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csziggy

(34,136 posts)
Wed Dec 7, 2016, 03:24 PM Dec 2016

OMG - I HATE insurance companies!

I wrote last week about my husband's health problem. Well, first off he's doing much better. But he ruptured his appendix on Thanksgiving morning and didn't realize it. Last Wednesday I took him to our regular GP's office, got a CT scan, and he was sent to a surgeon on Thursday. Friday morning he got a CT scan with an interventionist radiologist who put in three drains in some of the abscesses he had from the crud out of the appendix.

He spent Friday through Monday at the hospital then they sent him home with supplies to flush the drains. Problem is, they didn't add up the amount of supplies right and I am almost out of the saline needed.

I figured, no problem, it's saline and while I didn't expect our regular pharmacy to have it, I thought I could get it at a surgical supply place. When I called, I was told they had to have prior approval from the insurance company. I called them and was told the doctor had to get the approval and it would take 24 hours. 24 hours is too long - that would mean we'd skip several of the prescribed flushes and take a chance on the drains clogging, maybe causing more infection.

I went off on the insurance company woman and basically told her that if my husband ends up back in the hospital it will be her fault and the insurance company would have to pay through the nose for his care.

FOUR hours later I am still waiting to hear from the doctor's office about where they got approval to get the saline.

It's fucking SALINE, for fuck's sake! It's not as if we are trying to get a controlled substance or an antibiotic that could be misused. It's sterile water and SALT.

Add to my frustration is that I needed a shower this morning but I have been making calls or waiting on call backs all damn day. So when I do find out where to go to get the saline, I will have to go with greasy hair and stinky body.

We need SANE healthcare in this country. I've used more time of the people at the pharmacies, insurance company, and doctor's office that it would cost to go out and buy on fucking bottle of saline solution. Add in my time and the total amount of time wasted cost more than several cases of saline solution.

11 replies = new reply since forum marked as read
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OMG - I HATE insurance companies! (Original Post) csziggy Dec 2016 OP
so sorry to hear of your problems rurallib Dec 2016 #1
Fortunately the doctor's nurse took care of it csziggy Dec 2016 #2
glad to hear a good ending at least for today rurallib Dec 2016 #3
Take it easy - I was blowing off steam in the OP csziggy Dec 2016 #4
We need area51 Dec 2016 #5
YES! And we need more actual health care providers and fewer clerks csziggy Dec 2016 #6
OMG! Kali Dec 2016 #7
I haven't been all that coherent about it csziggy Dec 2016 #8
nah, it sounds like you are a conciencious nurse Kali Dec 2016 #9
The surgeon's nurse went above and beyond for us csziggy Dec 2016 #10
LOL! Kali Dec 2016 #11

csziggy

(34,136 posts)
2. Fortunately the doctor's nurse took care of it
Wed Dec 7, 2016, 10:34 PM
Dec 2016

She located a pharmacy with the saline and arranged for it to be waiting when I got there. She recommended that I skip the insurance for it since that would have delayed things - the bottle of saline was under $12. I WILL send the receipt into the insurance company for reimbursement but I needed to have that bottle on hand tonight at midnight for the next flushing session.

The thing is, all the hassle today cost the insurance company, the pharmacies and the doctor's office much more than the $12 that the actual product cost. I'm not counting my time since I'm retired and this week my job is to get my husband well.

csziggy

(34,136 posts)
4. Take it easy - I was blowing off steam in the OP
Wed Dec 7, 2016, 10:42 PM
Dec 2016

It's been a difficult two weeks but things are getting better.

csziggy

(34,136 posts)
6. YES! And we need more actual health care providers and fewer clerks
Thu Dec 8, 2016, 12:43 PM
Dec 2016

One of the problems in health care now is not enough nurses and aides actually working with the patients. If the for profit hospitals and other facilities had to pay fewer insurance clerks maybe they would hire more nurses to work with the patients.

When I was recovering from knee replacement, the rehab hospital had one nurse and one aide per ten or twelve patients. That is far too few people to care for patients who need assistance for everything. But the place had plenty of insurance clerks to make sure they could collect their money from the various companies and agencies that would pay for the facility.

Kali

(55,007 posts)
7. OMG!
Sat Dec 10, 2016, 11:27 PM
Dec 2016

I missed something! so it was his appendix - and ruptured! oh man. and you don't like nursing humans. oh brother, sure hope you both are doing better!


for next time: vet supply

csziggy

(34,136 posts)
8. I haven't been all that coherent about it
Sat Dec 10, 2016, 11:40 PM
Dec 2016

Reconstructing what happened:
Tuesday before Thanksgiving he had a stomach ache. Drove home from Panama City Wednesday feeling bad. Thanksgiving morning he felt terrible - that's probably when the appendix burst - but he wouldn't let me take him to the emergency room.

He actually felt slightly better over the next few days. By Tuesday I was worried that he still felt bad and couldn't eat much so made doctor appointment for Wednesday morning. They sent him for CT scan which showed something going on in his intestines - gave us possible diagnosis of bowel infarction. Sent us to surgeon who specializes in abdominal surgery. He and his radiologist looked at the CT results and decided it was abscesses in the abdomen from ruptured appendix.

Friday, week after Thanksgiving, he went in hospital, interventionist radiologist used active CT scan to insert drain tubes in three abscesses. He spent until Monday of this week in hospital, then they sent him home for me to nurse - flushing the drains and cleaning them up.

This Friday he went in for another CT scan, they took out two of the drains. Now I just have to flush enough to keep the tube open. Wednesday he goes back to see if the infections are gone. A week from Monday he sees the surgeon and we talk about getting the remains of the appendix out.

If one of my horses had been as sick as he was on Thanksgiving, I would have hauled them to the vet! But my husband who refused treatment was allowed to suffer for a week. I suck as a nurse!

I came close to calling my vet and asking her if she had sterile saline on her truck! She keeps her cutting horse down the road and could have dropped a bottle by.

Kali

(55,007 posts)
9. nah, it sounds like you are a conciencious nurse
Sat Dec 10, 2016, 11:46 PM
Dec 2016

you persisted until you got what was needed. your patient, on the other hand, needs spanking as soon as he is feeling better. he needs to trust YOUR gut, not his! (obviously)

vet supply is cheaper than pharmacy if you are having to do it with out insurance (and coban comes in colors!)

csziggy

(34,136 posts)
10. The surgeon's nurse went above and beyond for us
Sat Dec 10, 2016, 11:55 PM
Dec 2016

And although we have insurance it was simpler to just pay for it. I WILL send a copy of the receipt to the insurance company for reimbursement but I had no energy or time for the battle that day. It was less than $12 for a one liter bottle - more saline than we needed but all the pharmacy had.

This town doesn't have a local vet supply. Best choice is Jeffers in Dothan but that is either a long drive or overnight delivery. Second best is Tractor Supply but they didn't list sterile saline on their site.

As far as my husband goes, he hates needles and he knew that going to the doctor would probably mean some sort of shots. I got him back, though - when checking him in at the hospital they were concerned he hadn't had flu or pneumonia shots so I told them to give him both while he was at their mercy.

It's a good thing he's in pretty good health, otherwise I would be a widow by now.

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