Some Good and Some Bad, Some Happy and Some Sad
I’ve had a few doctor appointments these past few weeks: I saw the dermatologist for my three month checkup, and for the first time in the almost three years that I’ve been seeing him, he found NOTHING that needed cryo-freezing, surgical-cutting or punch-biopsying. And for the first time he said we could wait FOUR months for our next visit together. That was very good news, and made me very happy. Of course, while I was checking out, his secretary advised me that, with my new “senior managed care” policy, I would need to go back to having referrals from my primary care doctor.
But my primary care doctor has changed his once singular office location, and his new arrangement is now part of a group of physicians; his new office staff apparently had none of my “other doctors’ ” records and contact information. And they quickly told me, when I called for a retroactive referral, that they could only do that once for me, and that, as my dermatologist was not a part of their physician’s group, my request for a referral might be denied, in which case, BC/BS would like not pay the dermatologist’s bill. I eplained to her that I have been seeing him for more than a few visits, and have malignant melanoma which has to be monitored frequently, and she was sympathetic and said that she would do her best to ‘get him approved.’ A few days later, I called to see if in fact the referral had been approved, and was told that it had.
A few days later, I saw the ophthalmologist, who didn’t have good news to share with me, though what he shared was offered in his usual kindly way. My right eye, in which I had optic neuritis and/or optic neuropathy eight years ago, and where a cataract continues to reside, has deteriorated to 20-200 vision (which eplains why my eyes blur more quickly when reading or typing on the computer.) He told me that, while he could recommend cataract surgery for me, he could not guarantee that it would make a difference in my visual acuity, given the nerve damage caused by MS. He said that I could choose to have elective surgery, or choose to wait it out to see whether my good eye, my left, would hold its own or also begin deteriorating; it has developed its own, small cataract. I’ll wait. And again, on checking out, I was advised that I need referrals to see him, and would I please call my primary care doctor’s office and request a retroactive one for this visit? And here is the form that you need to sign saying you’ll pay for the full visit if the referral is not sent for insurance coverage.
And so I’ve spent the past few days trying to appease the referral gods … When I called my primary care doctor’s new office again, and asked for a referral for my ophthalmologist, I fortunately was connected to another of his new office staff, who listened to my story of having MS and Optic Neuritis/Neuropathy, and sympathetically said that, though he was not in their group, she would try to get my ophthalmologist approved by the physicians’ committee for a referral, but said that she would only be able to do this once. I wondered quietly how many office workers there were in this new office …
Deciding not to take my chances, though still waiting to hear of the dermatologist and the ophthalmologists’ approvals, I called my neurologist, whom I will see in another week. I knew I would have to get her NPI number for my primary care doctor’s office staff. I had asked if my pcp couldn’t just pull it from my folder, as I’d been seeing all of these specialists for a few years now, and used to need referrals before retirement and an insurance change that, unfortunately, has changed back to needing referrals for my medicare supplemental plan. No, she said, his old patient files are in a different system and hasn’t been uploaded into their system yet, so we would be essentially starting a new file of specialists. Of course, I called too late in the day to talk with my neurologist’s receptionist, and so left a “detailed message” as requested by the automated voice recorder. Unfortunately I guess it was too detailed as I was cut off mid-way. Luckily, I have an email address for my neurologist, and so sent my request for her NPI number to be used to request a referral for her visit.
While some of this is burdensome, it is admittedly also humorous. This, of course, is because my antidepressant is working. Otherwise, I would be frantic and panicked at the inaccessibility of my primary care doctor’s comprehensive file of information on my specialists. And the other piece of good news is that, though I have already called my psychiatrist and my psychologist offices and gathered their NPI numbers, I won’t need a referral to see either of them … I thought that was true (before, when I needed referrals for other specialists) but had to carefully explain that to the second office worker to my primary care doctor’s new office staff. I’ll see both of those doctors in the next few weeks as well.
But on a note of unrequitted sadness, one of my favorite relatives passed away last night. My oldest brother in law Kip, who lost his dear wife, (my oldest sister Kay) three years go had fought leukemia unexpectedly for the past year or so, and lost the last battle last night. There is consolation in the thought that he and Kay are once again together and unseparable, and no doubt they are coordinating a 1950’s Rock and Roll Revival Upstairs. I miss them both, dearly; Kay was like my mother when I was young and our mother was having the next four children. And Kip was our go-to guy whenever our dad was at work; he was always fun, mischievous, adventurous and un-squenchable. Rest in Peace Together for Always, Kay and Kip. Love you both, forever.