The Pharmacy Chick

Flying the coup in retail

Mr Chick, the patient patient.

Filed under: Uncategorized — pharmacychick at 3:18 pm on Tuesday, January 6, 2015

Sept 20 2014 proved to be the day that the Lord moved us from one path to a detour  not of our choosing.  Whilst doing nothing more than pondering the selection of a pair of trousers from the closet, Mr Chick reported to have been struck by lightning that started at his hip, moved south to his foot and permanently resided there like a barbecue fire.  At that moment, he went from a perfectly well functioning adult to a man who couldn’t stand up, sit down or walk without great discomfort.  About all he could do comfortably was to lie down…and that wasn’t much of an option.

And in that moment, we went from “provider” to “patient”

Being the trooper that he is, he went to work.  How he got there while driving flat was somewhat of an endeavor but he did get there.  He is no slouch, his job requires attendance as obligatory as mine does so ” calling in sick” might as well be grounds for treason or a guillotine. Calling in sick usually requires a death certificate, and that is iffy.  Employees are required to die on their days off and find appropriate replacement coverage.

While neither of us are physicians we are pretty well versed in the human body and we knew he had either herniated or ruptured a disc.  Our first call was to our PCP whom also happened to be our friend.  He said ” MRI” first step.  He also said ” by the way, I am retiring at the end of october and going overseas to do some medical missionary work”.  Well, that wasn’t the best of timing but at this point we didn’t have much we could say about that.

Getting an MRI isn’t just as easy as walking into the imaging center and saying ” Get er done”, unless you plan on paying full price out of your pocket. No,  we  ( being the doctor) had to request a PA.  Then the fun began.  The office sent us via phone to a imaging center near our house….that had closed 2 years ago.  The phone still worked but it re-directed us to its remaining office about 50 minutes away.  We talked with person 1 who said they do appointments on mon, wed and thursdays only.  Then we talked to person 2 who said person 1 was incorrect.  Person 3 said we had to pay a 500.00 “deposit” on  the procedure.  But the insurance said our copay was about $100.00.  One lady at insurance said NO PA required and next person on the line said it was required.  It was frustrating to call and get different answers every time a different person picked up the phone.

An aside:  on a scale of 1-10,  I would rate myself a solid 9 as far as knowledgeable about  insurance and its rules and procedures.  Only an insider in the insurance industry might have a better go at it, but after all these years, I  know the verbiage, the routes and how to say WHAT to get what we need.  Nevertheless….

It took nearly 2 weeks before it was all straightened out–correct information, correct pricing and correct location about 4 miles from the house. It confirmed what we had believed:  Herniated disc right on the sciatic nerve and moderate to severe stenosis.  Ouchie.

Dr PCP said the first step would be to have a cortisone shot injected in to the site to reduce the swelling.  Getting that authorized was about as simple as navigating razor wire buck naked.  You may actually survive it, but you will be shredded in the process. It  took nearly 3 weeks of waiting, a dozen phone calls and actually required a hospital admission ( give me your clothes, here is your paper gown). The doc was very nice, very thorough and said basically ” ya, it may or may not help”.

It was a 5 minute procedure that took about 5 HOURS from  parking lot to parking lot. It was a process nearly identical to getting the MRI. Only this procedure cost us out of pocket about 700.00.  So we are now into it about 800.00 give or take.  We got the itemized bill later ( much later) on.  The “cost” of the triamcinolone injection ( drug only) was 125.00.  I should have bought it from my wholesaler and handed it to the doc…” here, this is same med only you won’t charge me a ten-thousand fold price increase for it”  ( that might have not gone over so well ya think??)

They said it would take 2 weeks before we might see a benefit.

No benefit was seen after 2,3 or 4 weeks.  More to come.. Time to see his holiness the surgeon…


Comment by pe2pa

January 6, 2015 @ 7:26 pm

While the situation most certainly is not humorous, your writing surely is. Oh, the image of the barbed wire!

I am sorry that you and your hubs are having to go through this.

Hope things with his holiness Medical Deity went better…

Comment by Kassy

January 7, 2015 @ 4:13 am

As I assume you are aware, the doc didn’t charge you one penny for the triamcinolone. The hospital did however.
The doc was paid some percentage of the charge for the injection itself. He was not paid one penny of the facility fee, the med fee, the equipment fee, the nurse fee, or any other fees you found on your bill other than the injection procedure itself. So of the $1500 bill(guess) the doc gets maybe $100. Not bad for 5 minutes admittedly(though after down time/documentation time it is 2-3 times that he is involved) but a small percentage of the i got a separate bill from the doctor. Paid that too…it was waaaaay more Than 1500.00. It was a hospital admit. You can’t even get a wheelchair ride anymore for under 1500.00

Comment by rapnzl rn

January 17, 2015 @ 11:53 pm

How very sad for you both. I hope Mr. Chick finds the best way through this and recovers (as) quickly (as modern insurance/medicine will allow/disallow). My ‘Mr.’ ruptured every disc (yep – all of ’em) in 1996. My, how insurance has NOT changed since then!

Trust me on this, you are fortunate NOT to have to deal with Workmans Comp!

(Long years of) bitterness aside, my thoughts and prayers are with you.

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