Tuesday, November 13, 2012

Hire The Professionals, But Still Cover Your Back Side



When you deal with the professionals of your life, many folk feel that once hired, you can trust them to have your best interest at heart.  And I'm sure they all mean to.  So at times you think you can sit back, relax and trust in processes like your medical system infrastructure.  I mean face it, they're supposedly on top of the game and know what's up.  Right?

Maybe not.  Or at least you can make sure what they say or tell you are correct.  Let me explain the impetus of this piece with a few examples from my own day.

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A few months ago a buddy of mine was looking for allergic reactions between medications, so she called her Walgreen's pharmacy.  She gave her list of her 2 medications to the pharmacist on call and they said there are no interaction issues with the two medications.

About a week later she wasn't feeling too good and decided to do her own homework and look things up and sure enough, after typing in her two medication names, the first Google results were warnings about mixing the two ingredients.

Note to self:  Ask, but confirm.  Get a second opinion.  It's your neck on the line so it behooves you.

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Next example is a medication I've been taking for eleven years.

When my medication first hit the market, it was my own research that led me to ask my doctor about it.  He looked into it and later prescribed me my new med.  It was a lucky stroke that I came across this med because at the time we were running out of things to help me since I had issues with other meds for my situation.

By looking after myself, I took care of things.

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At the start of this month, I went to pick up my meds but I was told I would have to pay full price ($170) because my insurance company didn't cover it. !  Eh?

OK, no problem.  It's only my breathing.  No worries here.  Right?

I chatted with my present doctor's staff and then my insurance company.  The insurance rep came back with some wonderful (sort of) news, that my medication needed preapproval.  Eh??

They gave me information necessary to give to my doctor, who in turn would call the insurance back at a special number, who in turn, after hearing from them, would contact my doctor who would then contact my pharmacist.

I'll pause and wait for you to reread and digest that mess.

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But regardless, my doctor's staff was on the job.

I waited about a week, and I just happened to be in the pharmacy for something else and thought I'd ask about my own other meds.  Sure enough, there was a prescription order for the generic version of my drug, waiting for me to come to the pharmacist and ask for it.

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Staff from my doctor's office left me a message about how I'm having issues because I only insist on the name brand of the medication.

This is what Diana, from my doctor's office said in a message she left on my phone.   But when I called back, no one at my doctor's office knew a Diana.  (Head smack!!!)

FYI:  Mind you, my own research discovered that up until a few months ago, no generic version of my drug existed so I had no choice in the matter.  And as soon as the FDA approved the making of generics, AETNA upped and pulled my medication from their approved covered meds list.

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Despite the bungles, bumps and misdirects, I want you to keep in mind that this is not about my insurance company.  This isn't about my doctor's office.  Sure, it's an eye-opener to see these events unfold.  But for the most part, say 99% of the time, I'm pretty damn happy with how I've been taken care of.  Though that 1% can make one panic.

No, this is my tale of warning... saying that, despite the fact that you hire experts in whatever field, it can't hurt to do your own double checking.  In fact, I say it behooves you to make sure they're on track for you.  Because in the end, they don't know your own special circumstances.  I don't think it's possible they know all of the nuances of all their patients.  It's up to you to make sure this consumer (you) gets what they need when all is said and done.

SO take care of yourself and do your own detective work to back up the experts... regardless of what field of expertise you're dealing with.

-Bruce


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Hi - sorry for the confirmation but I need to weed out the noise from the well intended comments. Thanks for leaving a note... - Bruce