The Rant Continues

[gja1000]

I'm posting waaaay to much in the vent section - what does that say about me???

This is just NOT my month for health care things. Or maybe it IS the month for health care challenges........

We FINALLY got Gary's injection for his neck scheduled for Jan. 30th. That is so far away though, I feel so sorry for him. He had a terrible night last night, but he is better today.

The story is that he went to the doctor on the 12th. They said, "yep, he needs another injection". But they had to clear it with his heart doctor to stop his blood thinner 3 days before and 2 days after the injection. So they called me on the 13th, to get the exact name of the cardiologist. I couldn't talk to anyone directly (of course :roll eyes so I left them a message on the 13th with the doctor's name and phone number, along with the NP that also takes care of Gary (it's a heart failure clinic and so he sees the NP actually more than the doctor). So, they had 2 contact names.

When I hadn't heard back from the neck doc's office by the 18th, I called and they were supposed to call me back - but they didn't. So then on the 19th, someone called and asked me, "DID YOU EVER GET APPROVAL FROM THE CARDIOLOGIST TO STOP THE COUMADIN" Like I was supposed to get the permission - no I don't think so. I told her that HER doc's office had called and asked for the cardiologist's contact information and I had given them that information on the 13th and now we were waaaay beyond patience for this delay (I was nice though, not mean).

So she says she will talk to the neck doc on Friday (yesterday) and call us back Friday afternoon (20th). By 4:00PM Friday, no one had called so I called AGAIN and of course, someone was supposed to call me back and yay! they did this time and we scheduled the injection. But of course by NOW, the first appointment available is the 30th - a whole 9 days away. I was pretty upset last night because Gary was in so much pain, but he is better today. The new pain meds they gave him don't work, but the muscle relaxant did work. We also have some stronger pain meds so he will try those if he gets into this shape again.

OK, that is issue #1

#2. We have been trying to get his medications transferred over to a new mail-in pharmacy (Caremark) and that has been a real saga, with many phone calls and LOOOONG periods of time on hold. Anyway, finally I was able to get his online account set up and so I thought everything was OK. I knew his insulin did not transfer over to Caremark, but I thought that was OK because we had an appointment last Thursday (the 12th) with his endocrinologist and I knew we could get a new prescription for insulin. We went to the doctor and I watched him submit the prescription for insulin via his computer. So, every day I checked to see if it showed up on Gary's list of meds on the Caremark website, but it never did. I tried calling Caremark one evening, but couldn't wait long enough on hold to actually talk to someone :roll eyes: So, yesterday (the 20th) there was a message from Caremark (on our voice mail) that Gary's doctor had submitted the prescription to Caremark Specialty pharmacy, instead of Caremark mail-in pharmacy (where he should have submitted it). They went on to say that Caremark Specialty had forward the prescription to Caremark Mail-in pharmacy but that they couldn't fill the forwarded prescription because was not submitted directly from the doctor. WTF! So I called the endocrinologist office and (of course) had to leave a message about the prescription. They called me back later in the day to say that Caremark had called THEM, and THEY had FAXED the prescription on the 13th, then someone from Caremark called them again and they FAXED the prescription on the 17th Mind you, Caremark called ME with the message above on the 18th!!! The nurse who called me from the endocrinologist office was at her wits end. She was saying what more are they supposed to do and I agree!!! She was going to fax it again and call them again. She said if it doesn't show up by Monday to call her again. Do you know how frustrating this is!!!

Oh, but i am not done!

Today I realized that we hadn't gotten Gary's insulin pump supplies (tubing and cartridges - they usually come about the 18th of every month). Gary gets his insulin pump supplies from Medicare since he is 100% disabled, Medicare is his primary insurance, and his BCBS is secondary. His pump supplies used to come every month, but Medicare changed some things and so when I called, they explained that he was getting 3 months worth of supplies in one shipment and his next shipment was due to be shipped Feb. 17th. OK, that was fine with me - EXCEPT - after I hung up I thought, "you know, I don't' think we have enough supplies to get to Feb. 17th". So, I went and counted tubing and cartridges and sure enough we only had enough to get to the 15th. THEN I realized we will be out of town from the 16th to the 21st and he sure as heck doesn't have enough supplies to last to the 21st.

So, I call the medical supply house that ships the supplies. Always in the past when we were going out of town, they would ship his supplies early enough to get here before we left. So, the lady on the phone says, "nope, can't ship early, Medicare won't let us". I say, "Well Gary will be out of supplies and unable to use his insulin pump for 6 days" She says, "I'm sorry, Medicare won't let us ship early" And I tell her that they always did before and she said they don't do it anymore. So, I ask to talk to her supervisor who says the same thing - but finally he says they will ship us a few sets to get us through the 6 days, AT NO CHARGE. I'm thinking they must be absorbing the cost because they can't bill Medicare, yada yada yada.

I'm very grateful for him doing that and I do understand that Medicare has really tightened up their procedures (there is SO MUCH Medicare fraud), so I understand that, but there can't just be blanket rules that can't be bent in special circumstances. Also, part of the problem is that when Gary is on Prednisone for his asthma, he uses more insulin so his pump tubing and cartridges have to be changed more often and thus, we use more supplies. The supervisor said that he would increase the number of tubings and cartridges we receive with each shipment, so hopefully this won't happen again.

WHEW! I am really tired of venting. I'm so tired of medical challenges!!!