I've spent the last two days arguing my my health insurance company. My son has been having increased pain and muscle spasms surrounding the hardware that's holding his hip together. We discover that he's got a new bone tumor, which, if not for the hardware, wouldn't be that big of a deal. But it just so happens that this tumor is directly underneath the large metal plate that bridges the top of the straight part of the femur and the femoral head. This is pushing the plate into an odd spot and "hooking" the iliotibial band, which just creates a huge domino effect of pain/spasms and general misery. Surgery to remove the existing hardware, excise the tumor and redo the hardware is indicated. Should be fairly straight forward, right?
Nope. Doc does a basic pre-op exam. He's not thrilled with the child's spine. Sometime in the last year (since his last operation), the upper part of his spine has straightened out. X-rays confirm the deformity, but give no indication of why, or any evidence that traditional intubation methods would be safe (and intubation is required for general anesthesia). So doc orders an MRI of his entire spine. Insurance company says no. Mama bear goes on a rampage. Granted it was a very polite rampage, but there's no way either the surgeon or the anesthesiologist are going in blind, and even if they were willing, I wouldn't consent. Beyond that, whatever's causing the spine to be deformed needs to be diagnosed and addressed.
So I got to spend the day on the phone with an ever escalating series of people trying to talk some sense into them. Apparently they stop reading "in preparation for hip surgery", and deny the authorization because you don't need a spinal MRI to operate on a hip. Most of these people needed to get out of customer service years ago. I get that calls centers suck. I really do. I've had a call center job. But at some point, you really need to actually listen to your customers or learn to read the doctor's notes. After being sent to the third different "supervisor", I finally got somebody to actually read the entire document. MRI is finally approved and scheduled, but seriously, it should not have been this difficult.
Okay, vent over.
Nope. Doc does a basic pre-op exam. He's not thrilled with the child's spine. Sometime in the last year (since his last operation), the upper part of his spine has straightened out. X-rays confirm the deformity, but give no indication of why, or any evidence that traditional intubation methods would be safe (and intubation is required for general anesthesia). So doc orders an MRI of his entire spine. Insurance company says no. Mama bear goes on a rampage. Granted it was a very polite rampage, but there's no way either the surgeon or the anesthesiologist are going in blind, and even if they were willing, I wouldn't consent. Beyond that, whatever's causing the spine to be deformed needs to be diagnosed and addressed.
So I got to spend the day on the phone with an ever escalating series of people trying to talk some sense into them. Apparently they stop reading "in preparation for hip surgery", and deny the authorization because you don't need a spinal MRI to operate on a hip. Most of these people needed to get out of customer service years ago. I get that calls centers suck. I really do. I've had a call center job. But at some point, you really need to actually listen to your customers or learn to read the doctor's notes. After being sent to the third different "supervisor", I finally got somebody to actually read the entire document. MRI is finally approved and scheduled, but seriously, it should not have been this difficult.
Okay, vent over.
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