Denied!

You thought I was talking about going for the basket and having my shot blocked, didn’t you? No, Okay, well I tried to shed a bit of humor into this post. I spoke to the insurance company twice today, the first time in the morning where my prior authorization was still open. They needed some clinical questions answered, I told them to send the FAX to the Dr. office and I’ll call them and give them a heads up. This was at 9:30 AM. At 1:40 PM, I got a call that they denied the PA, due to not getting the questions answered. Um, what? You gave my Neuro 4 hours to answer the questions? So I called the Dr. and spoke to his assistant, and she said she got the questionnaire in the afternoon (12:43 was the time stamp). So they essentially killed my PA within an hour of sending it. I called MedCo/Express Scrips to ask why it was denied. After bitching (I felt sorry for the chick on the phone, I was not pleasant, but I’ve been waiting since the end of October), she called my Neuro and got the questions answered, spoke to a pharmacist, and then came back on the phone line. After holding for 10-13 minutes, I was told it’s denied because I hadn’t tried an injection medication yet.

So now, we are going to appeal it, and get on the Avonex (1x week inter-muscular shot). From what I’ve seen on their site, they will give me a month’s supply right away while the insurance company figures out the rest. So I could be on meds soon! Thankfully they have someone who will come out and teach me how to inject myself. If not I am sure my mother in law would do it for me, since she’s a nurse.

That’s the update! Oh and with all this insurance frustrations, I went to the gym to burn off the pent up frustrations. Woo! Knee brace worked well!!!!

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3 thoughts on “Denied!

  1. Hi Melissa!!! We are just heart sick to hear the news that you have Multiple Sclerosis – we are so sorry, and do so hope that it can be controlled, or whatever can be done to make it as livable as possible, is done. But – “it’s an ill wind that blows no good” so I must say I’m glad to find your “blog” or whatever this thing is called. I will enjoy being able to drop a few lines to you whenever I feel like it – hopefully it’ll be much easier than getting things set up to write a “proper” email, if there is such a thing 🙂
    We loved getting your Brown Family Christmas letter and loved the pictures of Chandler – he does love being “coy” doesn’t he? and Lincoln – he’s obviously going to be a movie star! You and “Bobby” ( I’m his Grandma and he said I could call him that!!!! but I’ll get over it – I get confused with two “Rob’s” in the family.) look great too, but “Rob’s” glasses need fitting – they’re blocking his face ;(.
    We are doing pretty well here. I seem to be having a bit of a problem with remembering but more disappointingly have found I can’t read books very well any more, as I can’t remember what they are about – I haven’t given up yet – I’m still trying. I’m more upset with that than with “Small Vessel Ischemic Disease” which is what that’s about I guess. However we both, and the doggies are doing quite well. I have started joining Bob on their walks each day and that together with our various church activities – attending services (they changed the first one to 8am ARGH!!!) All Ages and Stages Sunday School class, they are great people and love to go out to eat, so we get along very well together. Bob is still “doing” the Food Fund, his Men’s Bible Study – he’s the “treasurer” and generally volunteering with his friends for quite a number of things. We just had a sort of Christmas Snow Land last weekend in the parking lot – sleigh rides on REAL snow and the whole bit. I think that just about did him in, but he’s recovering.
    As you now know, I’m not “short winded” so you’ll probably like to stop anytime now. If you’d rather I not use this as a means of communication, I can change back to emails. much love to you all “Sunny”

    • Thank you Sunny for writing! Glad to hear things are going okay in S. California. Sorry to hear about the health troubles, my memory is not doing great right now, too thanks to the MS. I guess it’s normal. I’d be so upset if i couldn’t read, it’s one of my favorite things to do. The boys are silly and those pictures came from the summer, where there was a bit of goofing off happening. 🙂 I hope both have a very Merry Christmas. And this is a fine place to comment. I am trying to keep this as a place to vent my frustration and irritation at MS and weight loss, which they both cause, so it’s a fitting spot. 😀
      Merry Christmas, and I look forward to hearing from you. Melissa

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