Re: Fwd: Tired all the time

[Guest guest]

Thanks Val !!

I was hoping to have my UAE done this month, but the insurance company will

not pay for the procedure at all. I am looking forward to having more energy

again though when I do finally have it done. I have opted for the UAE

because of the recovery time (which I hope will go quickly for me). It's

good to talk to someone who has had a successful UAE, because there are many

people out there (including many GYNs) that have only negative things to say

about the procedure.

Debbie

[Guest guest]

No, the insurance won't pay for the procedure no matter what happens. I've

worked in the medical field all my life and always heard patients complain

about HMOs and their coverage policies. Now I am experiencing 1st hand the

nightmares of someone else making lifealtering decisions for me. It's

unfortunate, because when you are well and choosing an insurance company you

don't always think of the " what if " scenario. My ins. company and primary

care office promptly remind me that I am on a managed care plan and that I

don't have choices about some things. The guy at the ins. company told me

the other day that they would pay for a hysterectomy, just not a UAE. He

said that future childbearing is not a concern of the insurance industry and

the they had to strictly follow their protocols no matter how the patient

felt about it. It made me so upset what I actually wanted to ask him

(esp. being male) was how would he feel if he had a growth on his " private

part " and the company would pay for the whole thing to be " wacked off " , not

just the lump...LOL (sorry for the graphic analogy) Anyway, I am going to

probably switch companies as this particular company has been difficult to

work with in any aspect. Fortunately, I am on a group policy which does not

allow for denial because of a pre-existing condition.

Deb

[Guest guest]

The problems with managed care ins. are such a nightmare for sure. I will

have United Healthcare as of Jan.1 and although they will pay for the UAE,

you wouldn't believe the crap I have to go through to get it approved. I'm

sorry Debbie that your ins. will cover a hysto but not a UAE..sounds like

you'd be better off with another co. I would have been way too upset to even

speak if my ins. co said that to me. Yes we have a double standard here is

what it looks like....the men would just love it if a penile growth or cyst

got approval for being " wacked off " as opposed to shrinking or removing

it....LOL

Beth

[Guest guest]

Pam good luck in trying to figure it out Sometimes it takes Medicare (and

even insurance companies) up to 6 months to get all the billing straight.

They have to get the proper billing codes from the facility in order to pay a

claim. Many times if they send the wrong one they'll deny payment, so it can

go back and forth for a while before ever being paid. Depending on how the

clinic submits their bills (on paper or electronically) it can also make a

difference in the payment time. Meanwhile the patient usually ends up

getting swamped with paperwork and not knowing what's been paid and what

hasn't. Good luck with the paper trail and your fibroid care.

Debbie

[Guest guest]

I think that was funny if I were you I would have asked that man about

having a growth on his private parts and wacking the whole thing off

instead of just the growth mabe then he would at least know how you are

feeling. I am also on Medicare as I am on disability so I am lucky to

not be stuck with alot of extra medical bills. My bill at the clinic

right now is over $1,200.00 it seems to take Medicare months to pay

their 20% and anything they don't pay they send me a note telling me not

to pay it so I am confused on my medicare I have a stack of insurance

statements that I am still trying to figure out what medicare has paid

but I doubt I ever will *LOL*

Have a great night.

Pamm

[Guest guest]

I did get a atatement yesterday that medicare did pay $36.20 My biggest

problems is when I get blood work done the clinic has their own lab

which does most all the blood tests and Medicare always deines payment

with the excuse of the lab has to submit the bill I called and told

medicare that the lab did submit the bill because the lab is at the

South Bend Clinic so as far as I know they have not paid their share of

any of my lab work since the beginning of the year and I have had

Thousands of dollars of lab work done. Every month the bills says I need

to pay the balance but medicare says not to pay it I sure hope they get

some of the bills paid soon.

Pamm

[Guest guest]

debb9-@... wrote:

original article:/group/uterinefibroids/?start=16

39

> Pam good luck in trying to figure it out Sometimes it takes

Medicare (and

> even insurance companies) up to 6 months to get all the billing

straight.

> They have to get the proper billing codes from the facility in order

to pay a

> claim. Many times if they send the wrong one they'll deny payment,

so it can

> go back and forth for a while before ever being paid. Depending on

how the

> clinic submits their bills (on paper or electronically) it can also

make a

> difference in the payment time. Meanwhile the patient usually ends

up

> getting swamped with paperwork and not knowing what's been paid and

what

> hasn't. Good luck with the paper trail and your fibroid care.

> Debbie

Hi this is Jeannie and I am sitting here at the computer bleary eyed,

praying.

Interesting that you guys would be discussing insurance companies. I

have multiple fibroids and am over 20 wks size and they are

degenerating. I am having my period. I have been bleeding so much, it

scares me. According to the nurse line for my ins I am ok unless I

bleed thru more than one tampon every half hour, and so far I have not

done that. But I have to wear a pad with super tampon and by one hour

I am soaking the pad. It is a little after 3 am here in AZ. I just

got up due to feeling soaked. I had a dream/vision that they were

carrying me out of my apt on a stretcher with a sheet pulled over my

head... this is how much fear I live with. Everyone is telling me I

need to be in surgery, that my health/life is at risk.

I am on a state plan due to being disabled. It is medicaid. An HMO.

Now, here in AZ they pride themselves on giving the best care on these

plans. I looked up my coverage and it says " for medical specialty, or

when care is not available " that I can go out of state. They just sent

a 14 yr old girl who was 25 weeks pregnant out of state to get an

abortion because it is illegal here after the first trimester. They

send for transplant operations. They do stomach stapling. But to save

my uterus is not a priority to them.

At one point, after being counseled by HERS, I rec'd written auth

saying I could go out of state but would have to pay my own travel. At

the time I didn't have an extra three hundred dollars and I looked it

up and they are supposed to pay transportation so I contacted them and

requested this. They promptly rescinded the out of state authorization

in a second letter. I appealed and ended up with a lengthy hearing

process. I presented seven letters from myo specialists guaranteeing

my uterus. They all had done hundreds of uterine sparing procedures on

a multi-fibroid uterus my size. No local gyn could be found who had

advanced techniques to control bleeding and repair the uterus. No one

locally had done more than 3 myos on a uterus my size with multiple

fibroids. One guy locally was willing to attempt a myo but was not

going to remove all fibroids as he felt this would be to fillet my

uterus. HERS told me in am email to tell him if he got in there and

could not do the myo, to close me back up. I sent HERS an angry email

in return, asking " are you serious? " I never heard from HERS again and

to this day HERS will not return my email.

I was able to get a settlement offer in writing from my insurance

company which says I can use any doctor in our county which includes

Phoenix and sdale, AZ...but this has not proved to be very much

help as they are very hyst happy around here. A couple of gyns have

offered to " accommodate me " but I don't want to be " accommodated " ...I

want someone who has experience so I can have confidence going into the

OR and so I can be assured of a good outcome...low chance of

adhesions/regrowth/infection...low chance of transfusion....less

traumatic recovery.

Last night I began another reasearch project. I am so exhausted. My

neck pain has been especially difficult since it got colder. They are

tyring me on new medication and I am not tolerating it well. I am not

really up to wading thru all of this information.

I am sitting here tonite scared and sick and I just want this over

with! I am wishing I was back home and am thinking about how good old

Dr. (my family doctor since birth) would always tell me my

options...and beleive me, if there were any new treatments he would

know about it and I would automatically be offered a choice. Of course

I had a PPO back then.

I have tried to have the same " what are my options " " what do you

think " discussion with my new PCP and HMO plan GYN....they very

skillfully and emphatically avoid " controversy " . In other words, I am

left to do the research, decide on my own, and even pursue the

authorization or make other financial arrangements. That is why I am

without surgery. I am stuck.

A patient advocate advised me to use the settlement offer I have and

try to get a myo specialist in another state to agree to take the out

of network rate that my insurance would pay if I went out of network

here in my county. Then to go to the ins co and tell them I will pay

my travel. I broached the subject with my case mgr and she felt they

would not go for it, but I could try putting it in writing.

I just purchased this computer. One idea I have is to publish a

website, with photos of my pregnant looking tummy and ultrasound/MRI

reports...and tell my story, as a sort of poster child for this

issue....and ask for feedback from the world at large...medical...legal

...... to raise the issues of alternatives to hysterectomy. Maybe I

could find a solution.

What do you guys think? I have the software and equipment to do it. I

would simply present my dilema....here's my conditon...this has been my

experience so far...

I am sorry to go on so long, but that vision really un-nerved me. I

don't want to get carried out of here on a stretcher with a sheet over

my head. I had better do SOMETHING and I just can't accept that there

isn't a way to get a good outcome. I was reading links on this site

last night... it seems if I can get to somebody with great skill that a

laparoscopic myomectomy might be the answer. Also someone emailed me

that there is a list of myo docs on OBGYN.net. I went to their site

but it is overwhelming. Does anyone know exactly where this list is?

One more thing, I don't want to go thru this again next month, and in

case I can't have surgery before then, I feel I should take something

to cut the bleeding. Did any of you use anything that worked in one

month, and if so, what was it?

Weird, there is actual rumbling and sort of popping noises coming from

my abdomin in the area of the tumors. And if last month was any

indicator, I am in for a rough few days even after my period stops.

Last month I had pain like somebody had punched me repeatedly in the

stomach.

So the six million dollar question is...what in the heck do I do about

this? I am SOOOOO tired of this problem!!! I just wish I could get

advice from somebody who is medically savy who knew all the information

and could help me make a decison....I wish I had a relative who was an

MD. That's why I am thinking of doing the website...maybe I would get

responses that would help me understand and find the answer.

Well, enough for tonite. I am going to call a prayer line. I am still

shaken up by that image of me with the sheet. Geese!

Jeannie

[Guest guest]

RFeld19703@... wrote:

>

> Jeannie..

> Bless your heart, hun. We have similar problems....I' m bleeding thru a tam

> and pad about every hour for about 1/2 days of my period. This has been for

> about 2 years.

> I just put on 2 pads....a big tam...and go to the bathroom a lot. So glad

> when I'm at home for those days. It's better since I know the general

> pattern and know it's the fibroid....

> But i'm (we're) gettin through it....and pretty good too. In the

> meantime...tryin to find out options.

> It is better for you if you can relax some....You are creating lots more

> stress by worring so much....I know that's crazy to say...and easier said

> then done....but try to get some help with that.

> Well....got to go to the bathroom....

> haha

> I do believe laughter can help us through all of it....my sweetheart and I

> make all kinds of jokes...I figure..it can't hurt.

> becky

>

Yes , I also know the feeling ladies... I just had a Horrible period

last week in fact i'm still not 100% from it all.. At one point i had

to wear two super tampons side by side along with a over night pad & I

was still bleeding through along with the passage of large clots ..I

also thank god i was home because it would have been a real night mare

to be out in public... this is scary stuff but we'll all get through it

with the help & support of each other ladies

> Teri Cliford

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