It's been a rough week here so far. Yesterday morning, I reached the "just shoot me" phase of this cold (y'know, where you just want it to STOP already), but I dragged myself out of bed at 6:30 anyway to get the kidlet ready for school and then drive him down to the funny car rally that is the parking lot and so-called dropoff "system" for his elementary school.
I had just gotten home and put my PJ's back on so I could go back to bed when the school called to tell me there was something wrong with his eye.
Now, the kid is smart and this is not the first time he's ended up in the nurse's office on a day that Mommy is sick and staying home from work. Because hey, if Mom can stay home by being sick, he can do it too, right? So, I'm sure the nurse thought I was nuts when I said (croaked) "Is there REALLY something wrong with him and do I REALLY have to come pick him up?"
She was probably ready to hand me the "Mom of the Year" award right there.
Anyway, turns out this was for real so back on with the clothes and back down to the school to pick him up and then over to the doctor's office to get his eye checked out. Turns out he had quite a scratch on his right cornea. I could even seen it with the naked eye, but at the doctor's office, they put a special dye on it and then turned on a black light and then you could REALLY see it.
Fortunately, it didn't seem to be bothering him much - he was more interested in trying to take the doctor's stethascope apart. They cleaned it and put a patch over it and gave me a prescription for some antibiotic eye drops and told me he could go back to school.
So, back we went to school and I dropped him off and went off to the pharmacy to get the 'scrip filled.
Which is where it all went so wrong...so very, very wrong.
Now, to be fair, I'm really sick. I haven't slept in probably 3 days. My hair is dirty and stuck up in a clip on my head. I've almost completely lost my voice so I can just sort of whisper/croak at people and then I get to the pharmacy only to have them tell me that my insurance will not cover the antibiotic eye drops and do I want to pay $82.50 for a bottle of drops that's about the size of my little finger.
Ummm...that'd be a NO.
I whip out my trusty cell phone and call the insurance company certain that this is some kind of mistake whereupon they tell me that I had to get "pre-authorization" from my doctor.
Okay...news to me. Never had to do that before. Haven't changed insurance companies. Doesn't the fact that the doctor PRESCRIBED this medication mean that he authorized its use? Plus, not like I'm going for experimental cancer treatment or anything. Antibiotic drops. For an eye injury...seems obvious to me.
At which point the ditz on the phone tells me "well, this is the agreement that Garden Grove School District made with our company."
HUH? I don't work for or have anything to do with Garden Grove School District.
I should mention at this point that my croaking and coughing on the phone is getting louder and the other pharmacy patrons are starting to edge away from me and yet still stare at me in horrified fascination.
And then it happened.
Little ol' polite (doormat) me who NEVER makes waves snapped and said "I want to talk to your supervisor because I don't think you know what you're talking about."
Holy crap! Did I just really say that? To a person? That's it, I'm going to hell!
And yet...the supervisor came on the phone and authorized the payment. Poof! Like magic. It's amazing what they will do to get me, the crazy person, off the phone.
Or, it might've also been the part of the conversation where I said "if you don't authorize this and my son gets an infection in his eye and goes blind I am SOOOOO coming after your company."
Yeah, apparently once I open up a can of backbone, I can't be stopped.
And I was feeling really good about it - like I slayed a dragon or something and then I came home and saw this. Zicam is the ONLY thing that clears out my sinuses. And I haven't noticed any impact on my sense of smell. In fact, if I have to trade a sense of smell for, y'know, the ABILITY TO BREATHE, guess which one I pick?
Win some, lose some, I guess.
I HOPE to be back to beady normal around here tomorrow. I've got to turn the corner and feel better soon, right? It's been five days.
For the contest winners - I've got your e-mail addresses and will be contacting you shortly so I can get the packages out to you.
For Sue who asked about becoming a Rings 'N Things Blog partner - they just asked me to do it. You might try e-mailing them and asking if they need any more bloggers at this time.
Hope everyone is having a good week!
KJ
13 comments:
Good for you for standing up to the mean ol' insurance company...You had quite the adventure!
I saw the story about Zicam earlier today - I've never used it, but, ask your doctor about Nasacort or something like that. I have to use it year round for my allergies, but my doctor tells me to be ABSOLUTELY sure to use it when I am congested and sick...
Oh...my...gosh! That is SO something that would have happened to me! Good for you for letting loose and getting those drops covered! Eye's are nothing to mess around with! Must have felt really good to open up that can of "Backbone", as you called it! LOL! Awesome, good for you! Hope the eye heals quickly, and that you are on the mend soon! :)
. . . wishes for quick recovery . . , peace for all
ROFL that is AWESOME!!! I love it! I have to say if I was in there with you I would have been cheering you on, not backing away. I hate it when people walk all over you, like they have the right. Insurance is sooo much easier in Canada.
Feel better soon :)
Hugs
Marie
Hello Kiddo,
Just a couple of tips, hopefully helpful :) When ever you need to deal with your insurance company, always ask to talk to the manager straight away. The phone back people go by scripts and can not deviate from them. They also have no authorization authority.
The bad news is Viruses have a life span of 7-10 days. There is no cure for them they just have to run their course. :(
Nasacort is a medication used to treat allergies it really isn't effective for treating the common cold. Zicam uses zink which some studies have shown will reduce the symtoms and duration of viral colds. It's the zink (a metal based chemical) that is causing the loss of the sense of smell. The loss of that sense is nothing to sneeze (oh now that's one BAD pun!!) at. You might want to check with your dr. on what you can use. Also if you have a local friendly pharmasist they can offer suggestions also.
Lastly, fill the tub full of wonderful bubbles, fix a lovely cup of hot tea with lemon (and a splash of brandy if you like) grab one of the new Somerset or Victoria magazines Slide into the tub of bubbles and spend a half of an hour of me time :) Can't cure anything but it's sure makes thing all the more tolerable :)
Feel better soon, be proud you "dun good"!!!!
Pattie (dr.Mom) ;)
Mazatlan Mx.
That's awesome! Sometimes insurance companies just need a big ole can of whoop ass taken out on them! I hope you feel better soon!
I hope you feel better soon - good on you for speaking up. How annoying is all that insurance stuff in the USA - it must be such a pain (excuse the pun) when you are poorly.
I hope you feel much better real soon!! That was a great post, I read it out loud to my husband! :)))
Im sorry to laughing at your misery...My son has done that when he knows Im home sick to pretend sick to get a ride home...And I too have won the mother of the Year award....I ask..Is running a fever over 100, or throwing up and u have seen it?...They say No...I say give him a Tylenol i left with you to give and send him back. So no guilt for asking....My son will be 16 next month...LOL
Sonia ;)
you poor thing, why does everything have to go wrong when your sick? i'm glad it worked out and hope you are getting the rest you need.
i too have been very sick and finally dragged myself to the dr. yesterday. i hope the meds will make me better now, :)
You and I should have found a hotel room with maid service to check into for the last week. At least the dogs haven't required me to go out in public! I'm *thinking* that tomorrow I may make a stab at the whole shower thing....I've been in bed since Saturday.
As for the Zicam thing...homeopathic remedies can cause the very symptoms that they're designed to heal. They're not risk free. But given the dosage that's in Zicam, chances of it harming you are so low as to be laughable. But since they don't have to cough up $$ to the FDA, of course they're dangerous.
You know, 14 dogs treated homeopathically to health in 10 years can't be any sort of fluke.
At Kaiser, the patient now has to take the lab samples to the lab...which is unsigned on a Saturday. When did that start? Hello? Me, sick person....you health care provider? Thank goodness Sean was with me to find the lab on the lower level of the facility to drop off the throat culture!
Kelly,
Funny-- I just paid $80.00 plus for what I'm thinking is the same tiny bottle of antibiotic eye drops. I too was told flat out "your insurance company does not cover this prescription." I should have taken a lesson from you and taken it further. It's a tiny vial inside a small pill container! Yikes!
You go girl! Hope you feel better soon!
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