Wednesday, September 10, 2008

Are you sitting down? Really, are you?

Trying to be proactive about the whole pain drug situation, I worked my way through the hierarchy of the insurance company to ferret out just who was denying my pills. The culprits were a trio who comprise the pharmacy management team. Yes, they have a phone number. No, a live person does not answer the phone. Still, I left a rather detailed, somewhat frantic voice mail message. I admit, I had little hope that someone would respond.

Then, I got this call yesterday. It went something like this:

"Miss Ducee?" [Note: This is NOT my last name.]
"What?"
"Ducee, Miss Ducee""
"You have called _____________"
"How may I help you?"
"What?"
"This is CareFirst. I am returning your call. How may I help you?"
"Oh, well. I have been...[rushed explanation]"
"Yes, I see you had this last filled in July 2007. I am approving you for authorization from the date you tried to fill the prescription. That will be August 2008 to August 2009."
"What?"
"You can pick up the prescription now."
"Really? I mean... Well... "
"Yes?"
"Just like that? It's been 3 weeks."
"Yes. Okay?"
"Uhm...well...you mean I can pick up the Celebrex, 200 mg, twice a day, not once a day?"
"I cannot see the particulars of the dosage, just the drug. I have approved that prescription that was denied for lack of prior authorization."
"So, I can just go pick it up?"
"Yes, that is what I said."
"Well...uhm...really?"
"Yes. Okay. I need to go now."
"I guess. Okay."
"Goodbye, Ma'am."
[More sputtering and bumbling on my part]
"Ma'am?"
"This is true. This is happening."
"Yes. I am hanging up now."
Click. Dial tone...

UTTER DISBELIEF ON MY PART ENSUED FOR MANY LONG MOMENTS.

Of course, that means I had to get a prescription from my doctor to give to my beloved Target pharmacist. Now, I had been asking to have the prescription faxed for two weeks in anticipation of this very happening, but it took another day and a half to get it.

Tonight, in my hot little hands, I hold a bottle of one month's worth of my prescription. Oh, my, I cannot begin to express my gratitude that this experience is over. However, I will say that the denouement of the saga was strangely disappointing.

There I was, embattled and exhausted from buckets of tears and fears galore, and it was over. I barely got my explanation out before the woman cut me off and made her determination. I should point out, that the same day I got the call, I received a disturbing letter documenting the denial of my medication. I felt pummeled by this experience. But I also feel as if the rug was pulled out beneath my feet in one simple phone call.

Simple.

This whole process should have been simple. But it was not. It was horribly complicated and drawn out. After the last three weeks, I was not prepared, frankly, for the sudden--and rather shocking I might add--about face resulting in a decision in my favor.

In discussing the matter with Pastor D, I confessed how afraid I have been the past three weeks. However, I am not quite sure if I fear the sheer agony of life without Celebrex or that pain is the path God has for me long-term...

Wow...I actually have my pills...

1 comment:

ftwayne96 said...

"Hot little hands"?