Case manager?

[Guest guest]

Has anyone here ever been offered a "case manager" by their insurance company?

I received a letter from a woman who introduced herself as an RN case manager. There were so many words in the letter like "maximize" and "quality" that all I could think of was a Dilbert cartoon, and my wariness meter started beeping.

She phoned me yesterday, and her personable manner made me a bit less guarded. When asked, she said it was the MS that had caused my name to be flagged for her, but she did have some info about my having scoliosis, as well. I made it clear that the MS thing is well in hand, and that I don't feel a need for any help there. I admitted that I am contemplating surgery, and she said that once I get scheduled I'll hear from her again. She seemed well aware that Harrington rods cause problems, and that revision is necessary for many of us. I steered clear of any mention of my tethered spinal cord.

While I think that it might be nice to have someone who understands my case helping me navigate the insurance issues, I can't help feeling that she can't REALLY be on my side AND work for the insurance company. Then again, if she had been assigned to my husband, maybe she could help clear up the issue of the company not wanting to pay for his Byetta, an injectable drug for diabetes. Hopefully the letter of medical necessity that his endocrinologist sent will do the trick, but we could really use an ally on that one if it doesn't. (Ironic, too, that they don't want to pay the $250 a month for the Byetta that holds great promise of making him thinner and healthier and reducing his need for oral meds, when they gave me no trouble at all over the $1500 per month for my Copaxone, for MS. Though of course I'm thankful it isn't the other way around!)

Any thoughts?

Sharon