Dealing with Medical Bureaucracy

[semiotic_pirate]

What I've begun to deal with since the beginning of the year, a series of tests, discussions with my doctor, multiple appointments, poking, prodding, and escalating pain related to menstruation. Right now, I'm on tenterhooks, waiting to find out the results from yesterday's biopsy. All this time, until this morning, I hadn't quite connected all the times I've been told "it is likely fibroids, but we'll be checking just to make sure" to the possibility that it might be something worse than fibroids.

As a result of the above, prior to today my subconscious has been increasingly interfering with my ability to focus on work. Today, with that contemplation moving into my conscious though process, I barely got anything done. On top of that, today was the day I had to talk with my manager and with the human resources representative, I also made quite a number of phone calls to my doctor (who's going to be the surgeon,) the hospital, billing with the surgeon, billing for the hospital, finding out that the surgeon fees are paid up front and are billed separately from the hospital, finding out that the hospital room charges, lab charges, anesthesiologist, and who knows what else are all billed separately.

With what I've got as a deductible (HDHP) and what I've got squirreled away in my HSA, I'll be able to cover the surgeon's fees, but I'm going to have to wait a week or two before I will be able to strong-arm the hospital to put what little is left to pay toward my deductible on a payment plan - because given the scheduled and immutable contributions that are automatically deducted from my paycheck and sent to the HSA, I'd have the remainder of my deductible paid in full. All charges beyond that are paid 100% by my HDHP.

I also made a call to the insurance company to "pre-certify" the procedure (which is required for inpatient procedures only and from what I've gathered via research this will result in 2-3 days in hospital.) They got me set up within minutes and certified me for five full days in hospital and was assured that more would be covered if necessary by my doctor or the hospital. That was reassuring.

The discussion with my manager and the HR person... was quite a bit more nebulous. I presented my plan to go in for surgery (I revealed what it was for to the HR woman but not my male manager) followed by taking a week of annual leave (paid vacation) followed by up to two weeks of working from home (which I expected to be approved without an issue, if I was lucky.) Instead of getting a rubber stamp, and why would I have an easy time here with this after prior experience. So. Before I can get approval for this, I need to fill out FMLA paperwork that HR will provide me tomorrow and any other documents that will be sent by the doctor in relation to the FMLA paperwork...

So the journey continues. If things work out in my favor and I get all my ducks lined up, I'll be able to approach the procedure itself in as relaxed a state of mind as is possible for an event of major surgery.

What's left to line up and/or wait for:
*Double check and confirm that this is an inpatient procedure, the packet the Doctor's office sent me was put into the mail prior to yesterday's appointment and the decision to go with a more complicated procedure than that originally contemplated.
*Getting results for the biopsy - attempting to better concentrate on my work in the interim because I'm still waiting on getting my annual review completed. Yay! Another source of stress!
*Wrangling the hospital billing people
*Navigating the FMLA process with HR

Wish me luck.

Comments

[ann-mcn.livejournal.com]

Several years ago, I had a small lump in my breast, and no insurance. It totally took over all my thought processes, while I was trying to get a doctor to agree to see me without insurance. I was very afraid of something fast moving (my mother died of lung cancer that had metatasized throughout her body before it was diagnosed), but the very helpful young female doctor who did see me (needle biopsy, only fluid), said that AFTER she got out of med school, she learned that breast cancer is nearly always very slow.

Anyway, this was different from your situation, and was meant to illustrate that I understand the inability to focus.