Just ONE Thing We Deal With

{The back story for this post is that after THREE years, Medicare keeps sending my claims to BCBS even though I don't have that insurance any longer.  Someone from Medicare told me I had to have BCBS send Medicare a termination of coverage letter (which I've already done twice)....that's how this all began. Oh, and I should mention I tried to call first, but the wait time was over 10 minutes, so I thought I'd try this...SILLY ME!}

Okay, this is the actual conversation I had with a "live agent" on mymedicare.gov website.

Thank you for contacting MyMedicare.gov Live Chat.

KERRI:  I need the mailing address to send a termination of benefits letter from BCBS (for the second or third time).

Please wait while you are connected to an agent.
You are now connected with MyMedicare.gov Live Chat.

Thank you for contacting MyMedicare.gov Live Chat.  My name is Karen.  Can you please verify your first and last name?

KERRI:  Kerri Sweeris.

Karen:  Thank you Mrs. Sweeri. (Um, ya, Sweeri??)

KERRI:  Are you still there? (three minutes had elapsed)

Karen:  If you cancel supplemental policies, you need to call the supplemental company that you are cancelling and tell them to cancel the crossover. {OH my WORD I have done this a dozen times already}  Medicare cannot cancel crossover files.  Please allow 60 calendar days for the process to be completed.  If it has been more than 60 days {It's been 3 YEARS, "Karen"}, please contact your supplemental insurance company.

KERRI:  I DID call them and tell them to cancel the crossover. But Medicare told me I also needed to send a letter TO Medicare FROM BCBS, which I have in my possession, to complete the process.  I've done this like 3 times, and Medicare keeps billing BCBS.

KERRI:  I have not had BCBS for like 3 years. {I say "like" a lot!}

Karen:  I am sorry.  Medicare cannot cancel crossover files.  You do not need to send them a letter.

KERRI: {banging head against cement wall over and over}  I understand that.  Medicare requested a letter of termination of coverage from BCBS.  Again.  I already told BCBS to cancel the crossover.  I just need the address of Medicare to send the letter to. {I wanted to make sure it went to the right "department" or they would say they never got it.}

Karen:  I am very sorry.  Medicare does not have an address for these types of inquiries.
Karen:  Who told you that Medicare needs a letter? {see above for how many times I actually said "Medicare said...}

KERRI:  MEDICARE.

Karen:  Was this by phone?  {no it was by smoke signal, actually}

KERRI:  Yes.

Karen:  What phone number? {What phone number? SERIOUSLY?!?!?}

KERRI:  1-800-MEDICARE {which drives me crazy, by the way, when phone numbers are made up of too many letters....like it's really 1-800-MEDICAR.  The "E" is extemporaneous.  Makes me CRAZY!}

Karen:  I apologize.  There is no address for this.  They might have been referring to something else.

KERRI:  OH my GOSH!

And I clicked "END CHAT"

The chat session has ended.  Thank you for contacting MyMedicare.gov Live Chat.  Have a nice day.

Start time: 1:04:08 PM
End time:  1:18:52 PM

Have a nice day.  REALLY?!?!?  Now that I'm really to brutalize someone and my blood pressure is skyrocketing, yes, I shall have a nice day.

OR NOT.

Random Letters Volume...Whatever

Dear Sandman,

You FINALLY got it right. God Bless You! Now I won't have to fire you or hunt you down and infest your armpits with the fleas of a thousand camels.

Most Sincerely,
Finally Got A Good Night's Sleep


Dear Medicare,

RE-Qualify AGAIN for oxygen? Serisously?? The orders from a Pulmonologist aren't enough? Oh, wait, let me break that down for you (please read very slowly): A Pulmonologist is a doctor who goes to SCHOOL for years and years so he can figure out whether or not people can breathe. So when a Pulmonologist tells you I need oxygen to breathe, I NEED OXYGEN TO BREATHE.

And if you check with my Neurologist (sorry, that would be a doctor who also goes to school for many, many years to study the BRAIN (something found in MOST people's heads) and diseases that effects muscles necessary for breathing.) You see, I have one of those diseases, and it effects all the muscles I breathe with. Yes, you use muscles to breathe, not just your mouth.

I however, don't even use my mouth to breathe, I use a trach. (That's a tube in my neck that I use to breathe through, but I still need those pesky muscles.) This disease has no cure, so it's not going to Magically Disappear. So this requalifying crap is just another waste of my time, money, energy, and so on. THAT I know you understand, because you are SO good at it.


Dear Congress,

You are {mostly all} pathetic. My deepest sympathies for those of you who think you can affect change on your own. More power to you. There are forces at work that have been at work since lobbyists have been allowed to bribe talk to you about their special interests.

Now you're having issues dealing with the debt ceiling. Let me remind you of something: The President printed his own money. He has upped the national deficit $3,715,953,067,638 in 2.5 years. And before you all start pointing fingers, George Bush added a total of $4,899,100,310,609 in his 8 years of Presidency. I'm not saying that's good either, but Obama is a big spender.

By the way, the dollar is already practically useless, China owns most of the country anyway, and when you're talking 15 TRILLION dollars that will never get paid off anyway....I just don't see the dilema. I mean, what ARE your options? Let the country go bankrupt? Let money become completely worthless? No one pays their bills? It would be anarchy. (On second thought...)

I have the BEST idea: Why don't ALL of you, all 535 members of the House and Senate, live on Medicare and government "assistance" for one year, and THEN decide if you want to make cuts. You may not use your savings, IRA's, CD's, offshore bank accounts, private health insurance, luxury cars, etc. Oh, and for fun, why don't you all live in subsidized housing for that year as well. Y'all need something called PERSPECTIVE.

With Seething Rage at Your Ineptitude,
Walk A Mile In My Mocassins

Catching Up

My goodness! This last week has been a whirlwind. Tracy came up from Florida for a week, but it seemed more like a day or two. It went SO fast. We went to Birch Run and Bronners...SO fun. LONG day though....we left at 8:30 in the morning, and didn't get back til 10:30 at night. Yikes. Exhausting!

I've also had Airway Oxygen here every day except Sat. Sun. and Monday for something or another. Crazy. I'm behind on everything, including my blog! I've got pictures to post on my jewelry site, and a few on facebook as well.

Last night I had to requalify for my oxygen AGAIN by doing ANOTHER pulse oximetery test without oxygen, but with my vent. So imagine me trying to sleep with a pulse ox, wrist guards for carpel tunnel, my vent attachment into my trach, the hose clipped to my nightshirt with a hairclip, kleenex shoved up my nose to stop the air leak....Yeah. I was a beaut I'm sure.

Try adjusting a tiny part of the adapter (that fits snugly INSIDE my trach) with a pulse ox on. Try doing suction with a vent (have to sit up, detach, do suction) with a pulse ox on. My Airway Oxygen rep. told me Medicare needed at least 4 hours. They got 4 hours and 3 minutes.

PLUS, I have to have some stupid walking pulse ox test at the flippin' hospital to qualify for portable oxygen tanks. Portable. Oxygen. Tanks. I have the prescription for oxygen from my doctor. I have a chronic, incurable neuro-muscular disease, but I have to drive an hour away to have a 6 minute walking test, and drive an hour home, because I have to qualify by MEDICARE'S standard. Don't get me started. That's a whooooooole separate post.

Then I turned on my oxygen concentrator so I could sleep better, and took that $#@*&% pulse ox off. What a pain. So I finally get to have oxygen (at night anyway). I turn the thing on, and at first it sounds just like my old one.

Until I hear "the noise."

Have you ever heard the air brake on a semi tractor or a bus? You know, the loud "Pshooosh."
Mmmm-Hmm.

Every.
Five.
Seconds.

At 3:17 AM, I'm standing in front of this O2 concentrator saying (loudly) "Are you KIDDING me??" I don't know how I managed to sleep, but I did. Oh, the visual.

Hopefully tonight I can just sleep. No tests, no projects, no qualifying, just SLEEPING!

New Pulmonolgist

Thanks to Medicare, I was forced to find a new pulmonologist so that I could get requalified for my oxygen use at night. My neuro. can't sign anymore, I have to go SEE a doctor, and get a written request for an overnight pulse oximetry test, so I can show them my oxygen dips down dangerously low at night ergo I need oxygen.

It's so lovely when I have to do these idiotic tests. Like I'm just going to be better one day and not need it. Jerks. MG is a CHRONIC illness people. CHRONIC. As in always. As in not getting better.

So I have to go a night without oxygen, wear this stupid pulse ox all night, wake up with a migraine, kill a few brain cells, all because Medicare wants to make sure they aren't paying for something that I could squeak by without.

Then my PHARMACY (the 3 month mail in one) held my birth control pills hostage because the INSURANCE company called them to tell them my CellCept interacted with the pill and MAY cause it to be less effective. So I had to get clearance from my NEUROLOGIST for the pharmacy so I could get my damn birth control pills. Heaven forbid I get pregnant again, we all know how much that cost last time! I had to call my GP three times to find the right person who understood the situation, and get them to call in one month of B.C. locally, and RE-issue the Rx to the mail in place.

It's ridiculous. Like I have nothing better on which to spend what little energy I have!

Anyway, at least I like the pulmonologist. He's really cool. Very nice, knowledgable, and best of all, he listens to ME.

To top it all off, I feel like crap. I've been fighting something for 2 weeks and I appear to be losing.

The REAL problem with government healthcare....

Okay, so I read this article about Medicare fraud. I mean, you have to be naive to think that no one ever tries to scam anyone else, including the government. But THIS...this is ridiculous. Here are just a few tidbits from the article (Reader's Digest, October 2009):

"One pair of scam artists in Florida used the Medicare identification numbers of DEAD DOCS to bilk $1.3 million from the government--also known as we the taxpayers.....More than 50,000 of the bogus claims involved doctors who had been deceased for at least TEN YEARS."

ARE YOU KIDDING ME??

"Here's another good one: the podiatrist who allegedly billed the government for treating people with no feet. Dr. David Quang Pham was indicted in St. Louis this past June for charging the governemnt for nonexistent procedures that he backed up with phony notes (Pham has pleaded not guilty) {of course}. As an unforgettable press release from the local U.S. Attorney's office put it, 'Dr. Pham submitted reimbursement claims for treating the feet of patients whose feet had been amputated prior to the dates of service.' Once again, it was the taxpayers who had to, er, foot the bill."

I'll just let that one sink in a minute.

"The National Health Care Anti-Fraud Association estimates that more than $60 BILLION a year is lost to fruad." Hmmm...I wonder how many Czar's you can employ for $60 BILLION a year? Maybe some of them should concentrate on plugging these holes instead of creating more programs for people to scam.

* Michael DeJesus Huarte set up 14 health care clinics to treat cancer and AIDS, and billed the government for $70 MILLION in Medicare and Medicaid reimbursements.

* 1,581 "medical equipment companies" billed Medicare for $97 MILLION.

* a "pharmacy" in Florida allegedly selling nebulizers for asthma patients was actually a broom closet, and the pharmacist, an air-conditioning repairman.

* In Michigan, Dr. Robert Stokes removed MINOR skin blemishes telling his patients they had cancer, scaring them half to death, and jacking up his Medicare reimbursement.

* In Pennsylvania, a dentist pleaded guilty to doing root canals on patients who didn't need them

"In January 2007, Medicare shut down 18 medical equipment sellers in Florida after investigators discovered they were phony. But the companies were reinstated on appeal--only to be indicted several months later, after they had been paid another $5 MILLION in taxpayer money. Loopholes that allow quick reinstatements-OFTEN AFTER JUST A SWORN STATEMENT FROM OWNERS-must be closed."

Okay, read that again. They were closed for being phony, appealed, and were reinstated (and PAID) for their word. Only the government.

The article ends: "True change may take some time. But here's one small step Washington could take right away to restore some confidence: Make sure that doctors collecting our dollars STILL HAVE A PULSE."