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	<title>Complex-Simplicity</title>
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		<title>DENIED, REJECTED, NOT COVERED</title>
		<link>http://www.complex-simplicity.com/2012/05/denied-rejected-not-covered/</link>
		<comments>http://www.complex-simplicity.com/2012/05/denied-rejected-not-covered/#comments</comments>
		<pubDate>Tue, 01 May 2012 11:17:04 +0000</pubDate>
		<dc:creator>Mz Gina</dc:creator>
				<category><![CDATA[Complex-Simplicity]]></category>
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		<guid isPermaLink="false">http://www.complex-simplicity.com/?p=1806</guid>
		<description><![CDATA[Someone please explain to me why I have a primary care physician and specialists? It just seems rather odd, to me, that my health insurance provider makes me pick a primary, and the specialists I see must be from their list of acceptable physicians if I want them to pay for the doctor visits. Yet, [...]]]></description>
			<content:encoded><![CDATA[<p>Someone please explain to me why I have a primary care physician and specialists?  It just seems rather odd, to me, that my health insurance provider makes me pick a primary, and the specialists I see must be from their list of acceptable physicians if I want them to pay for the doctor visits.  Yet, every time one of my physicians makes a decision regarding how to best take care of me (their patient), the course of the physician&#8217;s recommended treatment is <strong>DENIED, REJECTED,</strong> and <strong>NOT COVERED!</strong>  </p>
<p>Simply put, why must I waste everyone&#8217;s time, why can I not be seen by some employee from the insurance company?<br />
<h4><em>Hello insurance company lady, Is the janitor free two weeks from Tuesday, morning appointment if possible?  Oh, the problem?  The third choice of antibiotic your company finally agreed they would pay for, to cure my bronchitis, I believe is not working, cause I just coughed-up my left lung.  This is severely irritating my asthma, along with the cough that has thrown my back out, which is putting extreme pressure on that knee with the torn meniscus!  You know which knee I am talking about, the one you keep rejecting any and all pain relief medications unless of course, it is a controlled substance, then you will allow it to go through.  But, between the asthma situation and the heart issues, my physicians do not recommend I take these drugs, even though you do not agree with their educated decisions.</em></h4>
<p>Being doctors, does not qualify my doctors to give me the appropriate treatment they feel necessary, this is according to the amount of rejected prescriptions I have.  So,  I am willing to wait to see the janitor,<br />
<h4><em>will he be available in two weeks?</em></h4>
<p>Health insurance companies rule the world!  Some person, lacking actual education and experience in the medical field -not a doctor, not a nurse, and not even a home health aide, makes the final decisions regarding my health care needs, based upon the company&#8217;s health insurances guidelines.  This is why physical therapy for my knee was rejected, as well as non-additive/non-narcotic pain patches,  and non-additive/non-narcotic pain cremes or gels.  Now, the medications that conflict with other medical issues I have, and the controlled and addicting substances are all available to me.  This is not good! I plan to live for at the very least another 30 years plus, <em>(I want to be a feisty old bat with enough spunk to drive the son nuts, but make him laugh!)</em> if they turn me into a prescription junkie, in my old age I will end up being a toothless hag on the street corner trying to by drugs to support the habit that was forced upon me, while my insurance company tells my son <strong>&#8220;I&#8217;m sorry we do not cover drug and alcohol rehabilitation.&#8221;</strong>  Poor kid will have to tell the ‘grandkids&#8217;, &#8220;No grandma is not dead, I just checked with a mirror, she is just passed out from her last fix!&#8221;  The alternative is to take what conflicts with other medical issues, and at some point, drop dead.  <em>(Hmmm, what to do, what to do.)</em></p>
<h4><em>Will the janitor be in that morning, and if I have a severe asthma attack before my appointment, will he meet me at the hospital like my primary care physician does?  Also, if it is that bad, like the last time when I almost died, will he stay, spend the night at the hospital to be there and watch over me (–that was on his time), so will he?  Will he handle what you will not cover, and get me what I need?  No, it is okay, I understand.   I will be seen then, oh while he is cleaning toilets, well I guess that will do!</em></h4>
<p>I don&#8217;t know, maybe it&#8217;s just me.  I think that I just heard a flush, it is the our healthcare system, another health insurance company just ‘crapped&#8217; on another one of us.</p>
<p><strong>Happy Mother&#8217;s Day to my mom, I love you!  And a, Happy Mother&#8217;s Day, to all you Moms out there!</strong></p>
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