Hopping Mad

Having breakfast with my friend Herm yesterday I described to him how great it feels to be beyond the symptoms of chemotherapy (That is for the most part… I still have numb hands and feet).  After feeling so bad for so long, this new crappy normal feels like ecstasy!  I cherish my appetite and lack of nausea.  My gut feeling is that I am back!  I am me again.  I have some side effects to deal with surrounding eating but at any given moment, I do not feel like a sick person any more.  It is wonderful!

OK, that is my bit of expression of positive vibes before I launch into a diatribe.  I am hopping mad!!

Yesterday I opened a letter I received in the mail and discovered that it was from a collections agency.  St. Mary’s hospital has sold my “uncollectable debt” to a bounty hunter.  The amount of $720 was denied by my insurance company (Priority Health HMO) for an operation I had back in May to fix a paralyzed vocal cord.  The operation was much more expensive than that; somewhere in the $4000 something range.  But one expense for that operation was denied: a “skin substitute” called Cymetra.  My doctor called it a stiffening agent.  My droopy vocal cord would stand up straight after being injected with Cymetra and would give my good vocal cord something to slap against to give me a voice.  You can read about it here from my April blog entry.

The operation was called, "Microlaryngoscopy with Left Vocal Cord Cymetra Injection".  It was successful and I can now speak clearly (although, as I have mentioned before, I still do not have my falsetto voice back).  Now you would think that a procedure that includes the name of the alleged, unapproved stiffening agent right in the name of the operation would raise some red flags in advance.  But I went into this thing with the understanding that it was 100% covered.

Imagine my surprise when months later, in August, I received a bill for $720 from St. Mary’s for $720 for the unapproved expense of using “Cymetra” in the operation performed in their hospital, "Microlaryngoscopy with Left Vocal Cord Cymetra Injection", as documented in an August blog entry.

Not understanding this, I called my insurance company for an explanation.  “There are cheaper skin substitutes and Dr. Winkle chose an expensive one.” They then suggested that I have Dr. Winkle write a letter with an explanation, asking for a review. 

I then called Dr. Winkle who told me he was very confused by this.  He always uses Cymetra for this operation and had never heard of it being denied before.  I asked him to write the letter.

I got a call back from my Priority Health RN case manager, Jayme, who helped me connect with someone in the organization who could delve deeper in the case for me.  I got on the phone with this nice person (I wish I had documented her name and the date) who promised to do some research and call me back.  She did just that.  On the return call, she started explaining about how other medicines could have been used in this operation and she went straight to the document while we were on the phone. We reestablished the procedure I had undergone and as she read the brief, she said, “Oh, look at this… Cymetra is on the list!  It is a mistake.” 

I was so relieved and I thanked her profusely.  She assured me that the matter would be handled by the end of the week.

Imagine my surprise when I got another bill for $720 from St. Mary’s dated October 22.  I immediately called them and explained that the issue had been resolved back in August.  They insisted they had no record of payment.

I once again called Priority Health, who looked up my case and told me that the bill had been paid back in September.  I thanked them and called St. Mary’s back to explain their error.  The person on the other end of the phone said he would look into it again. 

That was the last I heard before yesterday when I got the letter from the collections agency.  St. Mary’s will no longer talk to me as it is out of their hands.  Priority Health now says they see no record of a payment for $720 but will look into it.  Surely they have notes from my previous contacts.  But I know from experience that collection agencies have invested in my debt and they have no use for explanations.  My credit rating is already whacked and no one has any motivation to help me resolve this.

I am grateful for the fact that I am insured; they have paid a lot of money for all my treatment.  $720 is a small out-of-pocket price to pay and I would have paid it except for the fact that my operation was supposed to be 100% covered and I was told by my insurance company on 2 occasions that the situation was handled.

Grrrrrrr!!!!!!  I am so angry that I can’t sleep.

And I am so grateful that I otherwise feel that my health has been returned to me. 

Mary and I saw Ang Lee’s “Life of Pi” at the cinema last night, which is a beautiful story of survival and spiritual growth.  I am glad that I have lived to see it.