Pepper

Discussion in 'Spirituality/Worship' started by bandwoman, Feb 2, 2007.

  1. bandwoman

    bandwoman New Member

    Hi Judy,

    How are things going for you? I have been praying for a break through for you and your husband and that Cammie could pass quietly and be with the Lord. How is Mike doing?

    I got some devastating news today. I am still waiting on the insurance. If it wasn't so utterly ridiculous it would be humorous but I am certainly NOT laughing at this point. Incorrect fax numbers, you name it and I am still not sure if the insurance has received my letter from the doctor even after talking with them on the phone this morning.

    I was feeling pretty down about the whole thing and then we got a letter from our school district regarding our new insurance. They are claiming that PT was incorrectly calculated by our previous insurance (which was excellent)
    and it looks like as of March 1st it will be very doubtful if I will be able to afford my chiro and muscle therapy.

    Also they have stopped payments for another patient that has similar bodywork like I do and will not pay any more until they receive a complete history from the doctor.

    It may only be a matter of time that they also do that with me concerning my chiro and muscle therapy.

    I have tried in the past to go without it and it just doesn't work. I end up in a critical state. I really have no idea what I am going to do. I can't imagine still teaching and not having all of this support which has allowed me to keep functioning.

    I feel as if someone has punched me in the stomach and pulled the rug out from under me. I hate feeling at the mercy of the insurance company and yet I know we all are in that same boat at one time or another.

    I saw my chiro tonight and I said what are people supposed to do in chronic pain. He said the insurance co. are not wanting to deal with anything chronic.

    I know I need to just step back and let the Lord work this out. I tend to at first over react and then after filtering it through my brain things don't seem quite so bad.

    I am not at that point yet. I am still in the over reacting stage. I may have to look at retiring before I really thought I could. At this rate having a stroke over this certainly isn't the way to go.

    As you see I am in need of venting. I am sure you need to hear this as you have so many things on your plate already. I am sorry. I don't mean to wear you down. I just needed someone to talk to.

    You take care of yourself and I am hoping to hear of a job some time soon when hubby starts to feel better about things. Hang in there. We can make it together right?

    Love,
    Nancy

  2. pepper

    pepper New Member

    Of course you needed someone to talk to and I am pleased that you chose me. I am so sorry about what the insurance company is doing to you and the other staff members who need this therapy.

    I can only imagine how you are feeling tonight. It brings me back to the time that my LTD insurance company told me that I had to go back to work, that I wasn't sick enough to be on LTD, etc., etc. Feeling punched in the stomach about sums it up.

    I am wondering who negotiated the contract with this insurance company. It sounds like they should be taken to task.

    But first things first. You say that "they will not pay any more until they receive a complete history from the doctor." Perhaps it is time to get that complete history ready so that you will be prepared. Maybe that is all that will be needed.

    If you do not have your muscle therapy and your chiropractic, not to mention your IV's, working is going to be incredibly difficult for you, if not impossible. Surely your medical history and documentation would bear that out.

    Include in your history when you started the therapies in question (exact dates are most impressive if you can get them) and how your symptoms improved. State clearly the symptoms and rate the level of improvement in the pain, ie. from a 9 to a 6, on better days a 4 or whatever; explain if you can what you couldn't do before the therapy that you could do after starting it. Even stating what has happened in the past when you have had to go without them would indicate how necessary they are to your life. I have helped many people deal with insurance companies and our CPP (Canada Pension Plan Disability) and we have always won by being clear and concise.

    Worst case scenario, would you not be able to go on short term and then long term disability if you were too sick to work? If so, perhaps a letter to that effect should be sent to the insurance company. I wonder if your school board's LTD is with the same insurance company. If it is, I am sure that they would much rather pay for these treatments than your LTD. It is a kind of threat, I suppose, but they might listen if it was worded strongly.

    I don't know how the people who work for these companies can look at themselves in the mirror every day, knowing that they are affecting so many sick people in such a negative way.

    Do you have a person who represents staff in the grieving process to the insurance company? That might be a route to go if you have that available to you and if they refuse to pay.

    I am so sorry that you are going through this, Nancy. I was thinking about you and praying for your situation today, sitting in my detox bath (no bubbles). I came on here tonight to see if you had heard some good news from the insurance company. I was not expecting this. :-(

    My DH is snoring beside me here. He went to visit Cammie this afternoon and they discussed the funeral. My hubby came home very depressed. Cam is very very weak and he thinks that his death is imminent.

    I am afraid that he might be waiting to see one last sibling who hasn't come and who says he isn't flying here for financial reasons. We are going to try to come up with the money to pay for a ticket to get him here. All it would cost him would be the flight because he would stay with us and I am annoyed with him. You don't get second chances with these things and he should know better.

    At least Cam's pain is being controlled and he is still able to remain at home, hopefully until the end.

    There are a few jobs that are possibilities. Please keep praying that one of them works out for him. It would be so good for his spirit.

    Mike is doing really well at university. 100% on his last Calculus test! I was an English major so I find this very impressive. He finally seems to be getting his act together.

    I have given you way too much to think about right now with this insurance stuff, Nancy. But I wanted you to think about the options you might have.

    Meanwhile, don't have a stroke over it! I do think that being pro-active in getting your ducks in a row with your medical history from as many sources as you can would be helpful if you have the energy. Sometimes it helps just to DO something to take back your power.

    Thinking of you and saying extra prayers for you tonight.
    Love, Judy



  3. bandwoman

    bandwoman New Member

    I think with a good night's sleep I hopefully will feel better about things tomorrow. When our insurance companies want medical history it unfortunately doesn't come from the patient but is requested from the provider.

    I am already furious with my chiro as he hasn't sent in notes regarding my car accident (from June) to my auto insurance. I was treated for whiplash all summer and he has yet to send any bills in for this. They have bugged him, I have bugged him and he just says he is busy with other personal stuff right now.

    So, knowing his history of dragging his heels this may not bode well for me. My previous insurance periodically would want notes from him regarding treatment but they never threatened to stop paying altogether until he sent them.

    We have a teacher's union and our union president has much to do with the insurance issue. I have already emailed him a couple of times regarding the IV's. He sent my email to the head honcho of our school district and she really has been unsuccessful in getting any action from the insurance.

    She said they need that letter of medical necessity from the doctor. Well it seems like it is going to take moving heaven and earth for this letter to actually end up in the proper dept. at the insurance co. They have sent this letter through the mail and the ins. co says they never received it. They faxed it and it came back the wrong number. They faxed it again and no one seems to know if it has reached the proper destination. It is just maddening.

    Well I have bent your ear enough for one night. I sure hope this other sibling can get to see Cammie. I know this has got to be so awful for your husband having to go through this over and over again.

    My mom came from a family of 9 children and it seemed like we had quite a few deaths all at once. Of course most of these sibilings were well into old age unlike your hubby's family. That has got to be so hard.

    I will certainly think of some of the things you talked about. I am not eligible for socical security disablilty. In our state teachers do not receive social security but a pension and we cannot get both. That really makes me crazy because I have literally paid thousands of dollars into social security over the 39 years I have taught private clarinet lessons.

    They call it double dipping. I am hoping to teach for only four more years. I am so close but yet so far.

    It is possible that I could feel really good after doing this expensive test and what treatment follows with that. I would go to a compounding pharmacist and he would mix up all the things my body is lacking. This is the test the man at church said he would help me with. Little did I know my financial situation would so drastically change in one week. It will be interesting to see what happens there.

    Well I need to get to bed. It has been a tiring week. I had open house last night at one of my schools and I have many, many night committments this month. We have a jazz festival that I need to make an appearance tomorrow. Ugh. This time of year has been very difficult for me in the past. If I can make it till spring break I will be a happy camper.

    Take care and thanks for your friendship.

    Love,
    Nancy
  4. pepper

    pepper New Member

    I don't know how you manage to keep up with all your school commitments while feeling so rough without your IV's.

    You are in a terrible situation with your doctor's letter not getting to the insurance company and your chiropractor being so unreliable. I can only imagine how frustrated you must be.

    When I first got sick, the CFS doctor I was seeing (world-renowned supposedly) had to write letters to my insurance company for LTD. His letter was abysmal! Not only was it poorly written but he had the facts wrong. So I re-wrote it with the corrections made and just asked him to sign it. He read it and signed it and charged me $100 but at least it was done right.

    Whenever my doctors have to write letters, I make a list of facts, ie. dates, treatments, etc. and give the list to them "just as reminders". I wonder if that would be helpful at all in your case. Not with your chiro obviously. It sounds like he is hopeless if both you and your insurance company have been bugging him and he still hasn't sent in the bills. Sheesh!

    I didn't know that you aren't able to collect an LTD pension. I really don't understand that. So close and yet so far is right.

    There is always the hope that the expensive tests and subsequent treatments will work wonders. But that will take time. Meanwhile, how are you going to manage without your IV's and muscle therapy? And the chiropractor? I so hope that you can straighten this out and get your medical history to the insurance company. Does it have to come from each practitioner or from the doctor who coordinates your care? I suppose that would be the doctor whose letter is somewhere yet to be determined!

    I do hope that the philanthropist at your church hears about your difficulties and offers to help. At least you would know that there is a plan if the insurance company fails to live up to its responsibility.

    I have been praying for you today that this is resolved in your favour soon.

    I am a wreck tonight. My hubby got a call late this morning from his SIL. Someone from the hospital had called her to tell her that her husband was dying according to his early morning blood test results and had to be taken to the hospital. Of course she thought that this meant that he was dying today and asked us to go out there (45 min. away) to be with her and the kids before they took him by ambulance.

    His SIL was a mess by the time we got there. We got her calmed down and had her call his doctor. (We couldn't because the doctors are all French!) The doctor said that the person who called her didn't know that Cam IS dying and is on palliative care! His blood test results are what is expected from a person dying from cancer. It was a very stressful day for everyone - for no reason at all.

    Keeping you in my prayers tonight, dear Nancy.
    Love, Judy
  5. bandwoman

    bandwoman New Member

    I made it through a busy Saturday. I was hoping it wouldn't be so crazy but I have been running from morning till night and man is it cold out there. I just got home for the grocery store. Yes, I shop at night. No one there. LOL I had to make my appearance at this jazz festival and spent an hour there.

    I drove to my dr. office to get a copy of this famous letter. I was a little annoyed with the guy who has been dealing with this. To say he is annoyed with my insurance would be an understatement. We did find out that the fax number that the lady from the insurance emailed me was wrong. She inverted two numbers. Gee maybe she has brain fog too!

    It wasn't properly faxed until Friday. GRRRRR He had alerted me on Wed of the wrong fax number. Why it took so long to do it is beyond me. Anyway I have a copy of it and I can take over from here if they claim they haven't received it AGAIN.

    My juicing is really helping me I have come to the conclusion. I haven't been sick one day this year. That is an all time record. Since I have been doing alternative products I started seeing a definite decline in having to use sick days. I used to get sick when someone across the state would cough in my direction. LOL

    The insurance has not requested anything from my chiro yet. I was thinking about that today and this patient that
    they told me about who had to produce medical history etc. is a fairly new patient for only two months. It just occurred to me that he may have been seeing her three times a week. When someone is in a critical state that is what he does. With the muscle therapist added to the mix that lady would really be racking up the bills fast.

    That might be why they jumped on her. What is really alarming to me is when I signed up for insurance's website right in big numbers they have how many bills you have incurred for the month.

    I was talking to this insurance rep the other day and she pulled up my files and she said Oh Evie. I thought how unprofessional. I think she probably said that because I had cost them so much money that month. Of course that is why we pay an arm and a leg to pay the premiums.

    Thanks for your prayers. I am feeling more on top of things today. Of course I have no idea yet what I am going to do. I will hopefully see this man at church tomorrow and I would like to have a few moments of private conversation with him somehow. This is way out of my comfort zone that is for sure.

    I do want to tell him how much he blessed me and how I shared it with all of you and was able to bless many other people as well. I would like to tell him a little of what is going on.

    I am so sorry to hear about this person calling your SIL. Man, what a mistake. I remember the shock when the doctor told my mom and I that this could be the day. He was talking about my Dad's death. We were in total shock. We knew he was going to die but we had no clue it was going to happen so fast. I will never forget that moment as long as I live. Fortunately we were right there in the hospital and was with him when he died only hours later.

    I always felt bad because my Dad was not conscious that day at all for us to say our last words to him. I know this must just be so unbelievably hard for your SIL and the kids.

    You have been through so much in the waiting and waiting for many things. I remember my mom saying a strange thing right after my Dad died. She said I wish it was a year from now.

    I guess we could all wish that for those of us going through really hard times. I wonder what we will all be doing a year from now. I maybe have said this to you before but one verse in the Bible that actually means a lot to me and it is the one that says "and this too shall pass."

    I do pray that in these hard times we can draw closer to God and become stronger in ways that we wouldn't have if we didn't have the trials.

    Well I see it is my bed time already. Got to run. Thanks so much for your friendship and support. It does mean a lot to me. We will continue to lift each other up okay?

    Love,
    Nancy
  6. pepper

    pepper New Member

    I wrote a reply to this the other day but it isn't here! Maybe I didn't click on "Post this reply". Duh. I am stressed and was hit the other day with another candida infection in my mouth which makes my brain fog so much worse.

    Luckily I recognized that it was candida, contacted my doctors and started treatment early. It seems that my whole day revolves around my treatments - wait two hours after food before taking this, no flavored foods 30 min. before or after this and that, take this 20 min. after that, etc. I need a secretary!

    Cammie is still hanging in there. My hubby asked him the other day if he had had any "visitors" yet. He said that he had but thought it was from the drugs. My DH told him that it was probably family from the other side or angels coming to help him pass and not to be afraid. He was very comforted by that.

    The waiting is so hard. We were called to go out to his house on Mon. because it was "time". When we got there, he perked up and talked to my DH for hours, planning his funeral. We hate to appear to be anxious for him to die but this waiting is excruciating.

    I remember the details of both my parents' deaths well. I guess they will stay with me for the rest of my life. My mom died in '95. I was alone with her at the end of visiting hours and said the rosary for her. It was Wed. night. She used to attend Novenas at our church every Wed. night so I felt I was doing something meaningful for her even though she was completely non-responsive.

    I got up from saying the rosary beside her and cried quietly behind her. I bent to kiss her good-bye and a tear was rolling down her cheek. She died a few hours later. I believe that she heard me say the rosary before she died. So I think that your Dad probably heard your last words to him too even though he did not appear to be aware. :)

    "And this too shall pass". I do believe that I have quoted you quoting the Bible in a few posts here. I guess it really sunk in. Of course that is true but sometimes it is hard to remember while we are going through the tough times. Important words to remember.

    I can't believe that the insurance lady gave the wrong phone number! Knowing insurance companies, I would not be surprised to hear that they do this on a regular basis. I have become cynical. Has the insurance company at least received the letter yet?

    I think I would find their web site really intimidating with the amount you have racked up in big numbers. Are they trying to make you feel guilty for being sick and trying to get better? I think that we get enough of that from other places in this world.

    Were you able to have a private conversation with that gentleman at your church? I can only imagine how uncomfortable you feel doing this. You must be an independent woman, working all this time despite your pain, supporting yourself on your own. Asking for help must be so hard.

    That is good news about the juicing. I am still trying to decide which one I will buy. Our neighbourhood health food store has Omegas and Brevilles and I am researching them both. The thread on Juicing on the main board is very interesting.

    I hope that you are managing with all you have to do for your job and without your IV's. Have you heard anything about any of these treatments yet? I pray that a person with empathy reads your doctor's letter to the insurance company.

    Special prayers for you during Prayer Night tonight.
    Love, Judy