Insurance | Me, Myself, and Evan's

The Crazy Lab Charge

Posted on July 2, 2016

My insurance company mails me a paper copy of each claim or service rendered once a decision has been made. It always shows the amount/breakdown of what the provider charged, how much of it insurance paid for, and how much I owe. Usually these show up in the mail and I can throw them away because I have already paid the copay in-office and/or I don’t owe anything. I happened to open yesterday’s and it was for the lab work I had done at the original hematologist’s office – the lab work I never even saw, the lab work that was taken by the lady who didn’t wear gloves. Despite the fact that I made it abundantly clear to the hematologist that my vials needed to be sent out to either Quest or LabCorp, she sent them for testing at some random, local lab that isn’t covered by insurance. As a result, the paperwork I got from the insurance company shows they covered none of the cost and I owe almost $4,500! For lab work?! She only took five vials of blood! What in the hell costs $4,500 to test?! Did she combine my blood with liquid gold? I don’t understand.

The insurance paperwork says on it “this is not a bill”, but I know that means the bill from the lab is on its way. This could get interesting because there is no way in hell I’m paying a cent of it. I told the hematologist flat out that the blood needed to be sent to Quest or LabCorp because those are the only two labs my insurance covers AND they cover them in full – I shouldn’t even owe a copay for lab work. Somehow, this crazy lady took it upon herself to completely ignore my instructions and send the vials wherever she damn well pleased. I’m not paying $4,500 for lab results I didn’t even receive just because she was too lazy to follow directions. Quest & LabCorp are probably the two largest diagnostic lab chains in the nation – it should have been a very simple request. I’m not sure what happens when I get the bill – do I fight it out with the old hematologist, the laboratory, or insurance? Do I get my company’s HR Director involved? I’m already getting anxiety and the bill hasn’t even come yet. I don’t need this added stress right now. UGH.

The Treatment Approval!

Posted on June 20, 2016

This morning I called the hematology center to see if they had any update from insurance. The insurance company had told them it would be an additional 24-48 hours. They had all the paperwork they needed, but claimed it was still in the “review process”. I decided to reach out to my company’s HR Director, who was able to get our broker involved. I heard back from her around 4:30 that the approval went through! I don’t know what she and the broker did to speed things along, but it worked like a charm! I am so relieved to know treatment was approved. By the time the approval was faxed to the office, they were already closed for the day. My guess is that they will see the fax in the morning and immediately call me to come in. It looks like treatment will almost definitely be Tuesday-Friday!

The Busy Saturday

Posted on June 18, 2016

Around 9:30 I called my insurance company to check on the status of my IVIG request. After being transferred a few times they told me that the request was made on Wednesday (not Tuesday end of day as I had thought) and it takes 2-3 business days to process and approve (Thursday, Friday, Monday). She said to call back Monday and check on the status of the request, but my guess is that the insurance company will approve it Monday and tell the doctor who will then call me asking to start on Tuesday. It’s actually better that I get a full day’s work in on Monday anyways.

At 10:30 I got a haircut. I hadn’t had one since October!

I chopped my hair to shoulder length (a little past) and then went to lunch at Panera with my mother-in-law and sister-in-law. After lunch we walked from Panera to the mall entrance and my heart started fluttering. The pulse oximeter read 155+. It scared the hell out of me. Once I finally calmed down, we went into the mall to shop for a couple of hours. After being in there an hour or so I started to get very sweaty and overheated. Sweat was literally pouring off of me and running into my eyes. I sat down in front of a fan in the changing room for ten minutes and drank some water. Finally, my pulse returned to normal and I was able to continue shopping.

When I went to go to bed tonight, my husband’s heart was fluttering and he was having chest pains and vomiting so I took him to the ER in Milford. Luckily, everything looked normal and after a bag of IV fluids he was feeling better. The nurse and I spent most of the time talking about my condition instead. I keep forgetting the rarity and severity of my illness until I start describing it. Doctors and nurses seem fascinated by my condition, which I am not sure how to interpret. I talk about my treatment and diagnosis so casually and openly. It’s hard to know if I still haven’t really absorbed any of it or if I’m being optimistic for the first time in my life. Regardless, I am glad my husband is okay. After the month I’ve been having, it was nice to not be the one in the hospital bed.

The First Good Day this Month

Posted on June 17, 2016

I had a lot of trouble concentrating today. I anxiously awaited a call from insurance all morning approving my IVIG treatment. Since the call never came, the earliest I will be able to start is on Tuesday. Since I had to cancel Chicago anyways, though, Tuesday-Friday 9:00 AM-2:00 PM wouldn’t be the worst thing.

On a happier note, today was the best day I’ve had all month. Everything about my diagnosis has been confusing, overwhelming, and frightening, but today was wonderful. John & I drove into the city and parked near 30 Rock to go to the taping of The Tonight Show starring Jimmy Fallon. The taping was an awesome experience and at the end we even got to high five Jimmy as he ran up the aisle during the closing credits. We watched the show when it aired tonight and you could see us on screen! Appear on national television? Check!

In addition to that, my husband and my mother-in-law gave me an early birthday present – a t-shirt blanket made from all of my old college and sorority t-shirts! I had originally asked my husband for one back in August 2013 when we were still dating. We had just moved in together and I thought it would make a perfect birthday present. He never ended up doing anything with the box of shirts, though, and I started to think he never would. It made it ten times more exciting not knowing it was happening! It was a total and complete shock and I am absolutely in love with it. Today was a nice change of pace!

The Platelet Check

Posted on June 16, 2016

Today the doctor’s office called a little after noon and asked me to come in for a CBC blood panel to check my platelet count resulting from Tuesday’s transfusion. Within ten minutes I had grabbed an Uber and was on my way to the office. They took two vials of blood and then I met with the doctor. My hemoglobin went up to 10.7 (half a point increase), but my antibodies test came back positive, which means antibodies are still latching on to my healthy RBCs and destroying them. This was further solidified by the fact that the doctor said I’m still in hemolysis. I am hoping the IVIG will still be just as effective while in active hemolysis. I would hate to know what my hemoglobin would be at without the Prednisone. Somehow, with the Prednisone, it does seem to be going up!

My platelet count from today was up to 31,000, which makes perfect sense. The doctor predicted with the one unit of platelets that my count would rise from 13 to around 30.

The plan at this point is to stay on the steroids and hope that insurance approves the IVIG treatment late today or early tomorrow. Not sure when the tapering off will begin so I am trying not to worry about it. The doctor and his staff keep repeatedly calling my insurance company for approval, which is nice. It’s nice not having to do that myself. Assuming it is approved by end of day tomorrow, the office will call me and set up a time for me to come in on Monday for my first dose. Treatment will likely be Monday-Thursday, 9:00-2:00. I won’t know until the end of the first treatment if I am going to be able to work from home in the afternoons. The doctor said that 40-60% of patients, the majority, experience painful headaches following the treatments and spend the afternoon and evening lying in bed on prescription painkillers that he prescribes to help manage the pain. Here’s to hoping the pain isn’t too bad and that I am able to work for at least a few hours a day.

Also I asked the doctor a few of my questions:

Can I still fly to Chicago next weekend?
No. Because of the IVIG and the probable headaches, he doesn’t think it’s a good idea to be too far away or to take a plane.

If the IVIG doesn’t work, do we need to resort to Rituxan? If so, how soon will that be?
Since Rituxan can cause reproductive problems, it might not necessarily be the next step. He said he often tries IVIG a second time first, but that it isn’t worth talking about unless we need to take that step.

Was the large platelet drop due to my alcohol intake this past weekend?
Unfortunately, the answer to this was yes. He thinks the drinks I had at the wedding and the night before definitely were the cause of my platelet drop from 44 to 13. It sucks knowing I did this to myself, but at the same time, I thought maybe there was a small chance the alcohol would react with the Prednisone – I had NO idea that the alcohol would thin my blood and drop my platelets. I can’t beat myself up over an honest mistake.