Wednesday, June 25, 2014

SOME DAYS THERE JUST ISN'T ENOUGH COFFEE

I have TMJ.  Temporomandibular Joint Dysfunction.

Basically, my jaw is ALL jacked up, more than likely caused by my own stupidity.  Although, there are an AWFUL lot of teachers with this issue, which begs the question, why?  Something in our jobs is causing this.

I could give you a looooong list, but I'm not in the mood.

Not in the mood because of what I've been dealing with this morning.

I mean, there are times in your life where you just need to step back and say to yourself, "Self, how did things get so screwed up?"

This morning? Been one of those times, for sure. 

A number of months ago, something went very wrong with my jaw, and the pain, while it should have decreased, had increased ... A LOT.  It was as if I'd somehow injured it.  In fact, that is what my dentist suspects has happened.  

Too much talking?

All those darn salads I eat?

A rogue apple?

Who knows!  

What he told me was there was nothing more he could do for me, and so I needed to head to the Big Guns.  Only, the Big Guns cost TONS and TONS of money, and a lot of it is out of pocket, and I just don't have those discretionary funds available to me at the moment.  The joys of being a teacher ... 

So, he gave me a number to contact the Big Guns and find out what I'd be looking at in terms of initial out lay of said strapped cash.

This seems simple, right?

IF ONLY!

I called the Big Guns, who informed me that I would need to contact my insurance company.  

UGH!  

I HATE contacting my insurance company.  They NEVER know what is going on.  Ever.  One has a better chance of figuring out the whereabouts of Jimmy Hoffa than Humana does of knowing ANYTHING about the coverages they offer.   

They were initially unwilling to help, telling me that I needed to ask the billing department of the pain clinic for that information.  When I informed the Humana chick that the pain clinic had, in fact, told me that HUMANA should be able to give me that information, seeing as they are, in fact, an insurance company, she reluctantly did a search for me. When the search yielded nothing, things got weird, quickly.

"Miss Murray, if you could call the clinic back and get the tax id number for the doctor, that would be super helpful."

"Yes, while it would be, do they just hand that information out to anyone?"

A pause on the other end, where I am sure some eye-rolling was occurring.  "Okay, let me contact them myself. Please hold."

I am convinced, ladies and gentlemen, that hold music is a way for large corporations like this to slowly drive an already on-the-edge consumer right on over that edge, because I was near my breaking point when the REALLY stupid stuff occurred.

"Miss Murray?  I just got off the phone with the clinic, and they have THIRTEEN providers, all who bill individually. So, in order for me to find out whether you are in network or out, you must actually commit to a doctor via an appointment.  Then, call me back, and we can search his or her name?"

I am not a completely stupid person, but this particular direction of logic seemed, how shall I put this?  STUPID!  

"If I may pose a question which will sound like a very stupid one, what happens when the doctor I've committed to isn't in my network?"

Without missing a surly beat, she replied, "Well, you just cancel that appointment and make a new one with another provider.  Then call me back to see if he or she is in network."

At this, I could no longer help myself.  I.  Laughed.  Out.  Loud.  She found no humor in it.

"Really?"  I said.  "There are thirteen providers in this clinic.  So, potentially, I could be making appointments with ALL of them.  Doesn't this seem illogical to you?"

"Ma'am, that is your option."

I won't bore you with the details.  

I have spoken with at least TWO receptionists at the Orofacial Pain Clinic.  I have spoken to at least TWO Humana employees. I have spoken with the billing GURU of the pain clinic.  I have left a message with probably more whining than the billing GURU cares to hear, but the bottom line is this:


I STILL HAVE NO CLUE WHETHER THESE DOCTORS ARE IN NETWORK OR OUT OF NETWORK.
NONE.
ZERO.
ZILCH.
NADA.

Two hours of my life, I will never get back, and my blood pressure is up, my head hurts, and I STILL haven't taken a shower.  Buying stock in Ibuprofen seems like a better solution at this point.



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