rolanni: (Luna detail)
[personal profile] rolanni

So, an interesting day, so far.  Had fresh-bake bread for breakfast, with mint jelly (mmmmm, mint jelly); set the new coffeepot cleaning, so we can have new-coffeepot-coffee tomorrow morning; and called Anthem Blue Cross, our supposed health insurance company, to find out why they had denied an echocardiogram for my husband, a heart patient.

This is interesting — no really; it is.  See, Anthem doesn’t make “determinations” — they simply exist to take your money — there’s another company, something called American Imaging Management, and its purpose is to deny medical procedures in order to save their stockholders money review the available data to determine whether a prescribed test actually is, in their sole opinion, necessary.

It comes about that American Imaging Management decided that the diagnostic echocardiogram was not necessary, in Steve’s case.

I asked the customer service rep at Anthem where we went from here — just show up in the cardiologist’s office with a couple thousand-dollar-bills in hand and get the test off our own bat (which, to be Perfectly Fair, is what’s going to happen, anyhow, we having the Pay-Anthem-$600/month-so-they’ll-say-we-have-coverage-while-we-pay-all-medical-bills-out-of-our-own-pocket-anyway Special for folks who have made Bad Life Choices and don’t have a Good Job with health care benefits plan).

The service rep actually went the extra yard, and called American Imaging Management for me.  He reports that AIM declares that their ruling may be appealed.  All that needs to happen is that Steve’s Actual Doctor call a Doctor on Staff at AIM, and, well, convince the staff doctor that the test is necessary.

Easy-peasy, right?

After that conversation, I was more than ready to go to gym, and so I did.  Back now, with a bunch of cut ‘n paste in my afternoon, and a list of interview questions to answer, when I get bored.

While I was gone, Steve has been doodling around in the new Cafe Press store — I hear there’s tree-and-dragon jewelery to be had at the Hyperspatial Boardwalk Shop, along with the usual t-shirts, bags, clocks and teddy bears.  Check it out.

I have also been remiss in announcing that the Fourth Klamath Splinter is now up at Splinter Universe.  Progress had been set back due to scanning issues, which have now been resolved.  We thank you all for your patience!

And now! Cut ‘n paste.

No.  No, the excitement never does stop, why do you ask?

 

Originally published at Sharon Lee, Writer. You can comment here or there.

Date: 2012-04-18 06:18 pm (UTC)
reedrover: (Default)
From: [personal profile] reedrover
Thank you for the splinter. It was ... unexpected...

Hyperspatial etc

Date: 2012-04-18 07:10 pm (UTC)
From: [identity profile] spudsmom.livejournal.com
It might just be me but when I clicked on the link, I couldn't see any pictures. Just tell me if anyone can see pictures then I'll know its me and quietly recede into the background with my shameful lack of access or whatever.

Re: Hyperspatial etc

Date: 2012-04-18 08:45 pm (UTC)
From: [identity profile] psw456.livejournal.com
I get pictures with IE 9 and with my Android browser.

Date: 2012-04-18 09:53 pm (UTC)
elbales: (Unimpressed!River)
From: [personal profile] elbales
Ugh, good luck with the insurance issues. I'm grateful to have it, but man, I hate the companies. We got your death panels right here...

Date: 2012-04-18 11:41 pm (UTC)
From: [identity profile] attilathepbnun.livejournal.com
ALmost amkes me ashamed to be an Anthem customer myself ...
Good luck!!!

Re: Hyperspatial etc

Date: 2012-04-19 12:30 am (UTC)
From: [identity profile] kinzel.livejournal.com
I've been in and out of those pages -- you may have come along when I was fiddling with revisions.

Date: 2012-04-19 12:32 am (UTC)
From: [identity profile] kinzel.livejournal.com
Splinters .... may not be smooth and seemly -- they are roughest of old rough draft stuff ... just wait until Avindith (perhaps misspelled!) shows up....

Date: 2012-04-19 12:34 am (UTC)
From: [identity profile] kinzel.livejournal.com
Also? the parts were not written at the same time, nor in order, some were potentially going to replace other parts ... so yes, we do not always work in seamless fashion in the construction of the story.

Date: 2012-04-19 12:45 am (UTC)
From: [identity profile] amyirene-40.livejournal.com
Anthem sucks, and I say this as someone whose job for the last two decades has been benefits management. Definitely appeal. There should be a patient assistance group in Maine that can help with the appeal - let me see if I can find the info... here it is:

Consumer Health Care Division
Maine Bureau of Insurance
34 State House Station
Augusta, Maine 04333
Website: http://www.maine.gov/pfr/insurance/consumer/CHCD_Brochure.htm
Phone: 1-800-300-5000
Serves residents enrolled in private health insurance.

Date: 2012-04-19 01:07 am (UTC)
From: [identity profile] kalimeg.livejournal.com
Go check the AARP web site and see if they can do better for you. In some states they can, andd in others not.
Edited Date: 2012-04-19 01:08 am (UTC)

Insurance

Date: 2012-04-19 05:46 am (UTC)
From: [identity profile] catherine ives (from livejournal.com)
I hope that Steve can get his insurance thing straightened out. That has to be extremely annoying indeed! Cats probably need extra pettings anyway....and they say helps with the blood pressure thing.

Klamath Splinter

Date: 2012-04-19 05:59 am (UTC)
From: [identity profile] catherine ives (from livejournal.com)
Thanks for the Klamath splinter.

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