Friday, February 29, 2008

Finding someone who accepts responsibility

The update on my saga wrt the new medication. Yesterday I met with my doctor. He gave me a copy of a letter that the insurance company had sent him on the 14th, indicating that the prior authorization request was approved. I brought the letter to the pharmacy. The pharmacist was on the phone with the insurance company for 45 minutes and still couldn't get the request released.

I called today. The first person said that everything was approved and that pharmacy should just call the insurance company's help line if they're having difficulty. I explained that it seemed that there were two authorization requests in play here, one for the med itself, the other for the quantity. It appeared that the quantity had been approved, but not the med. (Imagine the tortured soul who came up with that rule.) The agent forwarded my call to the prior authorization line, which turned out to be an automated system that told me what I already knew, that one request had been approved.

I called back and eventually got to a supervisor who threaded his way through the events and explained that the approval had been for an increased quantity of a class of drugs, not for the drug itself. We still needed approval for the drug. But, mirabile dictu, he realized that I am a patient waiting for a medication. He arranged to have the pharmacy give me a five-day supply while he and my doctor worked things out. I thanked him for taking responsibility and helping me in a very direct way.

Now, this evening, we'll find out if the medication makes a difference.

Thursday, February 28, 2008

This week's depression links - 2/28/08

Tuesday, February 26, 2008

I was looking for an argument, but I keep getting Hit on the Head lessons*

So, nearly three weeks ago, my doctor wrote a new prescription for me. I brought the prescription slip to our local pharmacy. When I returned an hour later to pick up the medication, the pharmacist said that the insurance company needed prior authorization (the doctor must say that I really need this specific medication at this dosage.) Thus started an egregious violation of the Strange Sketch Act:

  • I've spoken with my doctor's office at least four times. In addition, the pharmacy has spoken with the doctor's office two or three times. The folks at my doctor's office have sent the prior authorization forms to the insurance company.
  • I've received one phone call from the insurance company that says that my request was approved. I've kept the message on my answering machine.
  • I've spoken with the insurance company at least a half dozen times. One time they said that the quantity of the medication was approved, but not the medication itself. Last Wednesday, I submitted an online query, detailing it all in four-part harmony. The email response that's promised within 48 hours has yet to arrive.
  • s been approved, and c) the pharmacy won't be able to place the order.
  • The insurance company's web site reports the following:


  • I've spoken with the pharmacy in person and on the phone at least 10 times. They've not been able to place the order because the insurance company hasn't approved the request. Today, the pharmacist called the insurance company who, in turn, told the pharmacist that they haven't received any information from my doctor regarding the prior authorization.
  • The pharmacist called my doctor's office. My doctor won't be in until this afternoon. I'll call everyone again later today and I'll bet you a nickel that a) my doctor's office will report that they've submitted the request, b) that the insurance company will either claim that they haven't received the request or that it'

* Bowing with reverence to the Monty Python argument sketch (in video) and in text.

Wednesday, February 20, 2008

Depression links - 2/20/08

Tuesday, February 12, 2008

Michael Moore is a rose-colored-glasses optimist

So I go to the doctor on Thursday and explain what's been going on, that I've been sleeping very poorly, waking at 2 or 3 in the morning and then trying to make do for the rest of the day. The doctor prescribes a medication that might help. It's fast-acting and short-lived so that I can take it at 2 or 3 and still wake at a decent hour.

I bring the prescription to the pharmacy. They say that it'll be ready in a half hour. I come back a half hour. They tell me that the insurance company needs pre-authorization, meaning that the doctor has to explain why I need this medication and why the others that we've used haven't worked.

That was Thursday night. I called the doctor's office on Friday. They said that they'd received the fax from the pharmacy and would send out the information to the insurance company.

It's now Tuesday afternoon, nearly five days later. The doctor's office claims to have sent the material to the insurance company. The insurance company is, like, nuh-uh. The pharmacy says that they'll sell the medication to me for $420 if I wanted to go without the insurance.

Oh, did I mention that it took four days to get a refill on another medication?

Thursday, February 7, 2008

This week's depression links - 2/7/08

Tuesday, February 5, 2008

On numbers

My psychiatrist and psychologist conferred last week and, among other things, recommend that I use the Beck Depression Inventory to assess my symptoms. For the past year, and recording the numbers since April, we've used a 1-7 scale to assess my mood, energy, and cognitive abilities. The scale is based on a similar scale used to assess pain - 1 is great; 7 is incapacitated.

It's a puzzle that they haven't recommended the BDI before. They've probably used it as part of interviews; I suspect that the hospital and Social Security folks used BDI or something similar in their evaluations. Nevertheless, I've been carefully recording and reporting our numbers for all this time and it seems strange that they're only now introducing the BDI as a tool for regular use.

I had an appointment with my psychologist yesterday and will see my psychiatrist on Thursday. The major issue of late, as I've mentioned before, has been my bad sleep and the toll that it takes on my resilience.

In spite of the tiredness and the nearby troubles, I've been able to get stuff done on a daily basis, something that wouldn't have happened even two or three months ago. Some of the tasks are as simple as being able to throw something away. Others involve more analysis and skill, such as setting up a home network for our two computers. I've been using Remember The Milk as a way to plan and track completion of tasks. There's a Firefox extension that integrates RTM with GMail, making it handy to look at the day's business in a single page. It's just nerdly enough to be fun.