3. American Health "Care" Strikes Again!
My 5-day EEG: Bogus. Heinous. Non-Triumphant--EXCELLENT!
CONTINUED FROM:
February 12: DAY OF THE EEG
3:34 a.m.
Bing! Awake because I have to pee. I hang out in bed until I hear the Parentals stirring at 3:45. The snowstorm that was supposed to pound us overnight hasn’t hit. But it is coming now. We watch the weather, scour the radar, try to anticipate what it’s going to do. We call road conditions and the hospital. It’s not doing much up in Missouri yet.
As the snow begins to pile up outside the house and we see that the storm’s trajectory will follow us all the way to the hospital—and potentially create a mess for my elderly parents as they try to get back home to Arkansas—Dad makes the decision at the do-or-die hour: he’s not willing to risk that drive, especially when my admittance into the hospital isn’t even a sure thing.
I call the hospital back to tell them we can’t come. I’m transferred to four different places before I finally learn that I won’t be able to officially cancel until 7:00 a.m. when the neuro floor opens, and I won’t be able to inform my neurologist until 8:30 a.m.
Which I do.
But only after being transferred three more different times, even though I supposedly knew which direct numbers I needed to call.
NOPE.
I’m informed that my neurologist’s office will call me to reschedule the EEG.
Groovy.
So I enjoy the heck out of a luxury that does not live in my house—donuts. Then I crash out for a couple hours. I awake to find a response from my Hail Mary portal message to the Department of Human Services.
From: DHS Division of County Operations
To: Drooling Monkey Girl
10:23 a.m.
Due to the big ole Confidentiality Clause at the bottom of these emails, I’m not going to risk copy-pasting the literal messages to y’all who are “not the intended recipient.” To sum up: she tried calling me back about my Hail Mary message—the next day even!!!! 🤩 Then asks if I’ve tried calling Medicaid Billing to see if my appointment has been pre-authorized.
From: Girl Monkey Drooling, pretending to be a Chipper Chirper
(Say that five times fast)
10:29 a.m.
Hi there! Sorry I missed your call. I’ve been on the phone all day due to having to reschedule the EEG due to snow. I have no idea anymore who at medicaid and the hospital that I’ve talked to over the past 2 weeks, but I am thrilled to have that number to Medicaid billing itself.
I was told that this procedure would not need pre-authorization, but yet the hospital keeps insisting that Medicaid can’t guarantee one way or another in advance that they’ll pay or not. Whereas Medicaid told me that they could—or rather, that they could tell a PROVIDER, not me, that information. But I can’t get anybody in the Hospital system to make that phone call to the Provider Line.
Bonus to the snowstorm, at least we didn’t have to go up there for nothing, and now I have way more time to sort this than the 2 weeks that was apparently too short of notice to get this one question answered. Hahah!
Thank you so much for getting back to me so quickly!
Later:
Uh wow. That number told me to contact the number on the back of the insurance card and then hung up on me.
She apologized and sent me a different Medicaid Billing number.
👍🤪👍
Only two good things come out of having to cancel that EEG. It gives me more time to figure out WTF with this whole Medicaid fiasco, and it allows me to zip into the local hospital and have my aching, muffled ear flushed. Lo and behold, it is, in fact, jammed with gunk. She floods it with bright pink liquid stool softener until I can barely remain sitting upright I’m so dizzy.
Ahhhhhhh…blessedly, I can hear once more. Dad takes me home. I keep everything packed because I have no idea how soon they’ll want me to come up to Missouri.
February 13 - TRASHED TUESDAY
Twitch. Drool. GarbbbleGrabbleBabbledyBlah.
Therapy session. Joy. My trauma therapist gets to see me on a five-alarm bad brain day. I keep having dizzy spells when I’m just sitting there. I hope it’s my ear. I hope it’s my ear. I hope it’s my ear, not my brain again, lalalalalalala…
I totally space that I was supposed to call Medicaid. Oh well. Screw it. I deserve a break, and now I have some breathing room.
February 14 - HAPPY V-DAY!
10:11 a.m.
Call Medicaid. Learn I was given false information: NOPE. Actually, the Medicaid Provider Line is only for claims that have already been submitted, NOT for my situation. Same is true with this entire call center.
They kick me back to local DHS.
Again.
To: DHS
From: Me
10:26 a.m.
OK I called Medicaid. They are sending me back to you guys. That number is just for the call center, she had nowhere to transfer me and said I need to ask my local DHS office and get my provider to send in an authorization request.
The hospital where I’m having the test done says they asked and “no pre authorization is needed” yet nobody can confirm if this test will be covered or not. Since I can’t even pay my utilities right now, it has to be guaranteed covered because I can’t sign financial responsibility if I’m living on credit cards I already have no way to pay off. Plus I already am battling a $200 bill Medicaid should have covered—my annual exam.
I don’t know where to go from here. Thanks!
Poor DHS gals. Poor Medicaid gals. They were so sweet with me, but this is soooo not their job.
February 15 - HAPPY-THKIPPY THURSDAY
From: DHS
To: Me
11:55 a.m.
She tells me that she’s been speaking with someone else about my glorious adventures. She also advises me to get it in writing from my doctor that preauthorization is not needed. She says DHS does not contact medical providers, asking them to submit pre-authorization. Those are sent to ensure payment.
From: Me
1:03 p.m.
Will this do it? This is not my provider. This is from the hospital patient relations:
SCREENSHOT FROM PATIENT RELATIONS PORTAL STATING THAT “AUTHORIZATION IS NOT NEEDED FOR THIS PROCEDURE.”
🦗🦗🦗
February 16 - 18
🦗🦗🦗🦗🦗🦗🦗🦗🦗
I…whoa…
Something miraculous happens. Drumroll…I’m in the kitchen when the urge strikes me. Dancing! I try out a few little moves. My torn meniscus doesn’t tell me to piss off by micro-tearing like it’s been doing—sometimes just from standing there—since August when my brains started going to crap under the Dental Fiasco and 3-Front G-Men Bombardment.
To my utter shock, The Ginormous Dance Project tackles me and demands that I play with it again for the first time since my knee demanded that I pause dancing on it! Good thing my jaw has been realigning, because I have to scrape it up off the dance studio floor. So I pull out a veil. I pull out a big skirt. I play with them!
And it is good.
Gee, it’s amazing what happens when I don’t have to spend the entirety of my limited time and energy doing medical crap and battling The Matrix. I once again become capable of…you know…the things that used to be my career? The things I was born to do?
Because this crap ain’t it.
🎶 That ain’t it, kid.
🎶 That ain’t it, kid!
February 19 - McSqueaker Monday
From: Squeaky McSqueak Toy
To: Neuro Portal
8:21 a.m.
Hi there! Just making sure that y’all got a message from my gazillion phone calls around the hospital last Monday morning when snow prevented us from driving up for my EEG. I assume this will be rescheduled? Thanks!
From: Neuro Portal
3:59 p.m.
You can call {EEG NUMBER} and reschedule that. If you need anything please let us know.
4:38 p.m.
I call EEG.
NOPE. Because this is a 5-day stint of video monitoring, I will need to set this up with the neuro floor of the hospital, therefore it’s actually Neurology that I have to go through.
I shit you not.
I—
They—
Why—
Talk about the eternal game of playing “Not It!” I mean, I am not the first 5 day EEG this office has ever done. I can’t be! I’m not. So what the bleep, over?
Annnnd of course, Neurology Main closed eight minutes before I called.
In other news, earlier that day:
From: McSqueaker
To: DHS
8:23 a.m.
Hi there. Doing my Monday morning message checking and I’m seeing that my screenshot of patient relations portal message saying I don’t need pre-authorization may not have gone through. It looks different from the others. Did you get that? Thanks!
From: DHS Auto-response
She’s going to be out of the office until Tuesday, February 20.
👍🤪👍
February 20 - TACO TUESDAY
And yes. I do eat tacos. In fact, I eat tacos all week because there’s only one of me here, so I get them ALLLLLL!
✨👹✨
To: Performing Monkey Girl, Jumping #AllTheHoops
From: DHS
8:30 a.m.
After a pleasant salutation, she informs me that she didn’t see my email with the screenshot in her inbox, but that this does not guarantee that it wasn’t sent. I can guarantee that it was sent because I’m looking at the time-and-date-stamped copy of it in my Sent Folder.
I’m also looking at the copy chain of our entire conversation at the bottom of her message, in which it’s right there. So obviously it’s the message she replied to.
Me: …
🤨
…
Do you have any idea how often DHS loses my paperwork? Loses my change of address notification? Loses my tax return? Never receives my messages? Marks my stuff as late even though I turned it in on time?
It’s a chronic problem over there.
This problem loses me my food stamps for months on end, too. About every 18 months, this happens like coincidental clockwork. How convenient for them to get to shuck me for a few months and never have to back-pay me for their own clerical errors.
Moving on…
To: DHS
From: Monkey Girl Performing with her smile propped up by crutches
Hmmm…actually your reply has that message copy at its bottom. This is the screenshot I tried to send you, asking if getting this “no authorization needed” is enough from patient relations, or if it has to come only from my provider. If Provider Only, which one? Because my neurologist keeps saying they’re not the provider, and EEG dept. keeps saying they don’t handle anything except the actual EEG. So is patient relations good enough? 🤪
SCREENSHOT FROM PATIENT RELATIONS PORTAL.
AGAIN.
🦗🦗🦗🦗🦗🦗🦗🦗🦗
In the meanwhile, I call Neurology, which sets off another round-robin rabbit-hole of phone calls:
From: Chipper Chirper Cheerfully Chipping Away
To: Neuro Portal
2: 41 p.m.
Hi there! Me again. I called EEG yesterday. They said I had to call Neurology to reschedule. They were closed so I called today. They sent me to Sleep Lab who assured me I needed to schedule through your office. I assured them you guys had sent me to them—for the past 3 weeks for this rescheduling and for the fiasco trying to find out if Medicaid will pay for this. (Which I’m still trying to find out, after going rounds with half the hospital staff, billing, pre-cert, patient relations, multiple Medicaid offices, and now DHS.) Hahaha!
Since the portal can't do emojis and they can’t hear my “pleasant” chirping, gotta type the “laughter” in there, or use old school emoji mojo, don’tcha know. ;P
So Sleep Lab told me to send you a portal msg and then just sent me back to EEG. I just left them another message. Since nobody will reschedule this for me, are you guys able to call them and find out why? Thx!
2:43 p.m.
My neurologist’s office calls me to say that they’ve rescheduled the EEG!!!
PHASE 1: Ecstasy!!!! Leaping for joy! Woot! Triumph on one friggin’ front!
PHASE 2: Chill. Breathe. Relax. Celebratory food.
PHASE 3: Wait a second… TWO MINUTES? From the time I sent that portal message to the time when you informed me that the EEG was rescheduled and gave me the new date, it took you
TWO MINUTES?!?!?!
PHASE 4: *sucking my teeth* Mmmmm-hmm. I see.
PHASE 5: Crap-crap-crappioka pudding! I forgot to ask about the Medicaid fiasco!
PHASE 6: FuckItDuckIt. I’m done for the night.
February 21 - WOOT WEDNESDAY
Another desire to dance—woot! Unpack my suitcase since it’ll be some months before we do the EEG. Check to see if I’ve received a reply from DHS yet.
🦗🦗🦗🦗🦗🦗🦗🦗🦗
February 22 - THQUEAKY THURTHDAY
To: DHS
From: That Annoying Friggin’ Monkey who will just not go away
4:03 p.m.
Hi there, just checking back with you again to confirm that the “no authorization needed” coming from Patient Relations instead of my provider is enough to ensure that Medicaid will pay for my 5 day EEG. Thanks!
February 23 - FRIGGIN’ FRIDAY
DHS gal expresses her frustration over the fact that she apparently doesn’t have up-to-date info on all this stuff since all the numbers she’s tried to provide for me aren’t working. She tries one more—the Medicaid Resolution Center.
To: DHS
From: Burnout Monkey
8:11 a.m.
Morning! Thank you so much for not giving up on me! Yeah, apparently they don’t like to give this information out. Alas, I’ve already talked to resolution center. Since I haven’t yet had the procedure, they can’t bill for it yet, which means I have no case to resolve.
Sooo…I mean, there has to be a way to find this out. I can’t be the first 5 day EEG they’ve ever been billed for. 🤪 Thanks!
Tacos are gone. But I do have egg-n-veggie-bake slathered in peppery, creamy gravy awaiting me. I feed the Beastie and…another drumroll…actually read a novel with pretty decent success at remembering what I read the day before!
February 24 - 25 - WAHOO WEEKEND
🦗😴🦗📖🦗💃🦗🥰🦗
February 26 - JUST ANOTHER MADDENING MONDAY
To: DHS
From: Squeaker McSqueakin’
4:30 p.m
Hi there, just checking in if you’ve had any luck finding out where I need to go next. Maybe it’s time to send me to a supervisor. Everybody at the hospital seemed to have to. 🤪 Thanks!
February 27 - TRIUMPHANT TUESDAY!
9:28 a.m.
The gal I’ve been emailing with from DHS calls me. Whooaaaa… She tells me that there is absolutely nowhere else she has to send me. Heinous. There are no supervisors from DHS who can help with this issue because it’s just not their department. Which we know. Dude. Most non…NON-bodacious.
Apparently Performing Monkey Girl is so understanding, sweet, and yes, entertaining, that DHS Gal tells me, “Wow. You have such a great attitude. This is ridiculous. I would be…mmmph...”
Her ellipsis says it all.
Me: Oh, you should see what I write in my journal. And you should see me unload on my punching bag before and after I make these phone calls. I mean, it’s not your fault. This is soooo not your job, and I just cannot figure out whose job it is.
DHS Gal: *steam engine of her brain working so hard I can hear it through the phone waves* You know what…? Hold please.
I pause shark-circling my house to tippy-toe my twinklies across the un-patterned tiles of my kitchen, in time to the on-hold elevator music I can sing by heart now. I also sing along, wondering if perhaps all those psych tests were, in fact, incorrect. That maybe by now I really have gone off the—
“Medicaid snarflge-grabble.”
Me: *blink-blink, poised on one tippy-toe* Uh… *heel thumps down* Hi. I guess I got transferred from DHS…? Did she explain the situation?
Medicaid SG: She did.
My heart purrs a little harder than it already was because there’s so much compassion and genuine desire to help in her voice, too.
Unfortunately, she can’t help. Because this is not her job either.
We have a conversation about all the things I’ve tried, my coverage, authorizations, medical necessities, ordering physicians, messages I’ve received. In the end, she is quite testy—not at me, but at the fact that the hospital will not give me a definite YES or NO this WILL or WILL NOT be covered.
In the end, the best advice she has to offer me is to “go back to Square 1 with Hospital Billing.”
…
😳🥺🥺
*tiny-kitten MEW*
…
*tiny-kitten voice* “Okay.”
She’s super sweet. I thank her profusely. She massages my shoulders like a boxing coach at ringside and fits me with a brandy-new parachute of good-luck as she regretfully boots me out of the entire DHS and Medicaid airplane, once and for all.
Amidst my plummet back the hard, hard ground, I am Bill S. Preston at the bottom of the stairs over Ted’s fallen armor, because I just do not have it in me to start all the way over.
It is Bogus.
It is Heinous.
It is…
I mope.
I feed my face.
I take a nap.
I haul myself back up to the kitchen.
There on the counter lurks yet another bill from the hospital, telling me that I still have that $200 sitting on my account, even though way back in the middle of January I was informed that Medicaid totally should have covered this since it was nothing more than a standard annual exam with my primary doctor. So I slurp down some coffee, roll up my sleeves, and figure that maybe I can at least get one thing checked off my annoying to-do list.
I call Hospital Billing for the umpteenth time on this issue. Go through the long, convoluted phone system, only to hear from ‘bot: “There are {TWENTY} callers ahead of you. Would you like to take advantage of our—”
Beeeep.
“To confirm this is the number you would like a callback—”
Beeeep.
I wait. They call me back. Halle-flippin-lujah for automated callback systems!
By the time I talk to the billing gal, I’ve wrangled back enough coffee-spoons that I can easily rattle off my ID information to confirm that I am who I say I am. It takes her awhile to read all the notes that have been left in my file about this issue. She agrees that this is ludicrous that the bills is still on there, and kicks it back into the work queue. “Is there anything else I can help you with today?”
*gulp*
*shrug?*
What the heck? I’m already on the phone with billing so why not start back at Square One like Medicaid Gal suggested?
“Yes. Actually there is.”
Apparently there are copious notes in my file about my EEG/Medicaid issue, too.
Whoa… Notes that are not penned on my eight sheets of blue paper? Sha-weet!
BUT THEN…
🍗🥁 DRUMROLL 🥁🍗
She makes a suggested number to a department I have never heard of. Never, ever, not once. This mysterious and magical place is called “Pre-Registration.”
Not “Pre-Certification.”
I spy one tiny beam of sunlight and haul my carcass up to chase it. I call. I don’t even care that I have to go all the way through the whole hospital phone system in order to find it. Alas, they cannot help me, but they have a suggestion—another enchanted land I have never heard of.
It’s this place called, “Insurance Verification.”
Now that sounds like exactly what I need!!!!!
Lo and behold, it is.
Insurance Verification Gal describes exactly why the hospital can’t make any guarantees—because they have to cover their butts with how often Medicaid randomly denies stuff or makes a problem. She says that what I need is the letter stating that this is something Medicaid customarily covers and my estimated amount due, which should be $0.00
You know, like I’ve received for every other procedure prior to this one.
Good, good.
Exxxxxxcellent.
Now I just have to wait for the email notification of when that hits the portal, like usual.
Only one problem left.
Me: So…what happens if I just happen to be one of those oddball people who gets denied by Medicaid, and I wind up being saddled with a bill I wasn’t supposed to have to pay, and that I can’t afford? You know…like I do right now for my routine annual exam? Because I am currently living on credit cards just to pay my monthly expenses, and I’m disabled with no idea when that might change.
Insurance Verification: Oh. Well, have you applied for Hospital Financial Aid?
Me: Uh…no…? *that also sounds ever-so-magical!* But I will now.
And so I do.
And lo, I was accepted without even having to send them “additional information.”
Ya think?!
But at least my job here is finally done.
Okay, I’m wrong.
March 6 - WTF WEDNESDAY
After checking my email and portal for the umpteenth time in the hopes of spying that estimate, I call Insurance Verifiers again. Ready for it? Drumroll…There are NO NOTES about this in my file.
…
🤨
*back to sucking teeth*
She has to have someone call me back. Of course she does! But for once, I do actually receive a return phone call from a very nice Insurance Verifier who explains that she can’t send me this estimate until it’s in her system because my EEG is scheduled months out.
Yes. This makes sense. I never received the other estimates until shortly before the procedures so I thank her and enter a calendar reminder 1.5 weeks before the EEG to call them back if I haven’t seen it land in my portal.
NOW my work here is through.
Sometimes to get the triumph, it takes too much time and tons of tenacity. And it takes “Being Excellent To Each Other.”
So now at long last, I get to “Party On, Dudes!” Because I have Substack posts to write. And novels to read. Novels to write. And I have a dance project poking me between the eyes as costumes try to snag me whenever I pass them on the way to turn on my electric blanket.
Costumes: Put us on. C’mon. You know wanna. It’ll make you feel good…good…good…
Green screen backdrop: Psssst!
Green screen floor mats: Yo. Performing Monkey Girl.
Dance music: Come play with us.
Me: *propping my eyes open with toothpicks…grinning*
© 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: