I’ve repeatedly said, “Managing a chronic illness can be as time consuming as working a full-time job.” Do you agree? Round the clock involvement, treatment schedules, prescriptions, side effects, routine and follow up medical care, secondary illnesses, pain, unexpected down time and emotional stress are just a few of the daily/weekly/monthly obstacles.
As if managing the illness itself is not enough, there’s the administrative side of completing, organizing and filing paperwork and health insurance claims (which in my case requires it’s own filing cabinet). Being the patient who lives with the disease daily is hard enough, but factoring in the frustrations associated with denials, appeals and jumping through hoops can send a (relatively good) person over the edge.
Being a professional patient with almost 25 years of chronic illness experience, I’ve had my share of battles with benefit companies who were contracted to be on my side, yet made decisions about my care that were clearly not in my best interest. Changing treatments, having surgery or being diagnosed with additional illnesses is not something I look forward to or celebrate. In fact, it’s discouraging and often raises questions about self worth or continuing the fight. To be denied is like being kicked when I’m down. It makes me feel vulnerable and defenseless while stirring emotions, rage and anger that is not healthy for a body already under attack.
Several years ago, after being denied required hospital care because an insurance auditor randomly chose my case for review, putting all treatments on hold for an indefinite period of time, emotions got the best of me and I snapped.
After spending days on the phone pleading my case with the support of my medical team, I was told in order to expedite the process I’d have to take legal action, adding weeks of waiting to an urgent situation (not too mention another expense). Feeling helpless and defeated, I reacted and spoke out of line, making matters worse. My comment was considered a threat since it was first person and contained the words, “… going postal on your office …” Fortunately, the police officer who immediately called to assess my state of mind was understanding and did not feel the need to pursue action.
In my blog, “Health Insurance” (3/30/09), I questioned the qualifications of those with the power to deny coverage. Colleen posted, “Contact your Congressmen ... If you have a Congressman who will help you, it works fast!”
How do you respond when you see the word, “Denied,” knowing the claim IS medically necessary? Have you reacted because of emotions then had regrets? What actions have you taken to reverse a denied claim? Does contacting your Congressmen get results? If so, how long did it take?
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