insurance is really throwing the wrench in... no pm now

Well, finally heard back from the insurance company, they say (despite what the law says) that they don't have to cover my "out of network" PM. My PM says they'll be sending discharge papers by the end of next week, no refills, and no appointments. They also said they won't just refer me to another PM, it has to go through "the proper request channels" by my back surgeon, again. Which, after talking to his office, they'll try to expedite it, but they have to vet a dictation from the doctor, and type it out, which usually takes a week, and then approval takes up to seven business days, if they approve it.

No word yet on if the back surgeon will fill in the time gaps on that or not. Still waiting to here about that. The practice coordinator said likely not, but she did say the doctor does consider things on a case by case basis. As it stands, I'll be out of medication by Monday morning. If I try cutting what I have, in half, I can extend that a little, hoping it will be at least partly effective. They called earlier, wanting to move my appointment from.the 22nd to the 29th, and I talked to them further about what's going on, they said, they'll try to get an answer from the doctor within the next few hours, so that they can get the ball rolling on getting me a script, or whatever. Feeling very stressed right now.

Matt, I'm so, so sorry about this. I also can't believe that your PM is that uncaring to not at least give you one more script, its infuriating! Just shows to me that all they care about is money! Its not like you need the added stress while trying to heal!

I will pray that you get this resolved quickly and hopefully someone will give you a script until you can get in with the new PM. Remember, if you have to, go to the ER.

Matt,

That is just awful. You did not need this stress on top of everything else. What was the PM's deal of not wanting to at least give you one more script - to at least cover you making appointments and so forth? As David said - it doesn't seem to matter to them that you'll be out of meds, feeling lousy, etc..... but, trust me, if any of them were going through this - they'd for sure have their meds. Ugggh. So frustrated for you.

:( --Tina

Prayers that this situation gets better for you soon...keep us posted, will be thinking of you...

Matt this is awful, how can a pm doctor not give you the meds you need.....grrrrrrr. I guess going and waiting to be seen in the waiting room and sharing your story with anyone who will listen would not help.

Good morning SE, nope, no call back from the doctor. Not sure what I'm gonna do. It's going to be a fun week next week for sure.

Well, the plot thickens... at this point it's so maddening I couldn't help but laugh in tears about this. I had a small amount of Norco stashed for a rainy day, well, apparently I've been duped. I checked the bottle, which I hadn't opened in a few months, and the pills looked different than I remember. I looked at the bottle, and the pills were supposed to say ip 110, they did not, they said some numbers on them which apparently, according to Google, is extra strength tylenol.

Well, I still have a bottle of some stuff called fioricet, it's unopened, given to me for pain, by the industrial medical clinic that my bosses sent me to. I looked it up then, and it says it's for headaches. Not sure about this stuff. Funny that the PA gave me that, and the MD gave me Norco 20 minutes later. Those people were really on the ball.

Hopefully, I'll be able to get ahold of the Surgeon or his PA on Monday, his PA is a very nice lady, and I guess she's the only one.that will be in the office on Monday. We'll see what happens.

I should add to this, that I've kept my meds in a safe for several months now, not sure when my norco disappeared, or for sure by whom... it just shows that nothing is safe these days.

Matt,

This is appalling and it makes me ashamed to be in health care where the almighty dollar rules. It should be against the law to leave you like that. It is one thing if someone knowingly violated their pain contract but this....all the laws are for protecting the docs but what about us? Pain control is a big thing, the fifth vital sign. I can always tell the drug seekers in the ER, they pitch a fit and threatento sue if they do not get their drug of choice, we take what they give us afraid to speak out. We have rights too. What that doc did is unethical and believe to or not in some states docs have been disciplined by the state board of medicine.

I would look into reporting him. It is called patient abandonment and all states have rules against it. What state are you in? Check the state medical board site. And Fioricet contains a barbituate.

Take care and you are in my prayers

Thanks Kaely, and everyone else, I have talked to my attorney about turning the doctor in, he says that in California, it's not an offense to the medical board to stop treatment, unless it's a possible life or death scenario, like a transplant patient that needs immino-inhibitors. He said he'd double check, but so far this guy has been spot on. The worst part, is the insurance company is violating a work comp law, but my attorney says it's one that is violated frequently, and only gets inforced after waiting for a court date with a judge for 6-18 months.

I still have the surgeon to hear back from, and I remembered from previous calls that the surgeons are not in the office on Fridays, well, apparently he won't be in on Monday either. Hopefully his PA will be able to get this sorted out, I can start making calls around 8 local time, so I'll be on the phone like a tick on a dog until I get some answers.

I did have a glimmer of hope come in the mail, I got a letter on Saturday from the insurance company, standard letter about a utilization review, and it said that the surgeon's office had requested Norco, which, I think, with where my pain has been at the last couple mornings, may actually be pretty beneficial. Yes.... good news.... the raw pain levels seem like they're going down a little. I just hope I'm not speaking too soon about that.

I'll probably post an update on this tomorrow night, or afternoon'ish, I have some other things that I should be finding out later tomorrow, that everyone might find exciting, if what I think is going on, actually comes to pass.