Re: Choosing to use our health care benefits

[Guest guest]

Cecilia,

That was a very interesting experience you shared. It often seems as though

HR is doing things to help us, and many times they are, but working in

management for so long, I also know that management's primary concern is what

is best for the company, what is best for you is second. I am surprised that

they would fill out FMLA forms and then call you into the office to sign

them, without discussing the situation with you first.

I say that but then I remember the period of time after I was first

diagnosed. I remember that day, oh so well -- August 4, 1999. Having

dismissed my symptoms as insignificant for one year too many, I went straight

to a diagnosis of end stage Chronic Pancreatitis, and a month later had a

Distal Pancreatectomy / Spleenectomy. Unable to work and between the meds and

emotional shock, I was grateful for all the assistance I received to

coordinate time off, insurance, and eventually COBRA. When I was ready to

return to work, I was told that they were forced to hire somebody for my

position. They did offer me another position with the same pay. I wouldn't

say it was equivalent. I would have liked the opportunity to choose how to

use my medical leave benefits, especially when my job was at stake.

It is really the principal of the point as I was in no condition to return to

work. It made me also think of how healthcare providers write orders and

nursing staff provide so many unnecessary items when I am admitted to the

hospital...because my insurance will pay for it. I am currently writing an

article about managing medical bills. As I was writing I realized how hard it

is to actually monitor our bills..before hand. It is hard enough to decipher

our bills after discharge but, preventing staff from choosing how we use our

lifetime insurance maximum is difficult ---- possible, but difficult.

Karyn

Karyn E. , RN

Founder / Executive Director

Pancreatitis Association International

Corp. Office: Indps, IN, USA 1-

[Guest guest]

Heidi

If the hopsital won't provide you an itemized bill ask you insurance company

to get you one They are very interested in catching fraud. Some even offer

rewards to the covered person for finding billing errors. When I was BCBS of

Illionois I received $50 checks from them 3 times. 1) I had a mass od

endometrial tissue removed out patent surgery - they charged me $35 for to

sanitary pads I never got or used - nursing staff sucked that day. Mike

ended up getting me a bag at drug store so I could go home. 2) dentist

billed me in error for a filling in a tooth that wasn't even in my mouth

hadn't been for 20 years. 3) Cassie's 1st admision for CP they charged us

for meals in addition to IV feedings - she ate 1 meal - not 10 give it a try

Patty Hurst

Bangor, ME

Mane State Rep

PAI

[Guest guest]

>>>It made me also think of how healthcare providers write

orders and nursing staff provide so many unnecessary items

when I am admitted to the hospital...because my insurance will

pay for it. I am currently writing an article about managing

medical bills. As I was writing I realized how hard it is to actually

monitor our bills..before hand. It is hard enough to decipher our

bills after discharge but, preventing staff from choosing how we

use our lifetime insurance maximum is difficult ---- possible, but

difficult.

Karyn

This is an interesting topic, Karyn. All our bills from my two

endoscopies and the hospital stay from my diabetic

ketoacidosis are starting to pile in. Well over a dozen

statements arrived this week alone.

The hospital bill was a few pennies short of $19,000 and the

medicine charges were $4,000 for a four day stay. For such

expensive lodgings you would have thought we would get an

itemized bill, but all it says is for " services rendered " . The

nurses furnished me with many items that I never asked for or

used.....four boxes of kleenix, (left there unopened), the standard

plastic wrapped bedpan, complete with toothbrush, toothbrush

cup, toothpaste and spitoon, all also never used but a nurse

ripped the plastic cover off anyway.

I was also offered a full array of pain meds because my internist

wrote orders for each and every one of my pain meds that I'd ever

taken. I refused all of these because I wasn't in any pain after

the second day. I'd brought all my own meds and had them in

my locker in case they were needed. Someone said if I didn't

use the meds offered, I woudn't be charged for them. But

somehow they managed to provide me with $4,000 worth of

medications! All I had was a saline drip for two days, an insulin

drip for two days, and then insulin injections for the remaining

days.

How do I go about obtaining an itemized list of " services

rendered " and medications used?

Our insurance is adequate and covers most of these expenses

now. But during the last two years I've had ten CT-scans at over

$5,000 a pop, and know that many more will follow. There is

also impending surgery to drain my pseudocysts and another

hospital stay, medications, doctor's appointments and a full

plate of diabetic expenses....not to mention any unforseen

emergency room visits or hospitalizations. My husband was

talking about this with my visiting brother and jokingly

complained that suddenly I had become a " high maintenance "

woman......but he's right! Our insurance does have a lifetime

ceiling, and as these many medical expenses accrue, I need to

be more vigilant of what they are for. I don't want to pay for things

I haven't used or recieved. How does one dispute any charges

for items or services that weren't rendered?

Any advice or help on this matter would be appreciated.

With hope and prayers,

Heidi

Heidi H. Griffeth

Bluffton, South Carolina

Southeastern Representative

PAI, Intl.

Note: All comments or advice are personal opinion only, and

should not be substituted for professional medical consultation.

[Guest guest]

Heidi

Glad to see you finally getting to see the diabetic educator. It's a shame

everyone has to wait so long for services that are in such dire need.

After reading about your most recent complications this is now a subject near

and dear to my heart where Cassie is concerned. Only problem is Mike and I

are the only ones who see it that way. they say she hasn't had any problems

yet so why send her. We see it as she has pancreatitis, 2 of her great grand

parents had diabeties, both quite brittle, 1 grandmother had Crohn's, another

has kidney disease, an uncle with diabeties, stroke and heart issues at age

38. And a dad with a 8 inch by 1/2 inch scar that runs from below his button

and runs right up to his sternum. The only thing he knows about that is

something about the Pancreas and the Vega nerve. We have tried several times

to conact this Dr to no avail to find out what was done. But no need to worry

about her. Good luck, let me know how it goes. I wish you the best. god

bless you

Patty Hurst

Bangor, ME

Maine State Rep

PAI

[Guest guest]

> If the hopsital won't provide you an itemized bill ask you

insurance company to get you one They are very interested in

catching fraud. Some even offer rewards to the covered person

for finding billing errors.

Patty Hurst

Patty,

Hoakey-doakey....no, I didn't spell it wrong, that is just a bunch of

hoakey......especially the one about the tooth filling! And you've

proven that it really does pay to be vigilant.

I have to go to the hospital in thirty minutes for my long awaited

diabetic nurse educator appointment, so I think I'll stop by the

business office and see what I can find out. I'm excited to finally

get this appointment taken care of since I desperately need to

get my hypos and hypers under better control.

Thanks for your help.

With hope and prayers,

Heidi

Heidi H. Griffeth

Bluffton, South Carolina

Southeastern Representative

PAI, Intl.

Note: All comments or advice are personal opinion only, and

should not be substituted for professional medical consultation.

[Guest guest]

As the daughter of an insurance salesman, I would like to share that my father

is 80 years old and still continues to get referrals because of the following:

1) He keeps copies of all his clients bills, receipts, payments made and

received (they just bundle them up and mail them to him).

2) He goes to his elderly/infirm client's homes for signatures and to explain if

they have questions

3) He calls for explanations and keeps calling until he gets answers

4) If he finds a better price for his clients, he does all the necessary

paperwork and files it for them (but first checks regarding pre-existing

conditions!)

Anyway - if you aren't lucky enough to have an insurance salesman like my dad,

Number One Rule: call, call, call. I know there are times dad gets an answer

because he is so persistant.

Number Two Rule: ask for an " Request for Itemization " Form and last

Number Three Rule: Get a supervisor's name

Hope this helps, and if you get stuck let me know. Dad loves to help:)

Gail West, Midwest Regional Representative

http://www.pancassociation.org

gwest1955@...

[Guest guest]

Patty...it is probably the " vagus " nerve. Check out " vagotomy " ... I

cannot remember the reason this is done, but most certainly for pain

relief of one kind or another...

As for Cassie...you could put her on a diabetic diet of sorts, maybe

not as strict, but it's a healthy way to eat. Mostly we cut out

carbs, eat a little heavier in the veggie, protein and fat areas...

then as Heidi and I told the diabetes list we're on...fats and high

protein won't work for our pancreatitis ! It is definitely a

challenge, but I feel so much better than I did in Dec and Jan and

have lost 15 pounds in the last 10 weeks just giving up the " white "

foods...sugar, flour, pasta, rice, bread, potatoes...and the

associated junk foods that are full of these items: candy, cakes,

pie, ice cream, pastries, chips etc...most of those things are high

in fat anyway so we shouldn't be eating them for our pancs' sakes !

Hugs, Jeannine

my snacks have mostly been trail mix kinds of things...we have to

even be careful about fruit as it can blow the sugar levels out of

the water...

Dr Bernstein has a book called " Diabetic Solutions " you might wish to

check out of the library...I was hooked on it before I finished the

first chapter. He explians everything in easy to read fashion but

never talks down to us. He's been a lifelong diabetic so he knows

what he's talking about...

Would the doctors send Cassie to a dietician for her pancreatiits and

then when you get in there you could talk to this individual and get

a meal plan for both conditions...?

[Guest guest]

Jeannie

Back in 2000 after Cassie's 1st attack, I demanded that she be referred to a

diatician.

She had no Idea what pancreatitis was. We sat around and waited for 25

minutes so she could talk to dr that ran clinic. Then read to me out of a

book. Told me to reduce her fat by on 5% a day. Now if normal is Is 30% how

can 25% be considered low fat. whole trip was a waste of time and money.

Fool Even told her she was allowed 1 day a week where she could eat whatever

she wanted. Boy wasn't that hard to get out of her head. Still occasionally

argue about that one with her.

Patty Hurst

Bangor, ME

Maine State Rep

PAI