I should be prepping for surgery. My kids should be dropped off at different grandparents’ houses, and my bags should be packed for an overnight stay. Instead, my “provider” and I have been fighting with my insurance company. God I hate that word, provider. They are doctors and should be addressed as such, no matter what. Maybe by renaming them “provider” it is easier for the insurance companies to deny the approval requests.
For the last two years, and longer, I have been jumping through every step needed to get a partial hysterectomy. But even with the evidence provided by the doctors, UNITED HEALTH CARE has decided there wasn’t enough proof and deemed it elective and therefore not covered.
Strange.
I am unaware that removing precancerous cells is elective. I thought that was called preventative. Maybe the language changed while I was being put under for leep procedures and in-depth biopsies. The removal of MY uterus wasn’t only because I needed a more invasive way to remove the precancerous cell.
—side note: my doctors warned me that once they removed my uterus that there was a 90% chance they would find stage one cancer.
My cycle is so heavy that my doctors have said it is the equivalent to hemorrhaging. Last year I had to have iron infusions because my levels were so low. If I had been male, I would have been sent to the hospital four times over, but because I was female, I was told it was okay because being anemic was normal. My cycle lasts anywhere from 7- 9 days. For me to function like a normal human who isn’t bleeding out, I have to take a pill called Tranexamic Acid. This medication the blood clots hold longer in the womb, significantly reducing blood flow. But this medication is only a band-aid for the actual issue. The fibroids that line my uterus.
Another reason at 39 I am trying to remove my uterus. Let’s not get started on the cysts that make me throw up from pain whenever they swell.
My doctors told me that anyone under 40 usually gets rejected. Something about women changing their minds and wanting more kids. But my husband is fixed and we already have three kids. So because of this nonsense it’s why it has taken me two years of having my body scraped, burned, and prodded repeatedly before we even tried to submit UNITED HEALTH CARE. But it still wasn’t enough.
I had no idea that my procedure was rejected until Monday evening when the mail arrived. At that point, it was too late to call my doctor and find out what happened. Tuesday morning I called and spoke to the woman who submits all the information to the insurance companies. She said their office received the information Friday after their office had closed for the weekend and they did not know about the information until Monday morning. She was already in the works to send almost six years of medical records to UNITED (un)HEALTH CARE. When I called back this morning, she said she was on the phone with them for 3.5 hours trying to FAX — because it’s the 90s still in the medical world — the information over because UNITED HEALTH CARE’S fax was not working. She had to fight with them because the fax number they provided was not working, and they claimed it was the doctor’s office’s fault. It wasn’t until she tried three different machines before UNITED HEALTH CARE provided another number and it worked.
I called UNITED HEALTH CARE myself after finding out that it wouldn’t be another 72 hours before they decided my six years of preventative care would be deemed worthy by their standards. When I got a hold of a human they told me that they were unable to explain why there was not enough evidence. She also told me only providers can discuss this information. Not the fact that I know what’s going on with my body, or the fact that I have actively jumped through every hoop they have asked for…
No…
As a normal non medical person I am unable to hear why I was rejected or even be able to defend myself. If I were to try it would stop anything that provider had submitted.
So the only thing that would be able to hurry the process along would be for my doctor to stop doing her job, seeing other patients, and have a peer to peer call explaining away the miscommunication.
I find it absurd that anyone working at an insurance company would think themselves to be on the same medical level as a doctor who works for patients. Those who are insurance company’s medical directors are no longer working for humans. To me these people have sold their soul for the almighty dollar because that could be the only reason why so many people are rejecting those who need medical care.
I don’t know when I will be able to reschedule my partial hysterectomy. I had it set up this way so I would have my entire summer to heal. I know my body, it is stupid. It likes to reject anything to make it better. I need 8-10 weeks to heal and that is what the summers off give me. I didn’t want to have to schedule a sub to cover my classes for two months. If I was going to do that, I would have taken care of this in January allowing myself the ability to enjoy my summer. Now I am going to be playing the waiting game, wondering when I will have organs removed so my body has less of a chance of turning angry cells into cancer.