Monday, April 20, 2009

I Go Back to College

I just returned from talking to my daughter K’s senior Social Work class. I was asked to talk about how I've become my own advocate. Specifically how I've become an advocate for getting my insurance bill corrected and paid.

I wrote a two page outline of what and how I would like my little talk to go. I think K thinks I have turned a request to give a small talk into a huge issue. If I am going to get up early and leave early to get to an 8 AM class, I am going to say more than; "Hi the insurance company messed up and wasn't paying my medical bills correctly. So I went on a letter writing campaign and got them to review and correct my bill." And because I have been having more and more trouble talking and seem to tire extremely easy I am doing this on a day when P can come along to do my talking for me. I’ve included my outline notes at the bottom of this if you are interested.

I began my talk by going back to last year. About July or August of 2008 we noticed that the insurance company was no longer paying my bills for my medical equipment and supplies at the correct level. So began the trip through an Alice in Wonderland experience of dealing with my Durable Medical Supply Company, Anthem Insurance of Indiana and Blue Cross Blue Shield Insurance of Illinois. We would call the Durable Medical Supply Company about the billing errors and they would call Anthem Insurance of Indiana and then would call us back saying everything was corrected. Only it wasn’t. A month or so would go by giving all concerned to get the corrections through the billing cycle and we would still be receiving incorrect bills. So P would make more phone calls. She would call all three companies involved only to be told by each company that it wasn’t their fault so they were not able to correct the bills. At last we reached the stage when we began receiving collection phone calls about the amount owed the Durable Medical Supply Company. We would explain the situation and would be told that “yes the person calling did see a note on our account about the problem.” Finally P filed a complaint with the state department of insurance. As result of this, an Anthem Insurance of Indiana representative called us and promised us that she would get this corrected.

We thought “great, problem over.” We soon learned that the billing issues hadn’t been resolved and the collection phone calls continued. Then one afternoon I received one of the collection phone calls and I GOT MAD. So I started researching the issue of Anthem Insurance of Indiana billing approval errors. I discovered a large number of articles about Anthem Insurance of Indiana dealing with this issue for some time. I also researched and found out who owned Anthem Insurance of Indiana. I also found a number of email addresses for the company that owned Anthem Insurance of Indiana.

I wrote a lengthy letter about the issue we were having with getting my medical bills from the Durable Medical Supply Company approved for the correct payment level by Anthem Insurance of Indiana. In my letter I included the Anthem Insurance of Indiana representative’s name and phone number and all of the internet links of the articles about this problem. I then emailed this rather lengthy article to all the email addresses I could find for the Durable Medical Supply Company, Anthem Insurance of Indiana, the company that owns Anthem Insurance of Indiana, Blue Cross Blue Shield of Illinois, my state and national senator and representative, Indiana Department of Insurance,and a number of local and state newspapers.

The following Monday when P called the representative, she said that she had received a number of phone calls and emails about my situation and was working on resolving it once and for all, which I am glad to say she did.

My daughter K mentioned this to her professor who asked if I would come and talk to the senior Social Work class about becoming my own advocate and the need for advocates. As you will see from my outline, I gave a brief personal history, and P and I talked at length about the stress a chronic illness places on a family, and about how helpless and hopeless receiving collection phone calls makes one feel. Especially, when we had been spending hours on the phone trying to get someone to listen and help us.

I also took the opportunity to talk to this class about the importance of support groups for the primary care giver to a chronically ill person.

I thought our talk went well. At least I hope it did. I would like to thank my daughter’s professor for allowing me to tell our story.

Here is the outline I worked from this morning.

Social Work Class Visit OUTLINE NOTES

• Brief History (1 Minute max) (I don’t mean to spend much time on any of these items)

• Hip operation at age 12. (This is to show how and when I decided to remain as independent as possible even when not being able to fit in with the rest of my classmates.)
• Doctor telling me not to let my hips dictate my life.
• Doctor telling me to chose a career that would allow me to sit when the time came.
• Track meet Hays Kansas and how I refused to give in until they waved me off the track so they could start the next race. This is how my stubborn, independent spirit was formed.
• After multiple hip replacements & revisions, it became clear that it wasn't just my hips causing the problems but that there was some neurological process going on.

• How I continued to educate myself in order to work as long as I could. (1 Minute max)

• Because of my home situation, and the schools in western Kansas where we lived I wasn’t college material. However, I came up with a plan that allowed me to receive the education I would need.
• Being handicapped made me strive to be the best employee at each job I had.
• How employers would tell me that if I couldn’t do the job, I was out of a job.
• After I found out that people seemed to treat me differently on job interviews, I would go on job interviews leaving my cane in the car.
• Even after ADA I was told that but that SMMHC modified my work area. And allowed me to work from home.

• However this all combined to make be determined not to be pushed around or pushed to the side.

• After my Tracheotomy (1 Minute max)

• Wrote a book for my Grandson about a Handicapped Person who has two black bears living in his backyard. This book is my attempt to show my grandson how much a handicapped person can do. Also it is an attempt to show that you treat a person with a handicap the same way you would treat a person without a handicap.
Harry and Tom
• Use my laptop to read newspaper and magazines.
• Use my laptop to communicate with family and friends.

How frustrated I get when people ignore me because I can’t communicate for long periods of time on the phone. (As much time as it takes) (Tell how it bothers me that I am not able to help Pam make needed phone calls)

• How I use the Internet to research companies finding email address in order to communicate with companies I need something from.
• Relate how for 6 to 8 months my health insurance wasn’t paying my medical bills correctly.
• How I wrote emails to the insurance company and CC the letter to State and Federal representatives and senators, newspapers, Indiana Department of Insurance, the BBB, and the parent company of my insurance company. Included in these letters was the person’s name and phone number who was responsible for correcting the payment errors.
• How after being ignored by the chair manufacture and unable to hold a phone conversation with store I used the internet and email to get my chair repaired the second time.
• Writing State and Federal representatives and senators on health issues.

My beliefs (As much time as it takes)

• The handicapped must be their own advocate firm but not confrontational unless they need to become confrontational.
• That we need to change our health insurance system because companies don’t want to pay for the increased cost most people with chronic health conditions have.
• That we need to come up with a way to keep people in their own homes as long as safely possible before they end up in a nursing home.
• That church and other volunteer groups fall down on helping the home bound handicap person.
• Being homebound is LONELY & ISOLATING.
• The family become ISOLATED and loses their identity. They become "the family of the handicapped person" not people in their own right.

My biggest failure

• Trying to get my church to start a Caregivers Support Group. I'm not sure that is your failure - I think it is the churches and the people who were doing it not being aggressive enough. Caregivers have to be pushed to take care of themselves. (This note was added by P.)

• Favorite Movies
• Million Dollar Baby
• Rory O’Shea Was Here
• Door to Door

I am not certain how you as Social Workers and those of us as friends and acquaintances of the handicapped can influence the handicapped to become their own advocates. I do believe that we as a society gain from a personal experience with handicapped individuals.