Friday, April 24, 2009

You've Got To Fight For Your Right (To Be Sick)

As if battling a disease that in the old days was called "Creeping Paralysis" isn't enough, I've learned that the afflicted get the added bonus of having to fight a perpetual battle with the ungodly abominations known as insurance companies. Insurance companies rank right up there with the New York Yankees as the ultimate expressions of evil on earth. Their actions are enough to turn even the most rational person into the Unibomber.

A good friend of mine (another MS patient) was scheduled to have surgery this coming Monday, to try to fix her previously surgically "repaired" broken shoulder, which she injured in an MS related fall. The shoulder has been causing her unending misery for many months now, and my friend was hoping to finally find some relief from the constant pain. Unfortunately, that pain has now been compounded by the fiends employed by her insurance company, conniving ogres who have chosen not to authorize the surgery. Mind you, this is a surgery ordered by her orthopedic surgeon, not a cosmetic tummy tuck or facelift. They're forcing her to go through an appeals process, which won't be complete until sometime next week. So the surgery for Monday is off, hopefully to be rescheduled for the following week, if the insurance company's annointed ultimately deem the procedure worthy.

My own experience with healthcare insurance companies has been maddeningly similar. I suppose, on balance, I really shouldn't complain, as the company has paid for a myriad of expensive treatments and procedures. But I've also spent an insane amount of time on the phone with various insurance company goblins, desperately trying to convince them of the necessity of most of those procedures.

I'm generally very slow to anger, and not much of a screamer, but the insurance jackals on the other end of the line are possessed with an almost singular ability to turn me into the flesh and blood incarnation of Mount Vesuvius. I try hard to be a clear thinking individual, and strive to approach even the most emotional topics some Zen detachment, but put me on the phone with an insurance company rep and within five minutes I'm transformed into an eye bulging, mouth frothing crazy person, my senses of reason warped into the shape of a dyspeptic goat's small intestines, and my language skills diminished to the point where I can only make Tasmanian Devil noises.

It took a full year to get my wheelchair approved and finally reimbursed; a year spent screaming into the phone at the demonic entities employed by Blue Cross Blue Shield. I swear, as I talked to them I could hear their leathery wings lazily flapping in the background as they sharpened their pointy tails. When I wasn't busy trying to burst a blood vessel while holding a phone to my ear, I was scrambling to write scathing e-mails and letters documenting the fact that I was indeed partially paralyzed, and that the reason they call Progressive Multiple Sclerosis progressive is that it progresses, for God's sake. Unless they could supply me with a magic wheelchair that could fly me to Lourdes, I wasn't expecting to be going for a leisurely jog around the block any time soon.

Why they've given the name "Appeals Process" to the labyrinthine maze of bullshit they put me through is beyond me, because there's nothing appealing about it. It should more accurately be called the "Appalling Process". The situation only came to a resolution when an angelic RN, miraculously employed by the insurance company as my case manager (by mistake, I'm sure), interceded with her bean counting demonoid coworkers on my behalf. She has earned my undying gratitude and affection.

I'm a very nonviolent person, so mailing explosive devices to insurance executives is out, but I must admit to experiencing toe curling glee at the thought of a big box of ripe horse manure arriving on the desk of Blue Cross Blue Shield's Vice President of Interminable Agony...


  1. kicker

    Going through a 9 month grueling mess to get my chair (like I really want to be in one, your experience taught me "Duh. I'm chronic and tired of talking to a different person every time I call, I'll get a case manage. They better give me one, those #$%&@.

  2. What a great article!

    I am Katherine, a fellow Secondary Progressive MS patient, that believes that I have been living with this disease most of my life.

    I (too) have yelled, screamed, written letters, begged and pleaded with my insurance companies to provide the necessary treatment(s) for whatever exacerbation symptom was happening at the time. I understand "totally" what you have gone through, fighting with these people! It's just NUTS! I not only fight for myself, but for my eldery Mother, as well; out-of-state, which makes it seemingly impossible to accomplish, but with the right wording you CAN get things accomplished.

    The best course of action that I have found is to have your Doctor write a letter "always" stating that this is "Medically Necessary".

    Your Blog is GREAT! Keep up the great work!

  3. I agree 100% with you on the Blue Cross case workers. Sent from heaven, they are. Ours calls to check on us every month, and commiserates with the helplessness of the situation. We don't know what all she's doing behind the scenes, but we've gotten what we've needed from Blue Cross with the longest approval delay being about a month.

    That said, even a month wait for approval is too long, when the patient may only have a handful of years left.

  4. Marc,

    For all the BS Blue Shield has shovelled my way, I have found that they actually pay for MS-related charges far more timely and with far less shit shovelled, than for mental health claims.

    I hope there is a special place in hell for insurance company execs.