Still Staggering Along...

Still here, still braining, a bit.

I know, it's January, there's nothing at all going on, right?  Well, not in my world.

For starters, did your health care insurance change at the beginning of the year?  For some of you, it did.  The reason why matters little.  The bottom line is that, for thousands, probably millions of people, their insurance changed.  For some, it's a major change - as in one company to another.  For others, it might have seemed a minor change.  A few more things included in the coverage since they hiked the premium, or maybe it dropped a bit, and so did some options.  

Whatever those changes might have been, they play havoc in my world.  Let's say, for example, you're on an on-going therapy.  Like me.  I'm diabetic.  Is my insurance still going to cover the same things it did last year?  For most folks, that's a "yes."  For some it may be an "I sure hope so".  For a growing group of folks, it's a "well, once I pay a crapton out of pocket, then it'll be OK".  

Whatever changed, that throws a wrench or sixteen into my world.  Then we have our own self-imposed reviews.  Some of our insurance companies we work with are pretty good about trusting us.  And the health care providers in general.  I mean, if a doctor takes the time to document and detail why it is you need a particular antibiotic, they're inclined to trust the doctor.  Yeah, I know, but here's the thing.  People like me are just raw overhead costs in health care.  Why?  Well, my employer provides services to folks.  And then expects to be paid for them.  

Because some companies will, and some won't, I have a job.  My job is to ask the insurance company if they're willing to part with some of the money you've paid them in order to keep you alive.  Most folks aren't aware of the hard cold truth.  Insurance companies do not exist to provide for your care.  They do not exist to insure you stay well.  Or alive.  They exist for one reason alone.  To collect premiums. 

Yup.  That's right.  You give them money.  They really hope you stay healthy so all that money you and your employer pay them goes into their vast pockets and ... just stays there.  

Which is where my job becomes asking the insurance company if they might, possibly, maybe, pretty please, look I'm begging here, I'm really asking very nicely, respectfully, and I'm willing to wait for as long as you think you can draw this process out and delay as long as you want before you come back and tell me "well, maybe, yeah, we might just possibly consider the odds might be slightly better in your favor for us to possibly, maybe, kinda sorta pay you a little bit for your services." 

Sure, it's because lawyers are involved, so what I do is ask the insurance company if maybe they'll consider approving your therapy.  That doesn't mean you're approved to get it, it means that we're approved to be able to submit a bill without an excessive amount of documentation proving why you needed the therapy, why we provided what we provided, the doctor told us this would make the patient better so that's why we did what we did, now please pretty please can we get paid?  

Yeah.  That's about a tenth of the work I'm doing these days.  Well, it's actually 95% of the focus of my job, but the other 90% of the work is finding all of those patients who have long, on-going therapies, and making sure nothing significant has changed, they're still needing and receiving the therapy, and we're going to get paid for it.  

So yeah, I'm working 10-11 hour days.  The overtime is nice, when I see it, which isn't often this time of year.  It, like daylight, is pretty scarce.  So it goes.  Still here, still working hard.  Not complaining, just lacking any significant time to think through full thoughts to put them here.  Oh, I know, why change now.  Drivel is my middle name...  Some days.  Some days it's just good old Dipshit.  

Hope your days are better!