By week end my 4-wheeled walker is still the borrowed one from the PT folks at the rehab facility. There was no word from the approved provider that was going to see about one with 7.5 inch wheels. Likewise, there was no word on my request of a review of the “approved for a new PT place” so that too is still on hold. Timely apparently is not part of the concept of health care recovery.
Late-week mail brought two interesting items.
1. Back on Dec. 14 & 16 (Nancy is in the ICU) something was done by the cardiologists and described as “Subsequent Hospital” and billed for $120 each time. A statement arrived dated Jan. 29 indicating the insurance would not pay for these two things and we should send $240. John tried to call but got a phone-tree and so he wrote a letter stating his understanding of the insurer’s denial to pay for something “Subsequent Hospital” when the patient was still in the hospital. Now we have a new statement. This one seems to indicate that the bill was resubmitted to the insurer and they then paid $99.60 which settled the 12/14 debt of $120 but left the other untouched. Again, there is no explanation of what these charges are for nor why if the insurer can get by with paying only $99.60 of $120 we still have to pay the full $120. Also, were these things the same (the code of 99232 and description and cost is the same) and, if so, why didn’t the insurer pay both of them? We are still left wondering what we are being asked to pay for and why.
2. In response to a self-serving survey form from the insurer about a Case Management nurse calling program (talk-talk-nurse program) John wrote a letter. A couple of weeks ago we were called by a nurse from Spokane. She was the expected replacement in October for a nurse that called occasionally from Kennewick who was booted out of the process by the insurer when she didn’t agree to move to Spokane. This new talk-talk-nurse, in a response to a question from John, referred us to our EOBS. John slowed her down, stopped her, and had her back up and explain what our EOBS were. When the company pays a bill, or doesn’t pay, they then send a printout to you with the title “Explanation of Benefits.” This is an EOB. The talk-talk-nurse was surprised we didn’t have any EOBs. Because we did not have any we had no idea about the cost of Nancy’s long hospital and rehabilitation stay. The nurse promised to alert the company’s computers and have our EOBs printed and sent. A packet of about 40 arrived on Saturday. The $$ amounts are frightening. We will summarize them for you later. One item, the blood for the open heart surgery, exceeded $10,000.
Change of topic: Saturday we did go to a retirement community and I walked in with John’s help, my pillow, and him with my violin .. and took a chair I could get up from. We had a great turn-out and most everyone joined in singing many songs (the Irish ones, we provided words for). We went home for an hour, and then off to the Children of Chernobyl fund raiser with a dinner, program and silent auction. We got in at the front of the line with my walker and proceeded along the buffet with servers adding small dollops of things to my plate that was riding on the seat of the walker. I managed to eat a good meal, encountered many friends and enjoyed the program.
Now today, Sunday, is a non-event day. We have been resting and doing computer email. I was able to write a letter of recommendation for a former student from Thailand that I had in an Intro GIS (Geographic Information Systems) class two years ago. He is applying to graduate school in Texas and California, and, via computer, I contacted both places today. Until ex-students settle firmly into careers these sorts of chores crop up.
With no outings planned, after lunch we walked up the driveway and back, for my daily exercise. There were lots of small birds at the feeder including a small woodpecker, a Downy, we think. Tomorrow we’ll take the camera, walk farther, and see more.
Nancy