Well, it turns out that what we thought was a notice claiming to have paid for my ostomy supplies was actually the exact opposite. Furthermore, BCBS has now informed my medical oncologist that they are not paying for claims due to a major medical waiting period until September of this year. This is supposedly not applicable to those open enrollees who have credible coverage prior to enrollment. So, the doctor's office asked for a letter of credible coverage so that they could resubmit the claim for my chemotherapy. The thing is, is that we submitted the letter of credible coverage with the original application for open enrollment...they already have it! Kimberly spoke with her human resources person who stated that it was either going to be a bureaucratic hurdle, or either BCBS had determined my eligibility and will begin recouping paid claims from providers leaving us with the difference. As if cancer isn't enough. We will wait and see what happens with the resubmitted claim from the doctor's office before we call and start spinning the "let me speak to someone who knows two shits" wheel...sigh.
My spirits have lifted abit, but I know what that means. It means that my next treatment is near. I go this coming Thursday for my second treatment. After that one is complete I am half-way through the chemo (knock on wood). It gets harder and harder each time, so the side effects will probably be a little harsher and stick around a little longer. But half-way through doesn't sound that bad!
Peace,
Josh
5 comments:
Hey Josh,
Uncle Russ is getting ready for surgery so today he had to have an upper GI. As he was coming out of the deep sleep he looked at me and said How's Josh? I told him you were fine and he driffed off to the land of Nod once again. They are putting him on two more meds. One is Nexum and the other is Raglin (sp) I just wanted to let you know you are always in our thoughts!
Love,
A.C.
Gotta love the insurance system. Sorry to hear about the woes...we'll stay focused on the "half-way through" thing for now, I guess. I know things will work out for the best in the end. Keep it POSITIVE you two, we're thinking of you from NC!!!!
Josh,
The "Double Cross/No Shield" problems may eventually have to come down to a lawsuit. I know you and Kimberly do not want to deal with that right now, but if they continue to duck and dodge, I know of a good attorney who would probably take your case on contingency. I guess in the meantime, all we can do is continue to hope for the best, and all you can do is take your treatments and continue to get better.
Steve
Hey Josh and Kimby-
I want you both to know how awesome and strong you are - I don't have words to say it. I am praying for you every day, and will be doing so more on this Thursday.
With much love,
Mom/Andrea
Josh and Kimby,
Just one other follow-up comment about the DCNS problems. It would be a really good idea to retain all copies of correspondence between yourself and/or your employer and DCNS. Also, try to keep a written journal of all telephone conversations with DCNS,
date and time of conversation and the nature of what was said. This will be of great help if worst comes to worst and you do have to
bring a lawsuit against them.
Luv ya both,
Steve/Daddy
Post a Comment