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Patient Power


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Another unbelievable round of phone calls to have a medication authorized (or re-authorized in this case).  The authorization for my Orencia infusions expired and of course, no one notified me of that small detail.  The evening before my 8 AM infusion time, I received a phone call from my rheumatologist’s office stating that since I no longer had current approval from the insurance company, they had cancelled my appointment.

I asked the nurse if there was anything I could do to speed up the process so I wouldn’t be without the Orencia for too long.  I was remembering my last battle – authorization for an increase in my Humira injection.  This battle raged for 7 weeks, leaving me without anything but methotrexate to fight a disease that was currently winning.

In response to my “What can I do to help speed up this process?”, the nurse responded in a very patronizing tone “Oh, I wouldn’t know what YOU could do!”  I was left speechless, unfortunately.  I didn’t expect to be treated like a helpless child.

So, as soon as Blue Cross business hours arrived the next morning, I made a few phone calls.  I learned the authorization was already in place when the doctor’s office cancelled the appointment. Unfortunately, the doctor’s office didn’t make the necessary phone calls to determine this information. They simply assumed that if no one called them, there was nothing happening.

Because my doctor’s office has such a huge voicemail system and patients aren’t given extensions to call, I decided not to deal with the complicated process of leaving a message for my doctor.  I simply called the infusion clinic (who was already aware of the problem), gave them the updated info and rescheduled my infusion to the next day.

But my doctor’s office seemed upset by this process, calling me back at 5 PM and warning me that they had no authorization information and if I kept my appointment I would be responsible for the payment.  Another night of trying to sleep while worrying about my successful treatments being stopped or delayed.  I called Blue Cross again and the very helpful Outreach Nurse confirmed that things were in place for insurance coverage, but the doctor was not responding to phone calls. They again notified the rheumatologist’s office of the information.  And I went to my infusion, knowing that I had the power to make things work.

I’m the patient. This is my rheumatoid arthritis.  And since it’s my body that is being attacked, I am the most passionate to fight for what I need.

And that, my dear doctor’s nurse, is what I can do.

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2 thoughts on “Patient Power

  1. Reading this has made me realise how lucky I am to have the nhs system here in the uk. The only thing that can really prevent me from having my treatment is the hospital not ordering my prescription or my blood work being out of sync. Hopefully you can settle for a bit longer and continue to get your medication.

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    • Our health care system is so complicated in the states. Can’t help but think that the people who say there’s nothing wrong with our system are the ones who don’t need to use it. My medication is approved for the next 6 months, so I should be ok till December. Thanks!

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