Having now been released from medical lockup for what appears to be very successful correction of a long-standing issue (time will really tell), I feel it is safe to relate the behavior of my insurance company prior to my admission. I did not feel safe discussing said insurance company’s behavior before my admission because quite frankly, they held my life in their hands. And to be honest, I have serious doubts about their intent for the future for my life. I could blame their behavior on big business, but since I work for big business, the touch of evil that I sense in their behavior just seems to go beyond trying to make a buck.
I have to take back that last statement. I am not totally sure their behavior reflected evil. No it might just have been plain old stupidity. Whichever it was, it sure was uncaring, and in the end, their behavior did not save them on single penny.
I must take Warfarin because of my artificial heart valve; this creates a complication for any surgical procedure. It is necessary to stop taking Warfarin, then introduce a short acting substitute (often Lovenox) and finally start an IV Heparin bridge. This typically extends the hospital stay by a few days. If not done properly, the consequences can either be excessive bleeding or a stroke. Neither are acceptable alternatives (at least I sure do not think they are acceptable.)
The first insanity was the refusal of the insurance company to fill my prescription for Lovenox. The excuse provided was that I did not need Lovenox because I was taking Warfarin. It took four days and an unknown number of phone calls to get a sane person to admit that the purpose of Lovenox was to be used by persons who take Warfarin when they have to temporarily stop taking Warfarin.
The second significant insanity was related to the approval of the request for the surgery. The request was first for the surgery and second for the Heparin Bridge. The request was written for three days for the surgery and two days for the bridge (one on each side of the surgery). Because I was suffering from an infection that could only be corrected surgically, the surgeon wanted to proceed as quickly as possible. First the insurance company decided to delay even reviewing the case. They announced that by their rules they had a week to review the paperwork and they would take that week even though the surgeon wanted to perform the procedure six days after the paperwork was submitted. It took four days of phone calls from the surgeon and the hospital to even get the paperwork reviewed. And guess what the geniuses at the insurance company did? They approved the surgery! But, they disapproved the heparin bridge. There is no surgeon in this earth I would let touch my body who would operate without the bridge short of a life-threatening emergency. But then even the insurance company admitted that once I was admitted, if the doctors and the hospital decided I needed to stay in the hospital, they would have to approve me staying in.
In the end it was all a bunch of unnecessary waste and stress. In the end, I got admitted and the people who should be making the decisions about my care were in charge. But before that, the insurance company wasted a tremendous amount of time of the employees of all of the medical offices I dealt with. The insurance company also caused Still Here Too and me a tremendous amount of unnecessary stress at a time when we did not need it.
As I said, I do not know if they are evil or just plain stupid. But the insurance company sure was not looking out for my best interest, the medical community’s best interest, or really even their own best interest. I hate to think the insurance company was just being mean for the sake of being mean. But who knows.
Is Still Here