Wednesday, November 13, 2013

Hope there's no change and hope that there is.

Well folks, it was about that time again, it was time for my cancer check-up to make sure I still don't have it (the cancer). Two days ago I got a call from a very sweet sounding lady that told me that the CT scan that was on my schedule wasn't approved and therefore wouldn't be covered my insurance. She asked if she could have permission to cancel it, which I hesitantly approved. CT scans are expensive (everything medical is) and considering I typically haven't had them in recent check-ups I wasn't all that concerned about it. What was concerning was that it sounded like it was the insurance company that was making that decision by forcing my hand.

I've been a pretty busy guy these past several weeks and the next couple days were no exception. I could take care of it once I got to MD Anderson. Granted this was much to the chagrin of my lovely wife who had requested I call yesterday... whoops...

After driving into the ever wonderful Houston traffic I was at least able to start off with my ultrasound which went quickly and normally and with no abnormalities. Mission accomplished started. I called my insurance provider and asked them why they had cancelled my CT. They were surprisingly helpful. The lady on the other end of the phone looked up my information and after a brief hold came back to explain that they didn't actually deny the procedure. In fact, she said, they don't deny procedures... unless they're medically unnecessary. This sounded a bit off because the end result, and the obvious answer really, is that insurance companies do in fact deny procedures and there's no need to beat around the bush about it. In any case, from her records, it sounded like the CT was cancelled at MDA's side which I confirmed with the caveat that they had said it was because of insurance being denied.

Are you confused yet?

By this time another issue that I'd brought up when checking in at the ultrasound surfaced. In the process of canceling my CT scan, somehow my x-rays had been bumped to after my appointment with Dr Lewis. What then came to my attention to me upon closer inspection was that the x-rays were not only an hour after I was to meet with Dr Lewis but also tomorrow.  Considering that I'm sure she'd like to see my test results before our appointment and not after (also I was not going to rocket-run back and forth from Austin again) I'd asked whether my x-rays could be done earlier. They suggested going down to the diagnostic imaging center and just checking in because they can normally just slot patients in as soon as they were available. That's what I did and that's when the other issue popped up.
Apparently there was some block on my "account" that was preventing them from moving the appointment and checking me in for the x-ray. The receptionist said I'd just have to come back tomorrow... or call up the Sarcoma Center's business center. I called them up and a gentleman did notice a hold on the account, whatever that meant, and cleared it up. Apparently it was a glitch of some sort. Yay!

I headed back to the diagnostic imaging clinic and, low and behold, they were able to fit me in! The standard scrub top was given, I faced the forward, breathed in, breathed out, breathed in an held, then repeated the same on the side. Chest x-rays done. But what about my hand? The x-ray tech lady seemed to think we were done. I asked about the hand, she checked with her supervisor, he confirmed it wasn't on the order. They double checked and confirmed it wasn't there, telling me I should go to the Sarcoma Center in the Main building because they'd have to order it and there is a diagnostic imaging clinic there too. Ok.

A brisk walk through a number of corridors and the Skybridge later...
I arrived at the Sarcoma Center and thankfully found no wait to talk to the receptionist. I explained my plight about possibly needing the hand x-ray and she told me it wasn't necessary because I had gotten the ultrasound of my hand and with the chest x-ray that was all they needed. This was still not quite satisfactory considering that all these changes had happened a mere two days before this appointment and it all started with a phone call that was saying insurance denial was the reason for the first cancellation. Regardless, logically it seemed to make sense that an ultrasound would be sufficient for the hand and that an x-ray would be sufficient for my chest. The key issue was the way in which things had changed up and the stated reasoning. So I wait. My appointment with Dr Lewis is coming up and she'll be able to clear things up definitively as to what is necessary and what is not. Ultimately my trust is not in the medical system anyways, I'm just letting it be a tool.

side rant/

All this does bring to light the fact that there are some really stupid things going on with the healthcare system in this country. While we do have amazing and dedicated healthcare professionals, amazing technology, and continuous innovation, there are ridiculously confusing billing processes and relationships between those healthcare providers and insurance companies. 

All I know is that the way healthcare providers bill, sometimes reflecting insurance coverage, sometimes not, sometimes partially, sometimes mistakenly just plain screwy. We've wound up overpaying, accidentally underpaying, once getting a bill go to collections because it looked like it had been covered after all...  it is nuts. 

So far every plan that I've seen, including the embattled ACA is equally flawed, just in different ways and it is frustrating. We have a healthcare system with strengths but I don't like calling it the best in the world. The billing/invoicing/insurance part is the worst I've ever encountered personally. I hope there's reform but definitely don't like the gist of the ACA either. I have a feeling those reaping the massive monetary benefits from a service people don't price check and find vitally necessary are playing two sides off each other to create confusion and maintain a favorable system for continued massive profit. Somebody please break through that, I'm happy to help. 

/side rant

Turns out it's been an all around rough day at MDA... Just checked in to my appointment with Dr Lewis only to find out that she's not feeling well and neither is her right-hand associate Gina, both of whom are out today. I still get to see another of her associates so all is not lost but it does potentially throw a wrench in the amount of clarity I'll be getting about the scheduling and testing changes. I got to see the same associate that had taken out my stitches almost exactly 3 years ago and she assured me there would be a total review of the needed tests just to be completely sure and that I should get a call from Dr Lewis or Gina. She confirmed that the chest x-rays and ultrasound looked good and that I should be just fine though!

So the takeaway today is that there seems to be no change where we wanted it and I'm not going to touch the other matter again 'cause it's been a long day. Good night!

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