As I continue down this unrelenting path of caregiving, even in death, I can’t help but see the irony in statements that come my way like, ” what are you doing now that your brother-in-law has died?”
I’ll tell you what I’m doing:
“Hello, Medicare? I’ve now sent you a request for permission to speak to me as Executrix of my brother-in-law’s estate with all the supporting documents. I’ve waited the requisite 50 days for you to process it. I’ve waited longer than that because the first instructions I received were to take those documents to my local Social Security Office, which resulted in absolutely nothing, and now I have finally received a letter saying you will talk to me. Yay.
Medicare Person: What can I help you with?
Me: I’m trying to find out when a claim I have submitted will be paid?
Medicare Person: Why did you submit the claim Ma’am?
Me: Because the provider refused to submit it. They provide drugs and drug paraphernalia to the nursing home where my brother-in-law was residing at the time. They insist that they can only bill for the drugs to Part D Medicare and they have no authority to submit for the other items like IV poles, IV flushes and anything needed to actually administer the drugs.
Medicare Person (the THIRD Medicare person, because the first two couldn’t find the other conversations I’ve had and insisted that no such conversations took place). Yes, I’ve found the conversations you’ve had on April 4th , 11th, and 22nd.
Me: The last person I spoke with who connected me with you said she couldn’t find those conversations.
Medicare Person: Well, you’re both right. She can’t see these conversations, she’s in a different department.
Me: So, she couldn’t transfer me to you without wasting 30 minutes of my time and me insisting I speak to this department?
Medicare Person: I apologize for that Ma’am.
Me being Silent,
Medicare Person: Well, Ma’am I can’t find your claim. it takes 50 days to process.
Me: I filed that claim 120 days ago, and when your Medicare person CALLED ME ON APRIL
22 while I was standing in the middle of Times Square, and I popped into the closest restaurant and ordered a $12 glass of wine while on hold with your person, she told me that she was looking at my claim, it was paid to the nursing home and they would have to pay the provider. Then she proceeded to send me the wrong Medicare notices so I could prove to the nursing home, they owed the provider and the Estate of my brother-in-law was not liable for this bill.
Medicare Person: I can’t find that claim Ma’am. And so the only thing I can do is request a review.
Me: Okay
Medicare Person: I’m not allowed to request a review until 150 days has passed and it’s only been 120 since you filed the claim. A denial can take up to 150 days to process.
A missing claim is like a missing person. Maybe they went missing on their own. Maybe they are just at a friend’s house and forgot to tell you. Maybe they will use a credit card and then we can trace where they are and stop all this nonsense. But instead of waiting 48 hours, you have to wait 150 days. Imagine telling any person you’ve ever worked with that it will take 150 days to look at a piece of paper you sent them.
Medicare Person and I then went on to discuss the many fun and esoteric ways that Medicare can screw up a claim.
Medicare Person: I know this is complicated and confusing Ma’am.
Me: I understand perfectly, everything you’ve told me. It’s not complicated or confusing to me, it’s just crazy! (Yep, I really did say that).
Medicare Person: Well, I know it seems complex, but we train for WEEKS to process this, so it would be harder for you to understand.
WEEKS? WEEKS? I’ve been dealing with Medicare for 25 years. And in all your weeks of training, the best you guys have ever given me is ridiculous, arbitrary waiting periods to process claims, a myriad of departments who don’t speak to each other, wrong information that has cost me precious time, and heartburn without the doughnut, wine or deep-fried food I deserve to go with it.
So glad your weeks of training have made you an expert.
I didn’t say any of that, I just got out my corkscrew and toasted the Universe for the never-ending supply of blog posts!
You Just Have to Laugh…………
© Cathy Sikorski 2016
Please God help me to never need anything from these insane entities.
I know, and I hope the same for you me and everyone, but it’s not looking good.
WOW!!!, this sounds like work at the county, i work at. sad!!! you are one patience lady, Cathy. i must agree with “Laurie” i hope i’m dead before i have to deal with them or any of my kids have to deal with them for me.
Unfortunately, Jerome, the health care industry is going to keep you alive as long as they can…I’m pretty sure it’s just to torture us, but we laugh in the face of danger just like Maxwell Smart!! Smiles
Frustration is the byword when dealing with any insurance issue, isn’t it? Laughter really is the only sane response.
Yes, Claire. And so happy to hear from you!
Dear Cath,
Lol! The beauty of government run programs.
Keep us laughing!
Beth
Thanks, Bethy…I could’ve waited weeks to tell everyone, but I have so much to learn!
I hope you win the Lottery too…just because, why not!
Seriously. I hope I die before I need Medicare. Or win the lottery. Yes, that would be better.
I meant to reply to you Laurie, not just post…see even on my own website I’m still techno-challenged! So, I hope you win the lottery and can BUY all of Medicare!! You’d do a better job!