an irritating quincunx to your key planet Mercury now, indicating your inability to solve a problem once and for all. Instead, you'll need to keep coming back at it from a different angle, again and again. It's not that your strategy is ineffectual; it's just that things are more complex than they seem.

I don't understand the planet stuff, but the rest fits perfectly.

Here is a synopsis of today's insurance woes.

In order for Dennis to go home today, the hospital staff wanted one of three things to happen. One, a short term nursing home stay, which neither of us want to have happen again. Two, a short term stay at the hospital, with 3 hours a day of therapy, which the doctor seemed to think would not be a good fit for Dennis. Or three, a PT, OT and nurse to visit Dennis at the house for 30 minutes a day. We needed to agree to one option yesterday.

We were both open to the second and third option, with our preference being the home visits. The hospital social worker told us she would check the insurance and arrange for home visits for Dennis. Since the issue of being covered by an HMO in one state over had been fixed after two months of frustration, we did not anticipate a problem.

Today, she came to us and told us the insurance did indeed cover this option, and she had set us up with the in-house service, but that we had not made his monthly premium payment.

If you know Dennis at all, you know this is the last thing that he would let happen. He not only makes these payment on time, he pays them two months ahead of time.

So I get on the phone, all fired up and more than a bit ticked off. I called Medco, his insurance company, who told me that he was still considered an active member. But, since the did not take the payments, they could not guarantee that they had been made. This took two separate calls, by the way.***

Next, I call the payment collection company, ADP, and talk to a very nice lady in India, who of course cannot help me. I ask to speak to JoAnn, who has helped me, inefficiently, but finally effectively, in the past. She does not answer. I ask for her voice mail. India does not know that. So I ask for a different supervisor.

On hold. Bad music. On hold. Music gets worse. On hold.....

Finally, Harry from Detroit, answers. I go through my story again. We get disconnected.

I call again. Yes, we have made the payment and are up to date. They haven't let Medco know, yet, for some reason. It's only the 3rd of the month, he says. He says he will help me, but from past experience, I know that he is simply placating me, and has no intention of following through with promises give.

I call Medco again and explain the story, only to get disconnected once again.

I call again, and am now beginning my second hour of trying to straighten out something that should not need fixing in the first place.

To make a incredibly long, boring, and stressful story short, Dennis will receive the care he is entitled to, and ADP finally let Medco know that he is paid up in full.

But, unfortunately, as my horoscope suggests, this battle is not finished. But as Dennis' job is to fight Parkinson's, my job must be to fight for his rights.

Why does anyone have to fight so hard?

Ann and Dennis

***I will explain the process of each phone call at a later date.



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