My Cardiac Intervention was cancelled. So no surgery tomorrow.
I was told that the insurance company balked at the procedure. This is a definite set-back but also one that is beyond my control. I’m trying to accept it and move on to the next thing.
Once the TAVR was offered and I accepted, joy ensued. Perhaps it was a little too easy, bump, bump, buuuuummmmp. This offsets that a bit.
The next steps are a bit unclear. I’m told that the doctors will appeal and that I should appeal too. I was told that this will not be resolved for 30 days so that’s what I know.
My mental state is disappointment but more just utter confusion. Not sure what to do, what to focus on. It’s a bit like mental motion sickness.
I don’t want to go off in Premera. Yet. And I don’t know what the whole story is because I was told they approved it earlier. I was told by some other medical profession that they have seen this before where one person verbally approves it but then later, when confronted with the paperwork, the company balks.
I thought being in a study would make this irrelevant but the rules change all the time. I was also told that the procedure was recently approved for my specific situation, which should make it more of a no-brainer.
This too shall pass. And at some point they will either do the TAVR or tell me what else to do. In which case I will reluctantly accept it. Right now, the good news is that apart from the echocardiogram, I am unsymptomatic. Perhaps I will develop some good ones in the time until the surgery. To paraphrase Carl the groundskeeper, at least I got that to look forward to, which is nice.
I've received a lot of similar advice regarding the insurance issue. Thanks. And one of the bits of information is basically to press the case to them. I spoke to someone in the medical world who is not specifically connected to this. What likely happened was that there was verbal approval a couple weeks ago. The UW told me that the procedure was approved or I would not have been put through the tests. Later, the written approval with more of the details was submitted. There is a formula that my case doesn't presently fit. Therefore it is denied. Could be stupid actuarial stuff. Could be cost. Most likely, I was told, it isn't cost. But it's the easiest thing to see. The formula could require five symptoms and I have four. Eventually I would have all the symptoms and the doctors will try to explain this. And so will I.
Wow. It is sad and a bit scary that decisions about your health are made in an inhumane manner by a bean counter. Too bad the insurance company doesn't trust the opinions of the doctors who made the referral. It is similar to thinking that outsourcing and downsizing are good because they increase returns for the investor class while disregarding the human impact of such decisions. Sometimes cuts have to be made, but to see Jim Cramer gleefully speak about cost-cutting measures seems callous. I don't know which company insures you but articles like this are numerous: http://www.latimes.com/business/la-fi-blue-shield-pay-20150901-story.html