Tag Archives: Aetna

Sailed right back into it…….

Lest   (yes, I used the word “lest”) you think a caregiver ever gets a true vacation. Think again. I do not deride my fabulous time in Key West as anything but spectacular and so needed. And I am grateful, truly I am.

A Caregiver's Dream!
A Caregiver’s Dream!

And just as I was winding down that lovely time in the sand and sun and wine and dine, the phone calls began. Trouble was brewing and you, oh mighty caregiver, you were needed pronto.

One of the several disasters going on was that Aetna, once again denied an ambulance transport. I know. I know. We are all so very tired of this same story. But it just gets better and better.

Before I left on vacation, I went to the doctor’s office, who ordered the MRI, gave them a copy of the denial and asked them to write a letter explaining that my brother-in-law is not at all ambulatory and needed the gurney so that he could be lifted on to the MRI table and then transported back home. The woman who handles that task was out to lunch. Oh please, that joke is just too ripe for the picking!

“Hello, is this Cathy?”

“Yes, this is the administrator from the doctor’s office. I did get a call from Aetna and told them we did not order an ambulance for your dad (yea, sometimes I’m his daughter, sister, wife, whatever works). And when they said a ‘Cathy’ called I told them it was his daughter. So that’s why they denied it. ”

First of all, thank you? Thank you for telling them you didn’t order the ambulance and for not explaining that you did though, order the test, and that he would need an ambulance to get there.

What I said was:

“Yes, I called Aetna because for the last three years, your office refused to do that, and so I made the call to get him to the test. You see, he’s not ambulatory so he can’t have any tests on a table unless he goes by gurney.”

“Oh that’s not true, he could go by wheelchair.”

Yep. She really said that. Or she was still out to lunch. I’m not sure which.

“Noooooooooooooo…..he can’t get out of the chair and up on the MRI table.”

Dead silence.

“Well,” said the administrator, “I’m going to have  to have to check with the doctor. We’ve never written a letter before for something like this.

See, not only have they done this before, but I actually sat at the desk with the last administrator and helped her write the letter.

“So, if the doctor approves this, in the future will you call the ambulance for any test he might order?”

“Oh no. We don’t do that.”

You have to go on vacation and then……………

“You just have to Laugh….”

Cathy Sikorski