fretgod99 Posted August 30, 2017 Share Posted August 30, 2017 1 hour ago, iPwn said: Apparently filing a grievance and threatening legal action is the only way to deal with my insurance company. To be fair, they're The Worst. Insurance companies are the reason I never wanted to do personal injury work when I was in private practice. Aggravating af. Link to comment Share on other sites More sharing options...
pwny Posted August 30, 2017 Author Share Posted August 30, 2017 1 hour ago, domepatrol91 said: Insurance companies are terrible. What issues are you having? None now. But it’s been a pain in the [redacted]. I am on two medications. Adderall for my ADHD, and another one for a serious medical condition. December of last year, they abruptly pulled authorization for my Adderall with no warning. I found out when I went to pick it up that I could no longer get it and that new rules they put in place would require extra documentation to take it. This itself is fine. It’s a stimulant, abused by people. Fine, get some extra info to verify that I legitimately need it. But, you know, give me and my doctor some notice so that I can get the documents together before I run out. They didn’t do it. And then they jerked around and didn’t accept what my doctor sent as good enough, even though he literally sent an actual 10 part psychological exam to prove I had ADHD as well as his own exam, and the notes from my previous doctor. Three professionals all agreeing that I had ADHD wasn’t enough, they needed more info. So I didn’t get my Adderall. You don’t just quit stimulants cold turkey, you have to ween off. I was not given that chance. I just ran out and that was it. I went through withdrawals, missed about 10 days of work because I was so lethargic that I couldn’t get out of bed. Fun times. Fast forward to last month. Still not taken care of. I go into my pharmacy, and my other medication is blocked. Call them up “oh, we need a prior authorization”. Again, no warning, not info sent to me or my doctor. Just “lol, take him off a medication he needs to live and let him find out when he’s out and goes to get a refill”. I raised hell with about 10 different agents over two days before one finally told me that they didn’t even need a prior authorization, they just needed the pill form changed from two capsules at half dose to one capsule at full dose. Called up my doctor, and he sent over an update. fixed. They also informed me that my Adderall was finally approved, and only told me because I inquired two days after. Again, no call or anything, just “lol, let’s approve it and not tell anyone”. Went to my doctor yesterday and got a script for the Adderall (they can’t call in stimulants). Brought it to my pharmacist and it was denied again. Called up and they told me that it should be fine. The pharmacist called up and told me that they authorized the wrong formulary. Called in again, and asked why they wouldn’t authorize the actual medication that I had been taking. “Oh, the doctor didn’t put the XR there, so we didn’t do it.” 1. Even if this is the case, just add the two damn letters. You’re not changing the medication, you’re not changing the dosage, you aren’t changing the number of pills, you’re just changing the release schedule. 2. Why would you spend 9 months verifying an authorization and not even make sure you’re authorizing the right medication. The response I got was “we can’t do that, we have to request a new authorization.” That one got me to file a complaint with their grievances department last night. 9 months and the whole process gets started over again? And then this morning, to the second question “it’s not our responsibility to verify medications”. I lost it on the lady when she dropped that. Just snapped and tore into her. How the hell is it their responsibility to place my medication on hold for 9 months to verify everything under the sun but not to verify the actual medication? She started yelling back and I told her that I already filed a complaint and that if it wasn’t handled now, I was going to be contacting a lawyer. Had her get me a supervisor. Told everything to the supervisor again and told her I’m done playing their games and that it needs to be fixed today, or I’m seeing a lawyer. The supervisor looks through all the documentation that got sent to them and tells me that they sent two faxes to my doctor to see if it was supposed to be XR or regular release (so much for not their responsibility, huh?). She then went looking through everything and goes “his paperwork says XR. Let me see if I can get them to switch it when the guy who handles these comes in at 9”. Half hour later, before 9, she calls to tell me it got switched and I’m good to go. 1 Link to comment Share on other sites More sharing options...
fretgod99 Posted August 30, 2017 Share Posted August 30, 2017 But for real, sorry you had to deal with that, pwny. 1 Link to comment Share on other sites More sharing options...
Dome Posted August 30, 2017 Share Posted August 30, 2017 damn that sucks. I know you pain, I dealt with them for two and a half year after my accident. Probably 2 hours a week in phone calls during that time. Very frustrating. glad you're getting your meds though, I couldn't imagine. I would've snapped too Link to comment Share on other sites More sharing options...
cddolphin Posted August 30, 2017 Share Posted August 30, 2017 40 minutes ago, EliteTexan80 said: Oh yeah. About to start my fight. Have some roof damage. Nothing big, but enough to be a concern. Should've rented. Link to comment Share on other sites More sharing options...
ET80 Posted August 30, 2017 Share Posted August 30, 2017 1 minute ago, cddolphin said: Should've rented. Been there, done that, would prefer to own. But hey, to each their own. Or, to each their rent. Ha. Dad joke is Dad. 1 Link to comment Share on other sites More sharing options...
cddolphin Posted August 30, 2017 Share Posted August 30, 2017 Just now, EliteTexan80 said: Been there, done that, would prefer to own. But hey, to each their own. Also ADHD isn't a real thing. Source: B.S. in YouTube Science (Just kidding but I think it's vastly over-diagnosed) 1 Link to comment Share on other sites More sharing options...
Csonka Trucks Posted August 30, 2017 Share Posted August 30, 2017 7 minutes ago, EliteTexan80 said: Been there, done that, would prefer to own. But hey, to each their own. Or, to each their rent. Ha. Dad joke is Dad. I'll allow it Link to comment Share on other sites More sharing options...
husker_vikes3 Posted August 30, 2017 Share Posted August 30, 2017 Sorry, pwny. Insurance seriously is the worst. I went to a bar/grill after work back in May for a co-worker's birthday. I work nights so this was after midnight. Parked in a parking lot thinking my car would be fine. About an hour later, two guys come in and say someone backed into your car and drove off. The witnesses also said he'd been drinking (there were a few other bars in the area) but there's obviously nothing that could be done about that and no biggie, I really just care that the guy hit my car and getting that solved. Go out to my car, file a police report. Couple days later get a call from the police, they give me his insurance info and tell me he's been charged with a hit and run and leaving the scene. (Another interesting note: when the police called me, they said, "Yeah, we think he was drinking, but there's nothing we can do.") I file a claim through his insurance, give my statement and then hear nothing for two weeks. Call his insurance again. They tell me that, "they haven't gotten his statement yet because there were two open claims involving both parties and they weren't sure which one was correct." They also tell me that "a police report/ticket isn't enough to determine fault." Get a call from them later that week after they got his statement. The agent literally said, "Looks like he was charged with a hit and run so we're going to go ahead and accept liability." Link to comment Share on other sites More sharing options...
bucsfan333 Posted August 30, 2017 Share Posted August 30, 2017 Insurance is a scam. Link to comment Share on other sites More sharing options...
flyers0909 Posted August 30, 2017 Share Posted August 30, 2017 The worst part is that we have to be the middle man between the insurance company and the doctor. Like the other day I got charged for an out of network doctor when on the insurance website it clearly says the doctor is in network. I call up the insurance company and they say I need to tell the doctor to file some form so they actually are in network. Why is that on me? Link to comment Share on other sites More sharing options...
Dr LBC Posted August 30, 2017 Share Posted August 30, 2017 Today I learned an age-old lesson the hard way: Never go in against a Sicilian when death is on the line. 2 Link to comment Share on other sites More sharing options...
pwny Posted August 30, 2017 Author Share Posted August 30, 2017 2 hours ago, cddolphin said: Just kidding but I think it's vastly over-diagnosed Problem is a lack of actual diagnosis, instead just throwing pills at kids for being hyper. But yeah. Link to comment Share on other sites More sharing options...
cddolphin Posted August 30, 2017 Share Posted August 30, 2017 Just now, iPwn said: instead just throwing pills at kids Don't get me revved up. Link to comment Share on other sites More sharing options...
bucsfan333 Posted August 30, 2017 Share Posted August 30, 2017 46 minutes ago, cddolphin said: 47 minutes ago, iPwn said: instead just throwing pills at kids Don't get me revved up. But it's a hobby of mine. It's a bit more expensive than rocks. But it's so relaxing. Link to comment Share on other sites More sharing options...
Recommended Posts