My next glaucoma surgery was going to be on March 28. I got sick. It got rescheduled for Apr 11 - this Thursday. Monday Apr 8 I got a call that insurance denied my surgery and my glaucoma doctor was going to do a peer to peer review Tuesday - i.e. try to convince a doctor employed by the insurance company that I need the surgery. Because my optic nerve is dying. Today is Tuesday and nobody called. No idea if I am having surgery Thursday. And I have a fucking anxiety disorder.
@BenA
They really are everything that is wrong with health care as a capitalist business
@publickovacs
Wow! Why did the insurance company wait so long to make this known?
@arthurpendragon
Your guess is as good as mine - although it is possible that the eye clinic didn't check in a timely fashion
@publickovacs the insurance company would rather you lose your vision then pay for the surgery that could save it. Disgraceful because in the long run it costs way more when you are blind and need many more services. Hopefully it's reconsidered and you get the care you need.
Dreadful to see this—I’m so sorry for the insurance antagonism when you thought things were in the clear from before. The stress must be immense as you wait for an outcome 😔
💜🫂
@Minholkin
Thank you for the kind words - I am not doing too well. It is now midday on Wednesday and I still don't know if I am having surgery tomorrow
Gosh that's a terrible spot to be in--you don't know how to allocate your resources for coping so you're just all over :(
@publickovacs
The insurance prior authorization departments are horribly understaffed, and the whole process is based on doctors' offices not having time to do these "peer-to-peer" calls which require sitting on hold half an hour during patient office hours. Then when the insurance doctor gets on the line, exactly zero of any of the documents that were sent over to justify the procedure were given to that doctor ahead of the call. The approval usually does not need any discussion. It's all BS.
@AlphaCentauri
I understand why and how this happens but as the patient I experience it as cruel and unusual punishment
@publickovacs Hope everything works out well for you 😊
This has been such a tough time Mel. I’m here for you if I can help. Sending healing energy ✨💫✨💫✨💫✨
@publickovacs hope this gets sorted out soon.
@publickovacs I'm so sorry that you're in this position. I don't understand how it's even legal, and it's certainly not acceptable. My thoughts are with you and I really hope that there's a good resolution soon.
@Ironworker229
Thank you so much
@publickovacs You really deserve better. We all really deserve better, which makes it that much more infuriating. I don't think that you're some out of the norm case.
@Ironworker229
I am out of the norm upset...
@publickovacs I think that you have every right to be! Still no word, I take it?
@Ironworker229
I am not having surgery tomorrow. I will have tests done on Friday as a step to figure out what to do.
@publickovacs I think medical tests are a modern wonder, but are they testing to evaluate treatment options and therapies or to try to get out of paying for surgery? Grrr!😡
Sending you good vibes & hopes for surgery.
@Shenango_Linda
Thank you. No surgery today, though.
@publickovacs
Damn, Mel. If you didn't have bad luck, you wouldn't have any luck at all. I really hope your doctor convinces the insurance quacks to rethink their ruling.
About 15 years ago, my ophthalmologist did eye lid surgery on me. Both were drooping so badly that I had virtually no peripheral vision and could no longer read. The insurance company declared AFTER the surgery that it was a cosmetic procedure and not covered. It took months to get it sorted out.
I loathe all insurers!