Tuesday, July 23, 2013

A Very Pleasant Morning Phone Call.....

I'm fit to be tied and I don't even know what that means. Could it be someone in great health that's into S & M? Or perchance a man who is wearing a tux, sans tie? The first thing I thought of was a hangman's noose.

Don't you hate those situations when you need to blow off steam and no one's around? I sure do. I hate feeling like this. The last thing I need to do is call Wanda at the office and scream at the phone. Maybe I'll feel better if I yell at the wall, or the cat? It's like the conundrum (shit, maybe it's not a conundrum?) If a tree falls in the forest and no one's there will it make a sound? Or, What is the sound of one hand clapping?

Can I vent my frustration if no one is around to hear it? I don't know, but I'll feel better when I finish the blog entry today.

Go ahead, if you don't want to read my ravings, skip on down to THE END. I have a post script with some real juicy Royal Baby items and pictures of Jennifer Aniston's last sizzling bikini shoot.

Once again I'm doing the medication boogie. The last problem was two months ago.

A new person at the pharmacy sent my Rx request to the wrong insurance carrier. When I called to check on it a clerk said, "We're waiting for a prior approval request from your doctor." Everything had been smooth for many months, but I've had so many prior problems, I let it go for another few days. Then I did some checking.

Everyone is entitled to a mistake and the new person made one. The doctor they were waiting on, my primary physician, has nothing to do with this medication. He knows I take it but would ignore any requests for it. Eventually I discovered the problem and got it rectified.

This brings us to this morning.

Last Thursday I dropped off this months Rx. Thinking it would be filled at the latest yesterday, and needing milk, I drove to Safeway. I checked on the script (it wasn't ready) and asked them to put in another request. 

This morning I called the intermediary company I call "Oak Care." They handle durable medical goods like wheel chairs and walkers as well as medication requests. I know, I know, I'm beating a dead horse here (again with the idioms) but once more, the 'chain of command.'

1. Once a month I go to the doctor and get a prescription.
2. I take it to the pharmacy three or four days before I need it.
3. The pharmacy calls, texts, e-mails or sends smoke signals to "Oak Care" for approval.
4. "Oak Care" e-mails, calls, texts, or sends smoke signals to my insurance adjuster (and I use the term loosely) for approval.
5. "Oak" gets approval, notifies the pharmacy, they fill the Rx and call me when it's ready.

And last but not least, I drive to the store and pick up the medication. This scenario is what should happen.

Bored yet? I told you to skip on down to the juicy stuff.

Somewhere on this long road to wellness I was told the insurance adjusters have three days or three requests before they are required to respond. Remember, at one time I was a Nurse Case Manager and dealt with these people on a regular basis. 

I dropped off the Rx last Thursday early morning. So by my way of thinking, Thursday, Friday and Monday were the three requests. First thing this morning I called "Oak Care" to check on the hold up. I spoke with "Ron." He told me they had sent the three requests to the adjuster with no response, and added, "So now the patient has to contact the adjuster." Since I am 'the patient' I asked for, and he gave me, a contact number and a name. This gets better, it was 7:30 a.m.

At this point I have a few questions for you. Think it's safe to assume a contact number would be an office? Wouldn't you think the contact number would get you a voice mail? Well, maybe it was my error in thinking that. Apparently I was given a cell phone, a private cell phone. It sure sounded like I woke the woman up. 

The name I was given was Vicky.

I should have hung up as soon as I heard the sleepily voice but I didn't. 

I said, "Hello Vickie?" and was greeted with an ice-cold, "IT'S VICTORIA." Well, Fuck Me. I suddenly realized this was the same woman who gave me such a hard time last year.

So, I tried to explain the situation and apparently she likes to talk rather than listen. At one point in the conversation when I was trying to get a word in edgewise, she told me to "Calm Down." Seriously? If she would have let me briefly tell her this side of the situation rather than trying to explain all the ramifications of the "NEW LAWS" we could have wrapped up the call in a matter of minutes.

I heard the same story when all this shit hit the fan over a year ago. All about new laws and doctors letters and on and on and on. At one point I tried to ask her if these new laws went into effect between June and July, because I had no problem with anything in June. Now I need different paperwork and doctors requests? I don't want to do a "She said/I said" here. I much prefer the "She said-He heard" inclusions so I'll try to wrap this up in a tidy way.

By the way, when I told her it sounded like I woke her up she said, "EXCUSE ME?" in a nasty tone. Then I tried to say it was a reasonable assumption given the fact it was SEVEN F'N THIRTY IN THE MORNING. But she didn't hear that. She didn't hear much of anything I said. 

I followed protocols, "Oak Care" gave me a phone number and told me to call her. So I called her.

This woman eventually told me she would "authorize my medications this one time" but I should contact my doctor and have him, she's a her. OK, honest mistake (I'm getting nit picky and I don't know what a nit is) answer the request for information letter sent to him (her).

This insurance carrier sent a letter to my doc asking for information on what he (she) was doing to "discontinue the medication." It was sent three weeks ago and because she has yet to respond, the medication was not approved? 

And here I sit, not knowing about any of the "new laws" and requests to my doc etc. etc. etc.

Oh, another thing...I suppose whomever is asking about this is too stupid to see we have dropped the medication dose 66% over the last several months.

I lied about juicy gossip and sizzling pictures. 

The only person who has ever stressed me out like this woman is the bad spouse. Talking to "VICTORIA" is just like discussing who gets the house and contents with my ex-wife. I don't understand how it's even possible. 

Thanks for letting me vent this morning.

1 comment:

Susan from 29 said...

Never scream at a cat. The stare they give you in return only adds to the sense of frustration.

Trust me on this one.

Susan