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I envision myself talking to my kids about the olden days when insurance companies were just companies who were contracted through employers to suppliment health care costs versus
insurance companies dictating who lives and who dies by their STANDARD PROCEDURE POLICIES AND THE DOCTORS WHO DEPEND ON THEM TO MAKE A LIVING.
I went for my pre-op appt today.
It was ok.
I just filled out the usual forms and had
blood drawn.
I stopped by my surgeons office to drop
off the lame form they sent regarding the need
for a surgical assistant and my signature stating
if my insurance doesn't pay for it that I will. While I was there, I tried to see the person who
set up my surgery and sent me the forms stating
that I had to set up my own physical therapy appointments
and find my own therapist- as she sent me a long list
of therapists which "might" be on my insurance list of
providers- but that I would need to check and confirm my
choice myself.
She also did not send me a script which is needed to even set up the physical therapy appointment- and I called her last week 3 times leaving messages for her to return my call and also messages stating that I needed a physical therapy script. Alas, I did get the script but I never got to see the person, her name is Donna,
as the receptionist insisted upon relaying the messages back and forth herself by listening to me, walking back to where ever Donna was and then coming back to me with Donna's once sentence reply and then returning to tell her my one sentence reply back and forth. It could have been funny if it hadn't been so annoying. I wanted to ask about the chair that does passive range of motion and I wanted to ask about the thing that ices the arm and shoulder but I didn't get the opportunity to and I couldn't recall the name of them when I was there. I wonder if I should ask or not?
I wont see my doctor again until the day of surgery. I came home and started looking at the paper work, and the list of physical therapists and I felt nauseous.
I had already called the physical therapy office where I went for 5 months before I had my MRI where I had a few bad incidents regarding some therapists well, 2 in particular that made me feel like I wasn't trying hard enough when my range of motion decreased and you know what....
I actually feel a bit traumatized by those incidents.
I mean at the time, it was a big deal to me because I was in a lot of pain but I was trying so hard to believe that physical therapy would work and that given time my shoulder would heal. But, for the life of me, I can't seem to get over the inconsiderate and blatent rude behavior of the physical therapist who simply stood there with her hand on her hip looking clearly annoyed and unphased when I had pushed myself beyond my limit and could do no more physical therapy that day.
I ended up walking out, mostly due to the fact that I was fighting back tears but, also because I was flabbergasted by the fact that instead of seeming to have increased strength, I was degressing.
I had such a lump in my throat after she implied that I was being lazy and that I needed to just suck it up- I couldn't even respond to her. Anway, I called them week before last, and asked to speak to one of the therapists. Of course the only one available was THE ONE whom I had the main incident with.
I decided to not back down when she came to the phone and I introduced myself and triggered her memory of me, and explained that I was having surgery at the end of the month and would be making post op appointments but that I wanted to touch base before hand... And I reviewed with her my upset and discouragement of that time.
She said she was sorry if there was some misunderstanding and said that given the mri results it made perfect sense where I would fluxuate in my exercises and range of motion abilities and if only they had known at the time, my specific injury, that it wouldn't have been an issue, and inconsistencies would have been expected.
She didn't exactly apologize for the way she made me feel,
she more or less apologized for the incident but made it seem more like it was a no fault incident since she didn't have adequate information about my injury as per an MRI. Anyway, the conversation ended pretty much with me explaining that I would be needing physical therapy and I expected for my therapists and I to work as a team and I expected that if I could not do anymore than I say I can to be treated with respect and not pushed into hurting myself. She readily agreed and we ended on a good note. But, today as I was reviewing the physical therapists and getting ready to make that first post op appointment...
I just couldn't do it. I picked up the phone and started to dial the number,
but, I suddenly got a lump in my throat, and I felt very.....
defenseless, and ........... something.
I mean, there is a therapist there whom I like very much.
But I couldn't do it.
The feeling of dread in the pit of my stomach was overwhelming. I quickly called the only other nearby physical therapy office,
where I don't even know anyone and made my appointments there. I have no idea, if I will like them, or if they will be patient with me, or if they even have the more modern equipment like the other office has.
But in some sort of strange way, it didn't even matter to me.
I think I'd rather go ANYWHERE, than risk another incident while
I'm feeling at the mercy of another, like the incident I experienced
with that one physical therapist.
And I KNOW that I should not be afraid to speak up when my pain is more than I can bear, or when I need to step back. I suppose if I don't like this new office, I could always switch back and request the one therapist I really clicked with. The only other thing that sort of took me off guard was when I called my insurance company regarding post op PT was that they mentioned that I only have coverage for up to 60 PT visits per condition.
I said you mean I have only 60 PT visits available to rehabilitate my arm after surgery?
The associate said NO.
She said I only have 60 total---- minus the ones I've already used since last November. I was astounded.
I said what happens if I run out of PT visits and my shoulder is not healed or I need more visits.
She said I would have to pay out of pocket totally.
I asked if there was an appeal process for extenuating circumstances, just in case.
She said NO. That really made me kind of angry because I wanted an MRI right off the bat when I couldn't move my shoulder in November.
I KNEW it wasn't a sprain, or some sort of inflammation that might settle down in time.
I definitly KNEW something was very wrong and I needed to find out what it was. But my doctor said, that insurance companies don't like to do MRI's in that way.
He said that it was standard procedure to do ALL conservative treatments possible and to wait at LEAST 6 months to review healing. I wasn't offered an MRI until the END of 5 months of physical therapy that was doing nothing for me except giving me a hard time. So, now I have wasted, 5 months of visits that were useless and could end up short on needed PT visits post op. I really feel cheated. If I could go back, I think I would have shopped for a doctor who would have done the MRI immediately- tho I do believe my doctor was acting in my best interest- I like him, and I trust him.
I just feel that insurance companies have NO business dictating
what the process of medical treatment should be. So, Who is the problem?
The doctor who followed standard procedure via following what the insurance companies deem to be standard procedure or
is it the insurance companies who are taking the liberty of practicing medicine without a license and getting away with it because THEY hold the funds? I envision myself talking to my kids about the olden days when insurance companies were just companies who were contracted through employers to suppliment health care costs versus
insurance companies dictating who lives and who dies by their STANDARD PROCEDURE POLICIES AND THE DOCTORS WHO DEPEND ON THEM TO MAKE A LIVING. Well, that was pretty much the basic deal of the day. eNd oF rAnT |
