1. American Health "Care" Strikes Again!

Monkey Girl on Medicaid tries to get a 5 day continuous EEG

“Post too long for email”?

Pffft, post too long for sanity!

---

Too Long; Need Answer NOW:

What you need is called “insurance verifiers.” You need to ask them to send you in writing that your procedure IS something your insurance covers, along with your estimated cost.

If you’re like me, and stand no chance of being able to pay for it if you’re one of those oddballs who gets denied even though Medicaid customarily covers your procedure, you also need to see if they have “financial councilors” to help you apply for financial aid specific to your hospital. Preferably BEFORE your procedure, but with mine they can backdate.

Ta-DAHHHH!

Was it really that hard?

YES. Apparently it is. This is why my ability to post here on Substack has gotten all constipated, why I am only just getting back to a little dancing even though it’s been over a month since I stopped Covid-wheezing, since my knee stopped displacing from the pressure of a stupid bedsheet, and since my meniscus stopped micro-tearing.

---

So let’s watch the shit-show, shall we? Kick back and make sure you have your popcorn ready. Definitely a beverage or few. Because I could not make this up!

Okay, that’s not true. I’m a fantasy novelist. But most of my best epic fictional dookie-storms come straight out of shocking and appalling history.

(Why do you think my fantasy fiction publication is called Twisted History & Myth?)

I’m gonna post this whole multi-part story in rapid succession for my bingers, and for anybody that wants to experience the full exercise in endurance that it’s been. If you prefer to digest this thing in shorter phases, remember that both the desktop and the app programs will slap in a digital bookmark to save your place if you have to tap out and…you know…get back to your life?

This was mine all last month.

---

January 12, 2024

From: My Neurologist’s assistant via the portal
To: Me

…{Doc} put in an order for a 5 day at home EEG. We received a denial back from them stating that they are out of network with your insurance and unable to obtain an authorization. Doc has asked me to set up an in hospital 5 day EEG for you and I will call you when I have all the information for you on when that will be.

From: Me

Oh yeah, I’m on Medicaid. Not surprised. Thank you!

Later…

They schedule the EEG for February 12 out of state, up in Missouri. Groovy. Since I live in Arkansas, I make sure that there is absolutely no way I can do this down here nearer to home, and there isn’t.

From: Me

Perfect! Thank you so much for checking! We’ll be there with bells on.

PS Medicaid will cover all that, yes?

*cue Jaws Theme music*
IT STARTS

January 18

I go for my annual dental cleaning. (Medicaid nixed the recommended bi-annual cleaning a few years ago, so I dance a massive happy-dance when I actually get to have a cleaning. Because without this coverage, I wouldn’t be able to afford a cleaning or x-rays at all.)

Oh wait!

Yeah, like right now. Because my dad drives me all the way out to my dentist since I can’t drive these days due to all this neuro-crap. I try to check in. Only then does anyone inform me that I have been kicked from the Medicaid Dental system.

Wha—?!?!

Wow.

Thanks. That would have been slightly important information to have.

I call DHS. They inform me that I no longer have any dental coverage because, since SSI booted me for a math-based loophole, I am about to be moved from Medicaid to a private insurance carrier, and that Medicaid will be covering that premium. (Halle-flippin-lujah! But…wait…what?!)

Unfortunately, this new policy has no dental coverage. I also can’t afford to pay for dental insurance or for out-of-pocket dental expenses since rent, utilities, brain and spine come first, and I’m already having to put those on credit card, so there’s not any money left for my teeth.

No biggie. Right?

I’m already more than a month overdue for my annual cleaning with no solution in sight, and my 4+ year dental infection is becoming crabby again because of it.

But hey. We have bigger fish to fry around here than stupid teeth. Like why the bleep have I had 23 years of seizures, and why won’t anybody test or treat those until I need an emergency CT scan and I start having symptoms that are closer to stroke than seizure?

Why? Because I’m on Medicaid, and I was on the Colorado Indigent Program before that. That’s why.

Same reason why no one—dental or medical—would test or treat that dental infection through what little dental coverage I had with my old Medicaid policy. I mean, pfffft, dental infections are no big deal…right?!

🤨

So back to my brain!

I’m told that, once my (also ludicrous and needlessly difficult) biannual Food Stamp recertification is finished being processed by DHS within the next 7-10 business days, I’ll be receiving a big welcome packet with all the conditions of my new health insurance.

Huh.

Groovy. Why wouldn’t that change happen just before the biggest, longest hospital excursion I’ve ever had?

From: Neuro Portal

The authorization team with Mercy is working on getting your EEG approved and will let us know if they don’t accept your insurance. I really don’t see that being an issue though since our office accept your insurance when you came up here for your appointment.

From: Me

Cool. Thank you! Just FYI DHS is about to do something with my my medical insurance. I don’t understand it because my latest reapplication is still processing so I don’t have the huge packet yet, but apparently I won’t be on actual Medicaid anymore now that I’m not on SSI. So…that should process within the next 10 days.

“Let us know,” yada-yada, we sign-off for now…

Keep in mind, for all my other scheduled tests and appointments in this adventure I’ve received a bunch of portal paperwork, including, “Your estimated cost is: $0.00.”

BUT NOT FOR THIS 5-DAY EEG.

🤔🤔🤔

🧐

Also. As of writing this post, I still have never received that welcome packet for my new insurance.

February 2 - 7

On Friday, I check the mail to find something I’ve been waiting for since August: the bill from Social Security Administration for the SSI Debacle. Since the worst of my neuro-crap all started when I had to deal with this issue last fall, I figured that during my 5 day EEG would be the purrrrrfect time to follow up on, “Heeeeey, so I never received my certified return-receipt from y’all, or any response to the phone calls and letters I’ve sent you trying to get ahold of my new case worker and find out what comes next so…yo, still alive over there?”

The reminder to begin this phone-tastic adventure is even on my calendar and everything!

No need. I finally receive a bill for over $5000. Due in 9 days.

Bwahahahahah!

My already over-taxed, elderly father and I dive into the monstrous paperwork packet required to deal with this. There’s not the time or cyber-space to get into that here today. Suffice to say, it is nearly two inches thick when we send it—also certified mail—and it has taken an accountant, Disability Rights, Legal Aid, and a disability lawyer to get it in the mail on time.

Gleefully, I toy with the silver lining: Heeeeey, since I’m also coming straight off all those medical tests and the Food Stamp Fiasco, my brains will be super splattered when I go to that EEG! So maybe we’ll be able to figure out the source of my brain glitching whenever I have to deal with all this paperwork, math, and audio/verbal communication where I can’t read lips.

Heh heh heh. Hoping I’ll have splattered brains for the EEG? I have noooooooo idea what’s coming down the pipe…

But first we have to backtrack to the overlap.

February 6

Amidst prepping the SSI paperwork, I determine to call Medicaid directly, like I did before I went to my first appointment with my neurologist back in December. I had needed to ensure that an out-of-state specialist would be covered. After a gazillion transfers and hours on hold (at least I got Christmas elevator music for that), I finally reached a super sweet agent who bent over backwards to hunt down this answer before I went all the way up there for nothing or got sacked with a bill I can’t afford.

So I called this handy-dandy Medicaid number again.

THUS…IT REALLY STARTS.

(I’d been cute before when I thought that it had started.)

12:10 p.m.

I call Medicaid.

NOPE, this is a question for my ordering physician. I call my neurologist.

NOPE, this is a question for EEG. My neurologist only places the order and reads the results of the test. I call EEG.

EEG: “Uhhhhhhhh…huh. Well…wow. Yeah, I have no clue about any of that. I think that’s a question for billing.” We share a laugh. Heh. Heh. Heh. “I guess you’re ruling out options…” he says.

Me: still laughing because what’re ya gonna do? “Yup. Thanks so much!” Chirp-chirp-chirp because it’s not the sweet EEG guy’s fault.

He transfers me to billing. Of course this is not the billing direct line so, after I reiterate all my identifying information for the third time, so they can really make sure it’s me (I do actually appreciate that, but FFS) they inform me that I need a totally different corner of the billing department.

Great. Groovy. They transfer me—

The call drops.

Of course it does. But I just so happen to have the hospital direct billing line because of that $200 bill sitting on my account from January 3, still waiting for them to finish processing my annual exam that should have been covered by Medicaid. (Spoiler: it would take over two months and seven different phone calls to fix this issue. They told me it would take 15 days to correct.)

So I call Billing Direct Line. I go through the gazillion phone system options. The ‘bot voice intones, “There are…{SEVEN}…calls ahead of you. Would you like to take advantage of our automated call-back system?”

Would I??

🤩 WOULD I!!! 🤩

Heck, yes, I would! So I do.

7 minutes later…

Billing: Have you talked to Medicaid about this? How about your ordering physician?

Me: *slowly. steadily. methodically. banging. head on. wall.* VOILA! *beaming porcelain Hostess With Mostest smile through the airwaves* Yes. Yes, I have.

Reiterate…reiterate…reiterate yet again where I’ve already been and what I’ve done.

Billing: Hmmmm… *genuinely concerned head scratching* Hold please.

10 minutes and 4 apologies later…

She is still trying to find the right department. Bless her, she tries her heart out so hard! Hey, at least I had groovy classical music with no “Have you heard of our portal? You can get way more done on the website,” cutting in every 10 seconds to interrupt my kitchen dancing and meticulous note taking.

I bleep you not. This incident was so ridiculous and so convoluted that I stopped taking my normal butt-covering and memory-saving notes that I always take. Instead, I started real time detailing every part of this rigamarole, how long it took, how many transfers and on holds I did, because I could see already that I was going to have to issue yet another Formal Complaint.

At long last, she has an answer for me: NOPE. This is a job for “preesert.”

Me: *blink…blink…* I—I need what now?

Billing: Preesert. You know…pre-certification.

Me: Ohhhhh, right-right-right. *smacking forehead* Pre-Cert. Great. Okay. Well, I guess I’m one step closer. Woot! I shall prevail. RAWR! *still laughing because it’s not the sweet billing gal’s fault and she worked so darn hard to find me an answer.*

She gives me the number, apologizes yet again, wishes me luck, and we sign off.

WE INTERRUPT THIS ADVENTURE

…for yet another hour of the latest big psych test I’ve been taking with my trauma therapist. Because, contrary to popular belief, hamster-wheel-round-robin phone calls to government agencies and medical facilities is not actually the most important thing I have going on in my life.

We’d really like to know why my brain is doing what it’s doing. At my last neuropsychologist’s direction, my job is to reduce all PTSD static to clear up more neural pathways. Hence, I got my butt kicked by two years straight of weekly EMDR. That was great for my PTSD reactions and my traumatized heart/mind, but changed nothing neurologically.

So this past fall, my trauma therapist and I embarked on an excavation hunt to analyze my original neuropsychological hardware that had been hijacked by that virus program called TBI.

This means monnnnnths of tests, twice a week.

The first round was for Autism: YUP. The second one was ADHD: YUP. This latest one we just finished was the “do I have a personality disorder or any other red-flag mental health issue that would require more testing and potentially some sort of diagnosis beyond C-PTSD, TBI and this…anxiety/dissociation thing we’re assessing?”

(Spoiler: NOPE. I don’t. Just got the results back.)

(Bonus: so there, and NEH, to everybody who has ever tried to armchair-convince me that I must be “psychotic, sociopathic, histrionic, narcissistic, schitzophrenic” or just “crazy.” Thhhhhpt. Bite me.)

---

So yeah. I did another hour of testing. I really needed to pass out and reboot my brains by then, but business hours were about to end for the night, and I was running out of days. Some of these entities don’t get back to you for “1-3 business days,” so I called Pre-Cert. Confirmed my ID. Again. Reiterated the ever-growing, ever-more-convoluted history of hoop jumping. Again. Only to find out:

NOPE NOPE NOPE. I need to talk to scheduling.

Me: *blink??* Oh! Uh…okay. (They know what they’re doing. Right?)

Pre-Cert: This is the last transfer. I promise, I promise, I promise.

Me: Ha ha ha ha ha ha ha… (I try to make it sound genuine and not full of what I’m really thinking: Yeah, I’ll believe that when I hang up and sigh in relief, question finally answered.)

She transfers me.

“Central Scheduling.”

Me: …

😳

…

Scheduling: Hello?

Me: Uhhhh…I totally thought this was gonna be some sort of special scheduling department for—I’m honestly not sure why I just got transferred to you.

She has me reiterate my ID, DoB, address, phone. Which, for the Dain Bramaged One to remember and get out her mouth on a good day takes Spoons. On a day like this?

Hahahahaha…

At this point, I literally lose the ability to remember my own phone number. Brains start collapsing. Stammer. Stutter. Glitch. Blink. I apologize for my TBI, and tell her what I’m trying to do. Since I’ve already spluttered my DoB and address out, she mercifully asks me if the number she has for me is right.

Me: *in a tiny-kitten voice* Yes. Thank you.

When I tell her the full extent of the situation, she is absolutely blown away and baffled as to why on earth anybody is sending me to Central Scheduling for this issue. So am I. We scratch each other’s noggins over this.

She pours out profuse apologies for having to put me on hold again, but she wants to go into the group chat for all the Leads (supervisors) and get me an answer once and for all. I say no problemo.

I have long since ceased my customary shark-circling through my house whenever I am on the phone for an extended period. I used to pace back and forth with tiptoes on kitchen tile patterns. Now that I have no tile patterns and a perfect oval from living room through kitchen and back, these days I tend to circle.

I mean oval.

But I’m not ovalling anymore. (Is that like Ovaltine but less…liquid?) I’m too exhausted to pace and I’m falling into punch-drunk humor, down there on my studio floor with all my notes. As I near the bottom of each sheet of paper, my writing gets smaller and smaller in the hopes of conserving needlessly murdered trees. Eventually, I have to give up and start a new sheet.

BTW I’ve so far detailed 1.5 out of five—nope, eight sheets of notes.

These sheets only cover the phone calls.

I shit you not.

G’head. You can tap out and just throw this post in the trash. I don’t mind. Kinda how I feel as I lay there on hold again—like I’d been chucked in the trash compacter.

Eventually the sweet scheduling gal comes back, sighing in relief because she has an answer for me: “You need Pre-Cert.”

Me: *blink. blink* 🤣🤣🤣🤣🤣🤣 You’re not gonna believe this. That’s who transferred me to you with the promise that you would be my last transfer of the day.

Scheduling: Whoa. That’s wild.

Me: You said it.

We confirm the number that I had for Pre-Cert. Yup. Totally who she was gonna send me to. With more apologies and the biggest good luck parachute she can send me off with, she transfers me to the super-secret Direct Pre-Cert Line—

It drops.

The part of ME will will now be played by Pedro Pascal:

Welllll…at least I had the Pre-Cert number. So I called it. It was the same gal (woot! what a miracle), and she assured me that NOPE, NOPE, NOPE she can’t help me because this is an in-patient procedure, so I need to call my ordering physician.

I assure her that I have called my ordering physician, and that I have heard—multiple times since my 2 hour EEG back in January—that my neurologist’s office has nothing to do with EEGs because they’re not even part of the hospital system. They are a completely different company who only rents space in the hospital, so my neurologist only places the order and then reads the test once it’s done.

Pre-Cert: All right, I’m gonna do some checking. I’ll call you back.

Me: Awesome, thank you. With my brain injury, I only leave my ringer on when I know that I’m expecting a phone call. Will this be today or tomorrow?

(It is now 2:19 p.m.)

Pre-Cert: Oh, today. I promise, I promise.

Since this is the same gal who had promised that scheduling would be my last transfer, I try to make the laughter that can’t help popping out my face sound pleasant and oh-so amused by this whole thing.

I mean, at this point, I really am. I’ve had to switch into “allowing The Matrix to entertain me with how ludicrous it is” mode, because if I don’t, I’ll either quit (like it wants me to), or I’ll start blowing neurons, and my latest MRI has already shown that I have constricted blood flow inside my brain that is causing further damage. Let’s not make it worse with pumping my blood pressure through the roof, shall we?

Popcorn mode it is!

Me: Okay, great. Thank you so much!

…

😵‍💫

…

3:00 comes. 3:01 goes. No return phone call. I don’t expect one today.

I figure I better let my neurologist know what the bleep is going on. Plus I have questions about…you know…the actual procedure itself.

I mean, it’s a pretty big deal. 5 days straight hooked up to a boatload of electrodes, leashed to a monster machine I have to lug everywhere, while I’m being videotaped and monitored 24-7 by strangers for everything I do except peeing, pooing, changing my clothes—NOT over the head—and cleaning off my nastiness with baby wipes—no water near the ‘trodes, yo. I hear I will come out of this lovely experience with sores all over my scalp. Woot.

BTW I hear this from people who’ve had it done to them, not from any of the medical staff charged with preparing me for this procedure.

🤨

From: Me
To: Neuro Portal
3:05 p.m.

Hi there! My DHS is processed. I have been transferred from Medicaid to billing to pre-cert to EEG to scheduling and back again all day and nobody can confirm that Medicaid will cover all of this procedure.

For the procedure…blah-blah questions-questions-questions…

In the meanwhile, I leave my phone on for my callback from Pre-Cert.

🦗🦗🦗

That night, after I’ve slept a bunch, eaten, and am twitching & drooling in front of the TV, I get a wild hair up my butt. I log into the hospital website to leave a detailed review on the compliments/complaints forum about everything I have been going through to get this one measly question answered.

Both Bella & Beast: OUT.

Zzzzzzzzzzz…

---

At first, I wasn’t going to break this post up, even if it was “too long for email.” I wanted it out of our hair in one ridiculous shot. But then I drafted it. More like, I copy-pasted it into chronological order from a number of different sources. I learned 23 years ago to always record dates, times, numbers, conversation details, and to save EVERYTHING for the next time I have to go up the chains of command to get a resolution.

As this adventure went down, it just became a laughable exercise in the ri-goddam-diculous. At first I was all, “Nah, this story is not really for anybody to READ. It’s just for people to KNOW. I’ll salute anybody who takes the time to skim it because that’s all it would take to realize how ludicrous this is.”

But then I remembered.

Oh, yeah. There are people out there for whom my situation would be a joy ride, so if we can’t even get through mine (I’m eyeing myself in the mirror here, for how badly I just wanna sweep it under the rug and forget about it—lalalalala), then what happens to the ones for whom stuff like this was so bad that they couldn’t get through it and had to quit, never getting the procedure they needed? Or they did push through, but it utterly wrecked them?

It’s gradually wrecking me and my family. In the past year of dealing with this kind of stuff (this is only 1 out of 11 similar episodes since the end of January 2023), all of our health has gone to crap. I can literally SEE the too-rapid aging and toll it’s taken in every one of us.

It’s starting to feel a bit tin-hatty around here.

SILENCE BENEFITS THE ABUSER.

And this system IS abusive. There are far too many people out there who can’t/don’t know how/have too much to risk to tell this stuff like it is.

*waving*

Hi there.

Love,
Your Friendly Neighborhood Squeaky Wheel

Up Next: FEBRUARY 7 AND BEYOND!

© 2024 Hartebeast

---

Why do I have this problem in the first place? Drunk Driver:

You can find all the posts about the initial TBI as well as the current fallout in the Section dedicated to these topics. Here’s a handy Table of Contents for your bookmarking ease:

Or start at the beginning: