The random thoughts of an architect-turned- lawyer from the deep south living in Washington, DC...

Monday, May 18, 2009

Dear red tape - enough already!

My physical therapist told me her goal is to make me as comfortable as possible until the surgery. I am currently going to p.t. for lumbar traction twice a week and she recommended that I get a take-home lumbar traction machine for the other days. After my last appointment, she handed me a piece of paper that had three steps (1) call insurance company; (2) give them this code; and (3) ask them these two questions. How very nice of a medical professional to make this easy on me.

Then comes the insurance.

I called with my code. The guy says he can't find anything. I ask him to try again. He does so with a sigh.

Him: "There it is. Oh, this code is wrong, it's telling me 'miscellaneous.' You need to ask the people who rent the equipment for the code.
Me: "That is where I got the code."
Him: "I don't know where you got that code."
Me: "That's what I'm telling you, the code came from the lumbar traction machine rep."
Him: "That is who you need to speak with - get the code from them."
Me: "Is there another way to look up the piece of equipment?"
Him: "No."
Me: "Really? Not by manufacturer name or description?"
Him: "No."
Me: "I find that hard to believe. You don't have a table of contents or something. I can narrow this down.
Him: "No. I need a correct code."

So I google to try to find the code - call back and get a different person.

Her: "It's not the wrong code, ma'am, it's just a miscellaneous code. Getting a new code will do no good. We need more information before we can determine if we cover it."
Me: "Phew, okay, what do you need?"
Her: "We need a letter of medical necessity from your doctor, a prescription from your doctor, the manufacuter's brochure, photographs of the equipment, a serial number, three price quotes..."
Me: "Oh my God, nevermind. I will just live with the pain."
Her: "Okay, thanks for calling and have a nice day."

I am now convinced that people turn to whacky home remedies not to avoid doctors, but to avoid insurance.

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