…sort of day!

Today is kind of like the perfect, lets wear sweatpants and my favorite sweatshirt, sort of day!

Today, the temperature, the wind, the sweep of the shade over the yard, it’s all perfect; TODAY.

Today is neither too warm or too cold; an, I don’t have to wear socks, sort of day.

It’s a, going for a ride, day, moonroof open, around the loop (our loop) playlist on shuffle, kind of day, this day, today!

It is a perfect, play fetch with the dog, day for sure!

Day drinking, skinny dipping, lounge in the yard, sort of day.

I need to remember TODAY

From 1 to 10, what would you rate your anxiety?

With my 90 day heart biopsy and general check up in Utah out of the way my anxiety level has certainly decreased a bit; however, it’s still pretty high which prompted a change in my medication again. Now I’m on two anti-anxiety medications and they doubled my dose of Prozac. I know I shouldn’t feel ashamed of the fact I need medication in order to chemically balance my brain, but the shame creeps into my head and make itself at home. The pill count for my anxiety and depression has officially surpassed what I take for anti-rejection. What does that say about me and my emotional stability? The stigma associated with mental health issues runs deep with me maybe.

I don’t judge others for seeking help for mental health issues, I’ve encouraged it, then I’m hard on myself for taking my own advice? How ridiculous!

I can’t express how much I wish I could go back and re-write the parts of my life that have changed the DNA of who I am. I don’t dwell on events from the past that hurt me; I have set those things aside and forgiven. What I haven’t done is forgiven myself. We’re always our own worst critics, right? I don’t know how to love this person I am who requires medication and regular therapy to get through life. I feel broken and I don’t want to be. So, I take the drugs, I go to therapy and I try to untangle my life, try to organize it in a way that I can makes sense of and live with without shame.

From 1 to 10, where would I rate my anxiety? About 45 minutes ago the answer would have been a hard 10, now, with a little pharmaceutical assistance, it’s about a 5.

Not OK

I’ve been trying to hold it together for months now. I’ll admit that I was in a state of denial that my generalized depression had returned. I should have spoken to my doctors sooner; I was such an idiot for waiting. I started by calling my transplant team in Utah and although they have prescribed me antidepressants before the Psychiatrist just didn’t feel comfortable prescribing what he had before (a low dose of Prozac) without seeing me. I live in Wyoming and he’s in Utah so I asked for a phone consultation and he didn’t feel comfortable with that either.

I feel like I’m circling the drain and finally reached out for help and all I get in return are barriers. I finally called my local doctor, who as usual wasn’t available. His nurse could see me but she doesn’t listen to me and is generally rude and quite frankly in the state I’ve been in I didn’t want to break down in front of her. Thankfully a nurse practitioner for another doctor in the practice agreed to see me and without hesitation prescribed me what I had been taking post transplant; I even brought in the bottle. She was also kind enough to give me a refill for my Xanax, which I’ve using more lately than any other time in my life.

I internalize my anxiety so to the people I live with or know me have no idea I’m a hot mess on the inside and just a nanosecond away from collapsing into tears. I’ve been extremely tired which is probably a combination of the depression and the hemolytic anemia I’ve had since the transplant. Together I could sleep 20 out of 24 hours of the day. it will take awhile to get the depression and anxiety under control, but there is no reasonable treatment for the hemolytic anemia.

This COVID-19 pandemic has me really scared. I fall into the high risk group because of my compromised immune system. I’ve been self isolating for awhile now and it’s lonely; when I’m awake. I hate sending anyone our to buy groceries in fear they will bring the virus home with them and we can’t have groceries delivered right now because all the stores have been picked apart by hoarders. I think the next couple of weeks are going to be tough.

I had hoped that opening up would help ease some of the anxiety and depression, but it hasn’t. We talk a good game on supporting people with mental health challenges but in reality no one has time to really listen or really help. We all have our own issues and don’t have time to help others. Ironically I was trying to help a friend going through a hard time and they totally turned on me and stopped speaking to me because they couldn’t handle that I have issues I need to deal with as well and couldn’t be there for them 24/7.

I feel like I’m on my own.

Finally Found

After a few DNA tests, many weeks of waiting, and more lost nights of sleep than I care to count, my biological father has been found. It’s been about a year since I found out who I thought was my father was in fact not, so, it’s been a long emotional year of ups and downs. And you’d think I’d be ecstatic finally knowing, finally being accepted, and finally having a father, but I haven’t felt that way since finding out.

Maybe it’s all that’s going on in the world right now (COVID-19), generally being depressed the last few months, and feeling pretty lonely have clouded what would otherwise be joy at the fact that I found him. Now my thoughts are filled with the idea that it’s too late, I’m 48. Maybe his family won’t accept me; I may never even meet his family for all I know. They are far more important to me than I am to them I’m sure. I don’t say that to be negative, it’s just a truth.

I don’t know what to do from here; I’m kind of lost. I don’t want to intrude on anyones’ lives, but I would love to know my father’s side of the family.

Medical Insurance Claims and Predatory Billing Practices

I’ve spent the better part of this lovely Friday morning dealing with medical bills. Bills from two different hospitals and billing to two different insurance companies, in dollar amounts in the thousands. I know that my case is somewhat different than the average person, I’ve had a heart transplant; however, I believe that everyone that has seen a doctor or been to the hospital has experienced something very similar.

For years I’ve felt like the billing practices of some medical facilities are predatory in nature and they prey on those who don’t know any better, are confused, or those who simply don’t have the time in their day to make multiple phone calls to deal with a single bill. The issue is, that if you don’t, medical facilities will send you to collection faster than you can even say “predatory billing practices.”

Below is an example of a bill I’ve been receiving for lab work done at my local hospital in October of last year. The bill isn’t for a lot of money, but I know that this was not billed properly to my insurance and I should not have to pay any of it. My husband and I have both made calls about this bill to both the medical facility and the insurance company. An interesting thing to note on this bill is that there are two account numbers. I asked the financial representative with the medical facility why there were two account numbers and they were not able to give me a sufficient answer. I can tell you that I have two other bills from the same facility where these two number match, why this one is different I don’t know, but it could be a source of confusion when it comes time to pay, whether I pay it or my insurance does.

The other interesting thing about this bill is that it appears that a claim for this bill has only been sent to BCBS and that the medical facility has failed to send it to my secondary insurance which would likely pay the balance. I have had secondary insurance for three years, this is nothing new to this medical facility; however, they consistently fail to send claims to both my insurance companies. Although this doesn’t seem like a big deal, this kind of failure on the part of the medical facility has taken us over a dozen phone calls and months to sort out.

Example of Bill

The next image is an explanation of benefits from my insurance company for the same date of service. Notice there is a “Notes ID” in the last column. The note reads “An internal protocol, policy, guideline, or rule has been used to process this service. If required, a copy will be provided free of charge by calling out Member Services Department.” The member services phone number is not printed on either side of this piece of paper, rather, it’s on a separate piece of paper, easy to misplace. The number is printed on the back of the insurance card so small you might need a magnifying glass to read it, if it hasn’t been rubbed off from the wear in your wallet. I could call the number on the back of my card and request the “internal protocol, policy, guideline, or rule has been used to process this service” but why doesn’t the insurance company just offer it up with the explanation of benefits? Why do I have to make a phone call where an automated system will answer and I have to jump through a dozen hoops to get to a person who will send me this information, and in the end I have wasted 15 minutes of my day on the phone for something that is going to tell me nothing about why this bill wasn’t paid?

So why do I think all of this is predatory in nature? I receive this bill every 20 days, the same bill, and my husband and I make the required phone calls to the medical facility and the primary insurance company. So far neither institution has been able to resolve this claim. If we failed to make these phone calls every 20 days this bill, in all likelihood, would go to collection and could balloon to twice what it is now with fees and interest. That being said, in this case the medical facility actually owns the collection agency that these bills go to so they not only get to collect the amount of the bill, but the fees and interest as well. That doesn’t sound shady at all does it?

What most people don’t know or don’t care to take advantage of is that if you call the medical facility that has sent you a bill to make payment arrangements or to dispute the charges they, in most circumstances, will not send you to collection; however, you have to call them EVERY TIME you receive the same bill. Any laps in your contact with the medical facility will be a signal to them that you refuse to pay and your bill will be sent to collection.

Collection agencies for medical bills are no different than any other collection agency, they can and will do anything to collect. They can legally lie to you about what they will do to you if you fail to pay. The most they can do is garnish your wages (if you have a job) but some have gone so far as to tell a patient that they will seize their home or other assets if they do not pay, which the collection agency can’t actually do, but how is the person being threatened supposed to know that? Their modus operandi is to scare and intimidate people into paying more than they are required to. And if you don’t think the medical facilities themselves don’t practice the same tactics before they send you to collection, you’d be wrong.

I believe medical facilities do everything in their power to make their billing as confusing as possible so they can bank on patients missing something that they can send to collection. I believe this of the medical facility I have to go to for service. Especially given that they operate the collection agency they “send” their past due bills to. One trip to the emergency room will generate multiple bills for the same visit. You will receive a bill from the hospital, the doctor, plus any imaging you may have had done during your visit. You will not receive these bills at the same time, they will come to you weeks apart, in the same format, with the same logo at the top, with little explanation as to what the bill is for, just a date of service. If it’s for a small amount you may pay it thinking that’s the end of it, but you’ll receive a bill two weeks later and you’ll disregard it because you thought you paid it. That’s where they have you, that bill you just disregarded will likely come to you again and if you disregard it a second time it will go to collection. If you do call the medical facility, they will likely tell you that the hospital fees are separate from the doctor fees and the imaging fees. In some cases, you can be billed by a doctor that you never even saw!

Some years ago, I went to the ER because I cut my foot rather badly and needed stitches. I never saw a doctor, only a nurse. My foot was x-rayed to make sure I hadn’t broken anything and to make sure there wasn’t any glass left in it, and then the nurse stitched it up. I received three bills, one for the hospital, one for the x-ray, and one for a doctor I never saw. Of course, my insurance paid for the ER visit and they paid for the doctor I never saw without question. I never called the hospital to ask who the doctor was and what they did. I probably should have called; however, my insurance covered the claim and I moved on. But I wonder, what did that doctor do? And why should I or my insurance pay for a doctor that never set foot in my ER room?

My point of this rant with visual aids is, that medical facilities and insurance companies don’t make it easy for the average consumer to understand what’s being billed, what’s covered, and what am I REALLY responsible for paying. Because of this lack of understanding I think people are paying far too much for their healthcare in some cases and some are being preyed upon by collection agencies on behalf of medical facilities to pay more than they should be required to. This is why people are having to make the decision to pay their rent or medical bills and are filing for bankruptcy over medical bills. I don’t think healthcare is as expensive as some might say it is. I think that both medical facilities and insurance companies prey upon people in our society who may be uneducated and/or socioeconomically disadvantaged by bombarding them with bills and statements that are designed to be confusing. I also believe that buying insurance and paying medical bills is what is contributing to some families being socioeconomically disadvantaged. If it weren’t for having to take a child to the ER for a broken arm they would have been able to pay their rent last month.