Posts Tagged ‘PPO’

No Problems

April 22, 2018

Well that’s what a girl likes to fucking hear!

Thank God.

I was praying in my head and doing deep breathing the entire time I was at the dentist getting x-rays and the exam prior to the cleaning, keeping my fingers crossed that there were no more surprises, no cracked teeth, no need for another crown.

Clean bill of health.

Except.

Well.

Not quite.

Turns out it looks like I may be grinding my teeth, this is the first time that that’s been mentioned in the two years that I have been seeing this dentist.

Might be time for a mouth guard.

But.

Of course.

My insurance, what the fuck, doesn’t cover it.

I was like.

Whatever.

Dentist says it’s an indicator of stress when teeth are ground at night.

Great.

Really?

Stress.

Hahahaha.

Sigh.

I asked them to check under my other insurance, yes, technically I have two insurance plans, Universal Health Services, a PPO, through my school, and I also have Delta Dental.

The Delta Dental doesn’t cover it.

Frankly it doesn’t seem to cover much.

It didn’t cover my cracked tooth and subsequent crown, that was $1400 out-of-pocket.

The mouth guard, should my other insurance not cover it, and considering the lack of shit that they do cover (remember this is the insurance company that won’t cover the endoscopy), will cost $495 out-of-pocket.

The admin team at the dentist’s office said they’d check for me on Monday.

I figure I’ll be getting a mouth guard my next dentist visit in August and it will be out-of-pocket.

Whatever.

Stress.

Meh.

What stress?

Bwahahahahaha.

On the up side, no cavities, no cracked teeth, and a good cleaning and I was out the door.

I was happy to be onto the next thing that I needed to do, supervision, and I had time to get cross town and find parking.

Which was a shit show.

There was a fixed gear bicycle race in the neighborhood and all but one of the blocks around my internship were closed off.

I had to circle for a while.

I’m super grateful I had the extra time.

I would have been late.

As it stood I made it just at the stroke of 2 p.m.

I had a good check in, got to relay that I had the clean (ish, I suppose if there’s evidence of teeth grinding it wasn’t exactly) bill of health and that I had made it to yoga today for the first time in six weeks.

Sigh.

Six.

That’s a lot of time, but I have been suffering with the reflux for so long that I couldn’t go, I mean, I wanted to, I signed up a few times, but I could never make it to class.

Today was hard.

But not overwhelmingly so.

I didn’t have reflux, though my tummy still has some issues, I was able to do the class and I’m quite happy for the exercise.

I am sure I will be sore in the morning.

I signed up for an early yoga class tomorrow.

7:15 a.m.

I can’t believe I’m going to do it, but I am.

I’m going with my best friend and then we’re going to have breakfast.

After I wrapped with group supervision I did exactly what I had hoped to get done.

Car wash.

And.

A mani/pedi.

It was lovely.

I also got some grocery shopping done then met my person at my Saturday night commitment and got right with God.

It was a really nice day, full of stuff, but really good stuff.

I have a lot to do tomorrow, and the paper is looming, but I feel like the self-care that I did today was good and that I am on the right track with getting the paper done.

I am going to not be anxious about it.

I’m going to really fucking try.

I don’t want to be grinding my teeth tonight.

Damn it.

 

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I’d Like To Speak

April 13, 2018

To the manager please.

Except.

I didn’t say that.

I did say, nicely, politely, with lots of pauses and deep, slow breathing, that I had been calling every day for the last four days, four, and that I really wanted to make an appointment with the doctor.

REALLY.

I expressed how much pain I have been in and how it’s been really hard to not be able to get through to the part of the story where I make an appointment and I’m seen.

REALLY fucking hard.

The woman on the line gave me another number to call.

How many fucking numbers am I going to have to call to get to be seen?

I am not good at this, and I wonder, is anyone?  But I played along and called the next number and sure as shit, I got a voicemail saying please leave a message and someone will get back to you within the next 24 hours.

Fuck you.

I mean.

REALLY.

I hung up.

I called my person, I left a teary message.

I sank down on the floor and cried a little.

The baby was playing by the train set and the oldest boy was in his room with a new Lego set grandma had gotten him.

I had a minute to cry and then I got up, blew my nose, and started a kettle for a cup of tea.

You know who called me back?

My person.

Fucking love him.

And he told me to get up early and go to the doctor’s office in person and make the appointment there and demand to be seen.

Ugh.

Just the thought of trying to do that felt horrendous and huge and awful and I had this inkling that the mom was going to ask me to come in early, which she did, but more on that later, and I couldn’t imagine getting up early, driving down town and marching into CPMC Sutter and pounding on the desk to get an appointment with the GI specialist that my doctor referred me to.

But.

I was willing to take it as a suggestion.

Honestly though, I wasn’t sure I could do it.

Fortunately.

A few hours later when I was wrapping up dinner dishes and the family was happily eating dinner, I got a call back!

I was shocked.

It was 5:30 p.m. and I wasn’t expecting any kind of response after 5p.m. had rolled on by.

It was the manager of the office!

She was super kind and very apologetic.

She’d listened to my message and combed over the records from the answering service and apparently there was no record of any of the phone calls I had made.

Not a single one!

I have called the office every day since I got the referral on Monday.

Monday, two hours after the initial appointment at One Medical.

On Monday I was told that the office hadn’t had a chance to look at the referrals yet and the doctor would look them over and call on Tuesday.

By three p.m. Tuesday I hadn’t heard a thing.

So I called and spoke to a woman who took all my information and assured me that someone from the office would get back to me in the next 24 hours.

24 hours later, Wednesday around 3 p.m., nada, not a single fucking call.

So.

I called back.

This time I got through to the doctor’s office and was told that they had never received a fax from the referring doctor.

Fuck my mother.

So.

I called One Medical, and they denied that, insisted they’d faxed it, but said, hey, we’ll do it again.

Then the guy at One Medical did me one better, I have to say I am impressed so far with them, great customer service, he called the office himself.

He then called me back and said he’d re-faxed the paper work, apparently the fax machine at the GI’s office had gone down on Monday and they were inundated with a back log of faxes.

Sure.

Sounded an awful lot like the dog at my homework, but whatever.

So I called back to the office and spoke to a woman there who said they’d received a partial fax, but not the entire thing and the doctor would call me tomorrow.

Which brings me to today.

And no phone call by 3 p.m.

Which led me to call the office again and this time I got the answering service again and I got upset and I was not in tears, but I was pissed, and I held it together, but I made it super clear to the woman I was talking to that I wasn’t going to leave a message so that I could be called back in the next 24 hours, I was in pain and I had been trying since Monday and I needed help.

That’s when she gave me the manager’s number, although at the time I thought she was giving me a direct number to the GI’s office.

No such luck.

Grateful though, that I pushed and got through to someone and really grateful that the woman took the time to call me back, after business hours, get me into the system fully and assured me that she would personally make it her business to have the doctor’s office book my appointment tomorrow.

I admit, I had a fantasy that I would get the referral and already be done with it by this point and have some sort of resolution.

And although that’s not what happened, at least I do know that I have taken the next step towards something.

I hope to hell I can get this taken care of.

I am so tired of it.

Really.

Really.

REALLY.

Tired.

How’s Your Poo Poo?

March 24, 2018

What the fuck did you just ask me?

Did you ask my how my “poo poo” was?

Did you really?

I’m a 45-year-old woman.

Jesus fuck.

Of course, you did, dear doctor, yes, I had a doctor ask me that, you also referred to your receptionist as your “office girl.”

God damn man.

Get with the fucking century.

I was not happy with my experience today, but I am happy to have gone, despite my trepidations, despite my annoyance at the parking in Chinatown, despite having to go to a fucking doctor in some weird old building in Chinatown, despite the bathroom looking worse than a JC Decaux public bathroom on Market Street, why was there a nest of toilet paper in front of the toilet?  Why? In the women’s bathroom, I had asked for the code after my appointment and I couldn’t even bring myself to use the loo.

This coming from a woman who has gone to Burning Man 11 years in a row and used many port-a-potties.

I just was over it.

Over the entire fucking thing.

Over having a PPO for my health insurance.

Over it.

As my best friend said to me earlier, look at it like an adventure, look at it like an experience.

An adventure I never want to do again, nor an experience I want to have either.

I am also looking at it from the vantage point of now I know.

Now I know how much I liked having Kaiser and now I’m willing to get it back as my insurance.  I just can’t handle many more third world microwave on top of the file boxes, 11 people in the waiting room to be seen by one doctor, with only four chairs to sit on, a doctor who infantilized what was happening in my body and the not so hygienic conditions of the entire space.

I just don’t want to have that experience ever fucking again.

Unfortunately I do have to go in for an endoscopy.

Fortunately it is not to be had at that office.

It will be at the Golden Gate Endoscopy Center.

Which will make four, no, five!

Five different places I have had to go to, all across the city from Ocean Avenue, to Noriega and 26th, to Irving and 22nd, to Pacific and Grand, to this place on Geary.

Five fucking different places to have this issue looked at.

Over a huge span of time.

It has taken months to get this far.

I am so very over it.

I’m pretty much done.

And have the god damn reflux so bad right now.

Ugh.

I still haven’t gotten the lab results back.

I’m still hoping that it’s an infection and that I can treat it with antibiotics.

If that’s the case, then no endoscopy.

I’ll cancel the damn thing.

It’s also such a nuisance, I’ll have to be at the facility at 7 a.m.

And I’ll have to have fasted and not drank any water after midnight the night before.

Which isn’t so bad I suppose.

What’s annoying is that I have to be released to someone because I will be put under for the procedure.

It’s not a heavy sedation, but it is sedation and I apparently need to be released to a friend or family member.

Yeah, no family members around this neck of the woods.

I got a little stressed trying to think of who I was going to ask who could come at 9 a.m. on a Wednesday and grab me.

My friends are all fucking working.

Not an ask I want to make.

However.

The mom at my job offered!

I was shocked.

I was so surprised.

Grandma happens to be visiting that week and she said she could come and get me and I was just so moved by her offer.

And she really meant it, she really wants to help.

And although I’m a little loathe to ask my employer to do me this favor, so far the one other person I’ve checked in with wasn’t available.

I have a few other folks I’ll ask, but it looks like I may very well be asking my boss to pick me up.

I work for some really kind people.

As kind as they are, though, I was happy to leave today, I was tired, it was a long week, it was an emotional rollercoaster with the doctor I had a feeling it was going to be unpleasant and yup, it was.

I’m glad it’s done and hopefully this will all be resolved soon.

Fingers crossed.

And in the meantime.

Well.

It’s time.

Time to research and find better insurance.

Time to take care of my health in a way that better suits my needs.

I need, very much so, to never have that experience again.

No fucking thank you.

A Little Rest

March 23, 2018

Not much.

But enough.

I don’t have to get up super early tomorrow.

Although the mom had asked that I come in early, having forgotten that I have a doctor’s appointment at 10:30 a.m.

So.

Early.

Not so much.

I have set my alarm for 8 a.m.

Which feels like such a luxury, to sleep until 8 a.m.

I am all about it.

It’s curious, though, now that I’m thinking about it, I just realized the doctor’s office that I have an appointment with has not called or texted me to confirm tomorrow’s appointment.

I will be calling before I go in to confirm.

I really don’t feel like driving all over town if I don’t have to.

I’m not really excited about going in.

I had hoped that the lab results were going to be in by this time.

I don’t know how long the lab results take to process, but I dropped off the sample on Monday.

I suppose five working day sounds about right, but I’ve never been in this kind of health insurance land before.

I really miss Kaiser.

It’s funny.

I’ll see people lambaste it on social media, and there’s some point to that, there are certain things they lack, they don’t have a great mental health services department and they don’t do one on one therapy, just group therapy, but their system is super stream lined, I could just go online, pop in my account, make appointments, cancel appointments, get lab results, it was super easy.

This using my school’s insurance has been such a huge pain in my ass.

I have asked the family if we could relook at my insurance, and I’m willing to do the step work to do that, and see if maybe there is another alternative route for me.

I would be willing to pay a little into it myself.

My health insurance is pretty much covered by the family, they reimburse me on a monthly basis and it’s the amount that I figured out would be how much I pay in school–which was paid for in my student loans, but whatever.

The cost per month is $225.

So that’s what the family gives me.

I would probably have to pay double that to get Kaiser.

I’m almost ready to.

I could continue using the school’s insurance, especially if I continue forward with my PhD.

Oh my God.

I almost forgot.

I’m interviewing soon!

Wednesday, March 30th at 10 a.m.

Eight days from today.

Realistically I could continue with the health insurance through the school for the next two years.

I wouldn’t really be day-to-day affected money wise, it would be similar to what it is now, I pay it out of my student loans and the family pays me once a month.

If I can be served well, if I can get services then maybe.

It’s just been such an uncomfortable experience.

I’ve never had a PPO before and I really just don’t care for it.

And yes.

Gah.

Do I think that my reflux might have something to do with stress?

Because I feel a little now, stress, and reflux.

Sexy.

Ugh.

I’m just over it.

I’ll go to this doctor and see what he says, I’m so not excited to go see someone else, I really feel done with the whole adventure.

Except that I still get the reflux.

Not as bad as it was, I really do think that cutting out ibuprofen was such a huge deal for me, as well as being really mindful of what I eat.

And then.

I get concerned.

What if I have to take more out of my diet?

What if that’s the main issue.

Does roast chicken cause heartburn?

I mean.

I pretty much live on it right now.

I suppose it might be time to shake up my diet a little, but I do have certain staples that I am so used to eating, just thinking about having to cut out something else makes me feel a little crazy.

I have cut out a lot already.

Then again.

I just want to stop having the reflux.

So If I have to take something out.

I take it out.

Blah.

I have other more exciting things I wish to think about.

I wish I could let the reflux take the back burner, but it’s been so consistently with me for the last few months, more months than I want to admit, I just need to deal with it and do whatever comes next in the grand adventure of my health care.

I’ll go see the G.I. and do what I’m told.

I am not doctor.

At least not yet!

So.

I’ll take whatever doctor’s orders are and do what’s best.

Sigh.

 

Tooth Ache

January 12, 2018

My tooth hurts.

Achy.

I’m hoping it’s temporary.

I’m one week and two days away from getting the permanent crown put in.

I’m not in severe pain, it’s just there and a touch disconcerting.

I got notice today that my dental insurance is about to end, as though it was much good, and I’ve looked up on my PPO to see if there is dental available through my plan.

It looks like there might be.

Then again.

Who the fuck knows.

I had made a opthamology appointment four months ago.

Yes.

I said four.

And today I got a message to call the office.

They weren’t sure if my insurance covers the visit.

I gave them all my information and am awaiting details.

It’s so frustrating.

I have not had this experience before.

Having to wait such long times to be seen, not being able to be seen, having to figure it all out on my own.

I had Kaiser for such a long time I got super spoiled by their facilities and the easiness of booking appointments.

I wish the school hadn’t changed over to this health plan, but it’s what I have and until I can afford something different, it’s what I’ll be using.

I do get a stipend from my family, so there’s that, it’s just the inability to be seen that has me really flustered.

I didn’t go bananas on the woman who called me but I did question why the hell it took so long to be contacted if there was a question in regards to the coverage.

I mean.

I just would have kept my October appointment with my ophthalmologist on Irving street.

Really nice guy, Dr. Kurtzbay.

I liked going there, although I did not like paying out-of-pocket for the services.

The last two pairs of glasses I got were both over $450.

Plus I was a little flush, for me, and I bought a pair of prescription sunglasses.

Which I managed to hold onto for about four months before losing them.

Sigh.

Anyway.

When I got this new insurance I was excited that there was ophthalmology and dental included.

Of course.

I haven’t been able to use the services, I haven’t been able to get in to a dentist or an eye doctor, so in a sense it feels useless.

I have used the insurance once to be seen by a new primary care physician in an Outer Sunset facility that reminded me of a bad made movie scene in a third world country.

I have the number for the only dentist facility that my insurance purportedly covers and I’m going to call them tomorrow and see if I can get in.

If I can’t then I will renew my own out-of-pocket dental care for the second year in a row and just stick to my guy over at Sunset Premier Dental.

He’s not first world, but not third world either, and he takes appointments on Saturdays, so there’s that.

Speaking of appointments.

I get to see my chiropractor in the morning.

I have a 9 a.m. session.

My back as been feeling better, I will say that, not 100%, but significantly better, I’m not in nearly the same amount of pain as I was a few months back when it started to act up.

I think this is my fourth session.

I’ll have a few more sessions still covered by my family and then I will see about continuing.

I really like her energy, it’s just $85 a pop and she wants to see my weekly.

Add that to my personal therapy at $120 a session, and the week get’s expensive quick.

I wouldn’t really be thinking that much about it, but the unexpected dental stuff did eat up my little buffer.

I’m not too worried, however, I’ve gone over my numbers a bunch of times and I’m going to be just fine.

Tighter than I want to be, sure.

Wishing I hadn’t committed throwing in $200 to the party on Saturday, yup, but fuck it, whatever.

When I was out drinking and using I blew more than $200 a night and frankly, I’m happy to help host a party and have a fun time and a good dj and friends come out to dance that I typically don’t see.

It’s only a few days away, my sobriety anniversary and it still doesn’t have that anxious feeling around it, I’ve nearly forgotten, in fact, that I had an anniversary coming.

I have heard people say that before, especially busy people, but I never really thought that there would be a time when I would not be acutely aware of an upcoming anniversary.

And I’m just not.

It’s rather nice.

The party makes it rather nice too.

So.

I’m not going to focus on money, it’s all God’s money anyhow.

I’m just going to focus on what needs to be paid next and have faith that I’m taken care of.

Paid my phone bill yesterday.

Felt great.

I actually like paying my bills.

I mean, even though I didn’t want to shell out the money to my dentist, I really like that I was able to pay it and pay it in cash, well, not paper-folding money, but you know, by debit card which is not a credit card.

I have not even used the credit card I got a few months back, I’m not even sure I will for that matter.

I like paying my debts with cash.

It feels good to be accountable.

And it feels really god that tomorrow is Friday.

Fuck yeah.

I’m ready for the weekend.

So ready.

Seriously.


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