Well it seems no matter how you try you just can't win!
I received a call back from Dr. Kelly's office quite quickly after my email. This it seems was not a good sign. I was told that even though my insurance said I have a DME benefit, that once they received the information the claims would still be denied, because you don't need a CPM for hip surgery and you can use ice instead of the game ready. Basically they go for the cheapest way out to not pay. Bugger! Plus, something I do not recall being mentioned earlier, I was told that HSS has a "very strict policy about DME's and where they are supplied from". Kickbacks anyone? Either way, I'm completely buggered and will have to pay out of pocket for both. ARGH!
On a different note, I am searching for a certain type of crutches that seem to be the best for me with my crap hands and shoulders. They are called Platform crutches, similar to forearm but not quite the same. Of course they're expensive and hopefully I will be able to get a hold of these if the PT approves. My main concern is not to destroy my hands whilst trying to save my hip.
Ain't life grand?
Well, the good news is that the surgery was approved, so I guess that is one less fight for me!
07 August, 2007
insurance insanity
I received the various papers from Dr. Kelly's office this weekend and did not really feel like dealing with them until today.
I guess if you can't plan a holiday, then planning surgery is an option!
I rang up the anesthesiologists office first to see if they are covered. They do not participate in any plans. Ok, fine, the dr's office warned me. However the woman I spoke to in their billing department was very helpful. She said to ring up Oxford and tell them that the Dr and the hospital both participate in the plan, and ask to what extent the anesthesiologist would be covered. Yippee! Ms. Crystal said that since both are covered then the anesthesiologist would be covered as "in network" status. That was definitely one thing off my shoulders.
The onto what is know as "Durable Equipment". I never heard this term before, but it seems the machines the dr wants you to use after surgery fall under this title. The dr's office did tell me that even though the insurance will say that they cover the CPM, when they see the diagnosis for hip they will not, as the machine was made for knee issues. A bit daft if you ask me b/c there is no CPM specifically for hips, but that's insurance co's for you! But it can't hurt to try to get some coverage! I asked Ms. Crystal at Oxford about this and she gave me a list of the nearest Ortho places that they work with for DE's. I rang up one and they referred me to their LI office, saying that all equipment can be sent into the city. They seemed most helpful when I rang, took down all of my information, and asked that the dr's office fax over a prescription for what I need. I've just sent an email to the dr's office requesting that prescription be faxed over (lets see how long this takes). If there is any way I can get some of this covered I'm sure as heck going to try! I have a feeling all of the incidentals are going to add up!
I guess if you can't plan a holiday, then planning surgery is an option!
I rang up the anesthesiologists office first to see if they are covered. They do not participate in any plans. Ok, fine, the dr's office warned me. However the woman I spoke to in their billing department was very helpful. She said to ring up Oxford and tell them that the Dr and the hospital both participate in the plan, and ask to what extent the anesthesiologist would be covered. Yippee! Ms. Crystal said that since both are covered then the anesthesiologist would be covered as "in network" status. That was definitely one thing off my shoulders.
The onto what is know as "Durable Equipment". I never heard this term before, but it seems the machines the dr wants you to use after surgery fall under this title. The dr's office did tell me that even though the insurance will say that they cover the CPM, when they see the diagnosis for hip they will not, as the machine was made for knee issues. A bit daft if you ask me b/c there is no CPM specifically for hips, but that's insurance co's for you! But it can't hurt to try to get some coverage! I asked Ms. Crystal at Oxford about this and she gave me a list of the nearest Ortho places that they work with for DE's. I rang up one and they referred me to their LI office, saying that all equipment can be sent into the city. They seemed most helpful when I rang, took down all of my information, and asked that the dr's office fax over a prescription for what I need. I've just sent an email to the dr's office requesting that prescription be faxed over (lets see how long this takes). If there is any way I can get some of this covered I'm sure as heck going to try! I have a feeling all of the incidentals are going to add up!
06 August, 2007
Expecto Patronum
"The Patronus Charm conjures an incarnation of the caster's innermost positive feelings, such as joy, hope, or the desire to survive, known as a Patronus. A Patronus can be viewed as the exact opposite of a Dementor. Even though it embodies all the positive emotions that a Dementor feeds on, a Patronus is conjured as a protector, and is a weapon rather than a predator of souls: Patronuses shield their conjurors from Dementors, and even drive them away. A Patronus "cannot feel despair, as real humans can, so Dementors can't hurt it." The conjured Patronus protects the witch or wizard that summoned it, obeys his or her commands, and fades away shortly after it is no longer required."
"Etymology: The Latin word patronus means "father" or (in archaic Latin)"guardian" (see patronus)"protector" . The plural of patronus is patroni, but the plural of the term as coined in the books is Patronuses. The incantation for the charm is Expecto Patronum. The Latin word expecto, means "I await." A rough translation of the incantation is thus "I await (my) guardian/father."
In the French version of the book, the spell is "Spero Patronum". Spero means "I hope" or "I expect," much as ex(s)pecto means "I expect, I await." This could mean that the spell is based on hope and faith."
Well, this brief history of the Patronum spell is to help me to remember what to do when I feel as I have the last few days - utterly depressed. I am not keen on whinging and would rather lock myself up alone than go on and on about all that is wrong.
So, lying in bed tonight, when I should have been asleep (crikey even those pills aren't working now!) I came to an enlightening thought. Of course this could be because I've recently finished the last HP book and only yesterday saw Order of the Phoenix. But never mind that. The thought that stuck with me is this, well, it's what Harry says - think of the happiest memory you can to create your Patronum.
Since nothing else has been able to get me out of this funk lately, I tried to do just that. And it was pretty simple. The memory I came up with was of the hugs I get from my nephews. So from now I on when I am feeling like crap, and I don't just mean physically, b/c that's 24/7, I will think of my two favourite people and the wonderful hugs they give me. And hopefully that will be able to keep those Dementors away!
"Etymology: The Latin word patronus means "father" or (in archaic Latin)"guardian" (see patronus)"protector" . The plural of patronus is patroni, but the plural of the term as coined in the books is Patronuses. The incantation for the charm is Expecto Patronum. The Latin word expecto, means "I await." A rough translation of the incantation is thus "I await (my) guardian/father."
In the French version of the book, the spell is "Spero Patronum". Spero means "I hope" or "I expect," much as ex(s)pecto means "I expect, I await." This could mean that the spell is based on hope and faith."
Well, this brief history of the Patronum spell is to help me to remember what to do when I feel as I have the last few days - utterly depressed. I am not keen on whinging and would rather lock myself up alone than go on and on about all that is wrong.
So, lying in bed tonight, when I should have been asleep (crikey even those pills aren't working now!) I came to an enlightening thought. Of course this could be because I've recently finished the last HP book and only yesterday saw Order of the Phoenix. But never mind that. The thought that stuck with me is this, well, it's what Harry says - think of the happiest memory you can to create your Patronum.
Since nothing else has been able to get me out of this funk lately, I tried to do just that. And it was pretty simple. The memory I came up with was of the hugs I get from my nephews. So from now I on when I am feeling like crap, and I don't just mean physically, b/c that's 24/7, I will think of my two favourite people and the wonderful hugs they give me. And hopefully that will be able to keep those Dementors away!
02 August, 2007
two steps forward, one step back
Dr. Kelly and the pt's said I must keep my strength up, it's v. important before surgery, especially since I was so weak when I first started back in December. So after PT yesterday, I was feeling ok. Went back to work, a touch sore, but was determined to go to the pool. It's been raining a lot lately after work so haven't been able to recently. I have a whole routine I do in the pool to strengthen my legs. Nothing too intense mind you, but enough to make me feel like I am doing some strengthening. I guess it was too much though.
I woke this am and was fine, at first. But within a few minutes my hip started to hurt like hell. And I hadn't even left the flat yet! So I am a limpy person again today. Hopefully it will start to feel better soon, otherwise I may just have to resort to a lovely lidoderm patch and see if that works!
Nothing like being caught in a catch 22!
I woke this am and was fine, at first. But within a few minutes my hip started to hurt like hell. And I hadn't even left the flat yet! So I am a limpy person again today. Hopefully it will start to feel better soon, otherwise I may just have to resort to a lovely lidoderm patch and see if that works!
Nothing like being caught in a catch 22!
01 August, 2007
PT appt
Just to update as of today -
I had a PT appt. My insurance is only approving two more appts at the moment, so we've split them up as Dr. Kelly wants me to be evaluated closer to surgery. Now it's up to me to do more "homework" as I call it. I have been doing some excercises in the pool and will keep that up as much as possible. Also, my PT gave me more shoulder excercise to do so I can strengthen it up for the crutches. He is recommending some type of "elbow crutch" but I will have to do some research. The key is to keep as much pressure off of my hands and shoulders as possible, since I'm such a complete wreck!
He explained more about the psoas muscle release and said it should be fine, but with all that Dr. Kelly will be doing on my hip, I will probably be on crutches 4-5 wks. G-d give me strength, that is going to be rough!
So, onwards and upwards as they keep telling me. I have much to accomplish before I even have the surgery, but I'm hoping all this work will pay off with a (touch wood) quicker recovery!
I had a PT appt. My insurance is only approving two more appts at the moment, so we've split them up as Dr. Kelly wants me to be evaluated closer to surgery. Now it's up to me to do more "homework" as I call it. I have been doing some excercises in the pool and will keep that up as much as possible. Also, my PT gave me more shoulder excercise to do so I can strengthen it up for the crutches. He is recommending some type of "elbow crutch" but I will have to do some research. The key is to keep as much pressure off of my hands and shoulders as possible, since I'm such a complete wreck!
He explained more about the psoas muscle release and said it should be fine, but with all that Dr. Kelly will be doing on my hip, I will probably be on crutches 4-5 wks. G-d give me strength, that is going to be rough!
So, onwards and upwards as they keep telling me. I have much to accomplish before I even have the surgery, but I'm hoping all this work will pay off with a (touch wood) quicker recovery!
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