Collections....

Well, no matter how bad things have been in the Great Insurance Wars of 2022, we have hit a new low.

Babygirl hitched a ride to my office a couple of days ago so she could walk to the dialysis center to drop of a box of, well, blood. Not the same as the last one, mind you. A whole different thing.  Or maybe it was dialysate, to make sure the water doesn't have, say, arsenic.  I don't know.

However, she spent half an hour in my office playing with her phone until it was time to go, which was how I happened to overhear The Phone Call.

I could tell that it had something to do with a bill.  After a minute I asked her to put it on speakerphone, which she gratefully did.  To be fair, I missed the caller's identity.  But he was asking for payment of $1600 toward her emergency room physician's bill from 12/31/21.  You know, the day she almost died, what, nearly 15 months ago? 

He was offering to help her set up nifty $25/month payment plan. 

At this point I took the phone.  Apparently only $455 of this bill had been paid by her insurance, so she owed the rest.

Except she DOESN'T.  She has Medicare and Medicaid.  It is illegal for them to sent her a bill for the balance, even if the balance wasn't fully covered. I pointed this out to him, strongly, and let him know I'd be checking with her insurance to see who FUBAR'd what THIS time.  (Maybe that should be DUBAR. I don't know.)

Yesterday I spent 65 minutes on hold with my insurance.  They paid in July, the $455.  They say the bill was resubmitted in September and rejected.  Well.

So I spent half an hour on the phone today with an honestly delightful representative of the ER doctor's billing office.  Turns out they NEVER call, and the bill was in collections. They had my BC/BS listed TWICE, once as BC/BS and once as SmartHealth (the biggest oxymoron in history, but it is our flavor of BC/BS, with the same exact ID#). Once the second BC/BS (same as the first, of course) rejected the bill, they failed to rebill to Medicare and Medicaid.  

She could see where I'd called before, given the correct information, and that the actual patient screen was not updated to match.  Yes, she agreed, it is not only illegal to bill her, but also illegal to send her to collections. 

"Ignore collections, we'll have it rescinded 'after a review.' "

I'm pretty sure she knew what she was talking about. Not so ducking confident about the reviewers.

DeeDee

So Much Water....

Super Bowl Sunday.  While the technologically challenged among us are still trying to figure out how to access this years' game (yeah, last year we used Peacock. This year, not so much LOL), I'm thinking back to the 2012 game.  I have no idea who played, who won, or what the best ad was.  I only know that we were finally out of the ICU, off dialysis, and on the road to what we thought would be a normal life. 

There's been a lot of water under the bridge since then.

The kidneyversary was last week.  February is full of things to remember. My grandson's birthday, a host of other family days. The anniversary of Mom's death. Remembering Jorge and his family, their loss and their gift to us. 

I still, more than a year after the loss of the kidney, can't think about that day like I did the previous 9 years.  

And yet, that gift, however temporary, DID buy us a more normal life. Beach trips, hiking, camping, Complete freedom from the dialysis machines. Every moment of freedom, every unconscious lack of worry, ALL of it, from that gift given at great cost.  

I remain incredibly grateful, endlessly grateful for all of those gifts.  None of the struggles of those years outweigh that gift. 

Gratitude remains the best defense against that ducking squirrel.

DeeDee.

Letting Her Grow Up.......

 Babygirl is 23.  

At 23, I had 2 college degrees, and had been working in cancer research for 2 years, actively prepping for medical school.  The sickest I had ever been my life was a case of strep throat in 5th grade, and the Russian Flu in my sophomore year. I almost never missed school. 

I have no real way to relate to her life. She's missed YEARS of school. She can't see well enough to learn to drive. She's tied to a dialysis machine at home for 4-5 hours 4 days a week, unless some frustrating SNAFU happens that makes her have to start the hour-long set up over, or delay for another day (which makes her feel like crap since she has to let all the toxins build up in her system for an extra day). 

I've been her mom since she was 2. I've been her support system since she was 11. 

I've been quietly trying to let her take on as much of own her care as has been appropriate at any given time.  She's been in charge of sorting her medications forever. She  takes care of ordering her medications, mostly. I'm no longer able to access her medical portal. She communicates with them on her own (I confess I miss the access. I have to search my soul and admit that perhaps I miss the control). 

Letting go of the details is extremely difficult for me. So when the details fall behind, like late refills and, well, unmailed blood, I want to snatch it all back and make her 11 again. Because if I do, then....what exactly?

This is one more run of magical thinking.  This entire last year has been...challenging. Difficult. Horrible. Exhausting.  And the squirrel that runs rampant inside my head periodically stops and yells at me about how I should have somehow prevented the transplant failure.  Paid better attention. Noticed how quickly she was getting sick. Ridden in on some kind of ducking flying carpet and kept us from landing in this quagmire. 

Two good friends have died of kidney disease in the last few months, and a third has had a kidney transplant. Of the ones who died, one opted to not do dialysis. One opted to do it.  The one who had the transplant is struggling through the horrors of the first year:  Infections, hair loss, fatigue. Granted, these astonishing women were/are all older than me, each bravely fighting kidney disease in her own way. And ultimately, advanced age notwithstanding, proved that this disease is the biggest bitch there is. 

In the end, nothing I do is going to win this. She's the fighter.  In all this time, she's done whatever she needed to do and complained damn little about it - certainly far less than I have, and do.  But....in the end....

Nothing SHE does is going to win this either. Life expectancy for a 30 year old with end stage renal disease on dialysis is about 15 years. Successful live donor transplant lasts about 25 years, and as we know, deceased donor transplants 10-15 years, typically. Clearly, statistics do not apply to individuals. Even more clearly, I have no access to a crystal ball. 

Borrowing trouble before it's due is as pernicious as magical thinking. In either case, I'm making myself anxious and crazy to no avail. Taking note of this does not, in any way, kill the ducking squirrel. 

DeeDee

Boxes of Blood.....

There is already a post about this.  But this is a different box.

Babygirl is supposed to draw her own blood during dialysis to follow her potassium and phosphorus levels, among other things. She is supposed to draw additional specimens to send to Rochester.  This has to be done every month, and the tubes are supposed to get boxed and FedEx'd to the tissue typing lab. Every. Month.

Without those samples they can't crossmatch her tissues and antibodies to an incoming kidney to confirm a match.  So if the blood isn't available, she could miss opportunities for transplant.

I really can't recall the last time we were in Rochester, but that is the last time that one of these specimens went to the lab. It's been.....months.

It isn't that Babygirl hasn't tried.  Our local hospital used to do this when she was listed at CHOP.  And CHOP (have I said how much I MISS CHOP??) provided us with a labeled mailing box for the hospital to use, along with an appropriately coded order.

All of that is missing. We have boxes, with no labels for the blood tubes and no mailing labels. The first order wasn't signed by her provider. Now we have a signed order but no codes. 

We got as far as having the blood tubes, hand labeled with Babygirl's name and date of birth. No order was needed as she drew it herself.  Per the new instructions from the dialysis team, we drove to the local FedEx office. 

This is the story they told us:  "We can't take that here because of the warning on the bottom." It is clearly labeled as a biologic specimen.  According to them, people at the store "lack the necessary training to handle that." They also would not print a label for it so we could put it in a drop box (which is apparently emptied by people who have the "necessary training"?). Not one word of that made any sense to me.

They told us to go online and get a label, email it to them, and then they would print it for us. We already travelled from our town to the next one over. So they want us to go BACK home, email them, and go BACK to them, and then back home?  

I went online. One full frustrating hour later (much of it spent trying to find a contact number and go through the endless "if A/press B" menus to get to an actual person), I finally downloaded a file for the label and emailed it to MYSELF so I can print it at the office and get the sucker mailed. Then I can stuff it into a drop box, which is thankfully located in my own neighborhood.

All home improvement projects have what I call a "swearing and screaming phase." Keeping your kid on the transplant list by mailing 2 tubes of blood to her hospital should NOT have that phase, but I'll admit that there was crying in addition. 

Just....why?

DeeDee