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PostPosted: Wed Sep 30, 2015 12:08 pm 
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Sorry to ask yet another question/make yet another topic, guys -- I swear, it's my last one...! I just figured I'm mainly writing to myself in my "journal" topic, and I'm not sure what to do in this situation.

"This situation" being that I called my insurance company, and they have a response, from my doc, to their prior authorization request. So my doctor sent his okay to the right insurance, which is a relief -- but they say he didn't mark it "urgent", so it could take "up to 10 business days" for the request to be reviewed. This is BCBS of Texas; my old insurance (BCBS in another state) seems to have processed the request in a day or two even without the "urgent" status, but of course there's no guarantee that will happen this time.

They said I could call my doctor and ask him to upgrade the status to "urgent". I was "supposed" to run out of medicine on the 3rd, I believe, so I don't know if it would seem weird or pushy to call him and ask for that. What do you guys think? Just sit tight and hope it goes through quickly, or would it be okay to call?


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PostPosted: Wed Sep 30, 2015 12:21 pm 
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If you are due to run out of medicine and I mean really out not oh I have a couple still here but take a low dose before the 10 day refill I woud call the doctor and inform them not hey you need to hurry but just tell Dr what was relayed to you from insurance or whoever but if you feel its "addicty" behavior then it probably is. You know yourself best. And addicty behavior is a slippery slope believe me I know.


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PostPosted: Wed Sep 30, 2015 12:43 pm 
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Hey Cross,

I understand why ur worried, heck I worry over everything. I'm one of these ppl who wants to have a backup plan for the backup plan lol. I've always been this way unfortunately, but honestly sometimes being overly prepared on certain things can keep ya covered. I'm always thinking about holidays my pharmacy or clinic Will be closed, or don't get me started on snow days and weather when it's close to my appointment day.....I tend to over analyze everything and have a plan already in place. That's just how I am and always probably will be. Is that addict behavior? I'm not sure, but I do it with everything not just my medicine or Dr. Regardless, I understand ur worried and I get it. So honestly if I were u, and I was worried about it, then just call ur Dr office and ask. Tell them why ur worried and how long it could possibly take and that this is a new insurance and u just wanna make sure there won't be any days ur without ur medicine. I don't see anything wrong with that. It may annoy the office ppl lol but you'll at least feel a whole lot better :)

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PostPosted: Wed Sep 30, 2015 3:08 pm 
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The office staff is usually great at handling insurance BS and may not even have to mention it to the doctor. My insurance company United Healthcare pulled the same crap. I just called the office and politely asked them to resend the form with a big ol' "URGENT" written on it. They laughed and commiserated with me and got it resent right away.

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PostPosted: Thu Oct 01, 2015 1:53 pm 
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Thanks for the advice, guys. I really appreciate it. I went ahead and called the insurance this morning in order to make sure it hadn't, by some chance, gone through already (so I wouldn't needlessly bother the doc); and, astonishingly, it had! I'm amazed. The advice in this thread really helped, though, because now I know what to do in the future -- and also because it gave me the feeling that this was going to get taken care of, one way or another. Thanks again.


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PostPosted: Thu Oct 01, 2015 4:21 pm 
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Over worring is a lack of faith. In a system,or ourselves. Im learning over these last few years that it doesn't help but action will.
When you step up and take a little action so many fears disappear. That is what happened with the ins call.
If there is a problem or worry, just ask yourself what is the Worst thing that can happen? In my book that is Death.
After that see if there can be a solution with the help of another. Yes, some problems are out of our control and it is important to realize witch ones. Many times though there is an answer and in the end it all works out.

Ive had to practice this. ..
Like my old jeep Tuesday was dead after work. Did i panic? No, but thoughts of spending alot of money to fix it sure popped up. But, i called for help. A employee of mine came and it jumped and started. New battery fix it, but I did nt need to worry till or If something major was wroug. .so..

Hang in there everyone!!!!

Razor


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PostPosted: Fri Oct 02, 2015 10:13 am 
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Wow Razor, beautifully stated. So true!


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PostPosted: Sat Oct 03, 2015 10:28 am 
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I hate to even post something after Razor's comment, just because sometimes a comment like that captures things so well that should be the 'period' on the discussion! But then again, posting something will keep the thread at the top of the page....

So much of the decision 'finger' was making (or is it 'cross'?) depended on the doctor's personality. And I find that to be such a frustrating part of medicine-- especially addiction medicine. I'm trying to decide if there are other fields of medicine, where the course of treatment can range so widely-- from understanding to angry termination-- all depending on personality!

From the docs's perspective, at least in my case, I would always prefer that patients be proactive. With the 100 buprenorphine patients and 300-or-so psych patients I've seen this year, I have a -- very hard time remembering details about insurance coverage if the chart isn't open in front of me. It's hard enough to remember the specific MEDICAL issues-- i.e. who is pushing to increase or decrease a dose, who has surgery coming up, who has a parent who wants to talk with me, etc-- without my notes in the chart. In this type of situation, as Amy said, the office would be taking care of everything-- so it would not be on my radar at all. The WORST thing is when a patient calls after waiting so long that I'm not able to help. All docs are familiar with the Friday late-afternoon phone calls-- patients who worried about something all week, then frantically called with an emergency at a time when the options have narrowed. I often get calls from patients saying they took too much of their medication--and now it is ALL gone. Had they called two weeks earlier, when the problem was first evident to them, I could have encouraged them to spread out what was remaining. But if they wait until it's gone, that gives me only one option-- to fill or not fill. And I think ALL docs resent being in that position.

I'm off track a bit, i know...


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PostPosted: Sat Oct 03, 2015 10:50 pm 
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suboxdoc wrote:
So much of the decision 'finger' was making (or is it 'cross'?) depended on the doctor's personality. And I find that to be such a frustrating part of medicine-- especially addiction medicine. I'm trying to decide if there are other fields of medicine, where the course of treatment can range so widely-- from understanding to angry termination-- all depending on personality!

(I would probably pick "Cross" for a nick, but either one gets the job done! :))

Yeah, that is frustrating; you've put forth the problem very well here: it's not a question of guidelines or rules or research -- things which I am much more comfortable with -- but of individual personality, and that can be really hard to know!

Quote:
Had they called two weeks earlier, when the problem was first evident to them, I could have encouraged them to spread out what was remaining. But if they wait until it's gone, that gives me only one option-- to fill or not fill. And I think ALL docs resent being in that position.

That's quite understandable. I think some people wait because they're afraid to risk telling you, or simply don't want to bother you, not understanding that it ends up in an even more bothersome situation! Of course, others probably just don't think ahead...


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