Re: [TMIC] HMO's
Jude: I can't remember are you on Medicare too? If so call them and see what they say about this.Tell me what state you are in and I'll see what help I can find for you. I used to work in Social Services before TM/MS hit me and I might be able to find something that would help you. hugs))) Sharon --from Arizona TM 1997 to MS 1998 It's not easy taking my problems one at a time when they refuse to get in line. ~Ashleigh Brilliant http://health.groups.yahoo.com/group/MSersLife/ - Original Message From: [EMAIL PROTECTED]To: [EMAIL PROTECTED]Cc: tmic-list@eskimo.comSent: Friday, August 11, 2006 8:24:36 AMSubject: Re: [TMIC] HMO's Jude:What a Bummer!That is what anger is for! when you have beenmessed over and it energizes you to do something about it.I am wishing Iwas closer so I could help you advocate for yourself!Perhaps AdultProtective Services could be called---I'm not sure what all they could do,but maybe they would have an "in" with some of the systems in your state.One thing we learned at the Symposium was that HMO s and PPO's sometimeswill assign a Case manager if you ask:I think that's the route I wouldtake ASAP.Also, don't just take one route.You can drop action fromother sources if you get results from any of the others.Cora Hi All and Frank, As usual, I need some advice and help.I am so darn madI almost cannot stand it! (actually, can't STAND it, at all)LOL I think that most of you know I have been waiting and waitingto go to the seating clinic so that I can get my tilting/recliningwheelchair so that I can get out of this danged bed I have been in sinceDecember. Well, the telephone woke me up early this morning with thegood news from my doc's office that all of this time the clinic they weresending me to is out of my HMO's territory!!!I hate ineptness somuch... (anger) What have I done lately to hurt anybody?(feeling sorryfor myself) I have been in this da bed (that I am so thankful tohave) since the first of December with two broken legs, after beingParalyzed with complete TM for 4 years (for those of you who do not knowthis), and I want to get up and in my chair so badly I almost can't standit! I can't sit in the chair for more than 1/2 hour because mylegs swell inside the casts so badly and become so painful that I can'ttake it and have to go to bed in order to raise them. Besides that, I have a pressure sore inside the anal cavity(caused by the ischema (sp) bone) that bleeds profusely when I perform mynormal bowel program.I was so looking forward to the new (my oldone was stolen) seat for the new wheelchair... (feeling even more sorry for myself) I just don't know what to do any more.I need help withsome ideas and answers.I don't know how to fight "city hall" anylonger and am almost out of the strength needed to do it.It's allINSURANCE COMPANY and HMO'S, not to mention the SOCIAL SECURITY COMMISSIONwho have all of the power...They are in charge and what I/we say is oflittle or no consequence. I am getting so pissed!!! (anger) Why is it always one step forward and three stepsback? Dr. Frank, I added your name to this email because you knowwhat I need to say and who I mostly need to say it to in order to getsomething moving in the proper manner, by doing whatever it is in theproper order, addressing the right people!And, I want ACTION,now!What do I do, how do I do it, and who do I address my actionsto?Help me, please! Some of you have already been helping from behind theList.Sally, the Nutritionist wrote a lovely letter addressing howthe use of a new wheelchair that raises up above my cooktop so that Icould take charge of making our meals using healthier foods (Dave does hisbest, but cooking is not his strong suit...), so that it would helpby enhanced healing of pressure sores and stomach ulcers, my weightloss, and all over general health. People have been sending me loving support through thegrapevine and I appreciate it all so very, very much.And Iappreciate all that Dave does.He takes care of me all byhimself...no one comes in to help and we can't afford to pay any type ofservice.He takes care of the animals, the house, the five acres,the laundry, all of my needs (staying up half the night last night becauseI had such deathly diarrhea I was in tears), and he works six/ten to twelve hour nights a week, at 54 years old.I don't mean ever tosound like I don't appreciate him. Anyway, I'm sorry for getting out of control with this. And for being so needy.But I am at my wits end and need whateverkind of help any of you can give. Peace and Prayers, Jude
Re: [TMIC] HMO's
Jude: What a Bummer! That is what anger is for! when you have been messed over and it energizes you to do something about it. I am wishing I was closer so I could help you advocate for yourself! Perhaps Adult Protective Services could be called---I'm not sure what all they could do, but maybe they would have an in with some of the systems in your state. One thing we learned at the Symposium was that HMO s and PPO's sometimes will assign a Case manager if you ask: I think that's the route I would take ASAP. Also, don't just take one route. You can drop action from other sources if you get results from any of the others. Cora Hi All and Frank, As usual, I need some advice and help. I am so darn mad I almost cannot stand it! (actually, can't STAND it, at all) LOL I think that most of you know I have been waiting and waiting to go to the seating clinic so that I can get my tilting/reclining wheelchair so that I can get out of this danged bed I have been in since December. Well, the telephone woke me up early this morning with the good news from my doc's office that all of this time the clinic they were sending me to is out of my HMO's territory!!! I hate ineptness so much... (anger) What have I done lately to hurt anybody? (feeling sorry for myself) I have been in this da bed (that I am so thankful to have) since the first of December with two broken legs, after being Paralyzed with complete TM for 4 years (for those of you who do not know this), and I want to get up and in my chair so badly I almost can't stand it! I can't sit in the chair for more than 1/2 hour because my legs swell inside the casts so badly and become so painful that I can't take it and have to go to bed in order to raise them. Besides that, I have a pressure sore inside the anal cavity (caused by the ischema (sp) bone) that bleeds profusely when I perform my normal bowel program. I was so looking forward to the new (my old one was stolen) seat for the new wheelchair... (feeling even more sorry for myself) I just don't know what to do any more. I need help with some ideas and answers. I don't know how to fight city hall any longer and am almost out of the strength needed to do it. It's all INSURANCE COMPANY and HMO'S, not to mention the SOCIAL SECURITY COMMISSION who have all of the power...They are in charge and what I/we say is of little or no consequence. I am getting so pissed!!! (anger) Why is it always one step forward and three steps back? Dr. Frank, I added your name to this email because you know what I need to say and who I mostly need to say it to in order to get something moving in the proper manner, by doing whatever it is in the proper order, addressing the right people! And, I want ACTION, now! What do I do, how do I do it, and who do I address my actions to? Help me, please! Some of you have already been helping from behind the List. Sally, the Nutritionist wrote a lovely letter addressing how the use of a new wheelchair that raises up above my cooktop so that I could take charge of making our meals using healthier foods (Dave does his best, but cooking is not his strong suit...), so that it would help by enhanced healing of pressure sores and stomach ulcers, my weight loss, and all over general health. People have been sending me loving support through the grapevine and I appreciate it all so very, very much. And I appreciate all that Dave does. He takes care of me all by himself...no one comes in to help and we can't afford to pay any type of service. He takes care of the animals, the house, the five acres, the laundry, all of my needs (staying up half the night last night because I had such deathly diarrhea I was in tears), and he works six/ten to twelve hour nights a week, at 54 years old. I don't mean ever to sound like I don't appreciate him. Anyway, I'm sorry for getting out of control with this. And for being so needy. But I am at my wits end and need whatever kind of help any of you can give. Peace and Prayers, Jude
Re: [TMIC] HMO's
Jude, I know this fits your question personally, but it might help someone else in an HMO also. I was in your same HMO since its existence until I went on Medicare May 2006. Michigan Blue Care Network no longer has territories. The HMO allows you to cross what used to be the territory lines and receive coverage from any provider who works with the BCN HMO. I must have saved my Blue Care Network notebook just for you. This is from the Winter 2004 booklet (page 22). No more regions: you can select any participating provider. It no longer matters what region you live in or where your primary physician is located. You can select any participating provider in our service area. Of course, its best to have one close to home, but you no longer have to worry abour crossing regional lines. My neuro was alway out of my PCP's region and the office manager gave me fits each time she had to go through BCN's process. She and I hasseled for two months over a referral. because she didn't know of this policy change. Maybe its possible that your doctor's office isn't going the extra mile and they are giving you the excuse of territory or regional lines when they are no longer a problem. I hope this is the answer you need. BCN phone number is 800-662-6667. They can tell you if this policy is still in effect. [EMAIL PROTECTED] wrote: Hi All and Frank, As usual, I need some advice and help. I am so darn mad I almost cannot stand it! (actually, can't STAND it, at all) LOL I think that most of you know I have been waiting and waiting to go to the seating clinic so that I can get my tilting/reclining wheelchair so that I can get out of this danged bed I have been in since December. Well, the telephone woke me up early this morning with the good news from my doc's office that all of this time the clinic they were sending me to is out of my HMO's territory!!! I hate ineptness so much... (anger) What have I done lately to hurt anybody? (feeling sorry for myself) I have been in this da bed (that I am so thankful to have) since the first of December with two broken legs, after being Paralyzed with complete TM for 4 years (for those of you who do not know this), and I want to get up and in my chair so badly I almost can't stand it! I can't sit in the chair for more than 1/2 hour because my legs swell inside the casts so badly and become so painful that I can't take it and have to go to bed in order to raise them. Besides that, I have a pressure sore inside the anal cavity (caused by the ischema (sp) bone) that bleeds profusely when I perform my normal bowel program. I was so looking forward to the new (my old one was stolen) seat for the new wheelchair... (feeling even more sorry for myself) I just don't know what to do any more. I need help with some ideas and answers. I don't know how to fight city hall any longer and am almost out of the strength needed to do it. It's all INSURANCE COMPANY and HMO'S, not to mention the SOCIAL SECURITY COMMISSION who have all of the power...They are in charge and what I/we say is of little or no consequence. I am getting so pissed!!! (anger) Why is it always one step forward and three steps back? Dr. Frank, I added your name to this email because you know what I need to say and who I mostly need to say it to in order to get something moving in the proper manner, by doing whatever it is in the proper order, addressing the right people! And, I want ACTION, now! What do I do, how do I do it, and who do I address my actions to? Help me, please! Some of you have already been helping from behind the List. Sally, the Nutritionist wrote a lovely letter addressing how the use of a new wheelchair that raises up above my cooktop so that I could take charge of making our meals using healthier foods (Dave does his best, but cooking is not his strong suit...), so that it would help by enhanced healing of pressure sores and stomach ulcers, my weight loss, and all over general health. People have been sending me loving support through the grapevine and I appreciate it all so very, very much. And I appreciate all that Dave does. He takes care of me all by himself...no one comes in to help and we can't afford to pay any type of service. He takes care of the animals, the house, the five acres, the laundry, all of my needs (staying up half the night last night because I had such deathly diarrhea I was in tears), and he works six/ten to twelve hour nights a week, at 54 years old. I don't mean ever to sound like I don't appreciate him. Anyway, I'm sorry for getting out of control with this. And for being so needy. But I am at my wits end and need whatever kind of help any of you can give. Peace and Prayers, Jude
Re: [TMIC] HMO's
The fun part you are having right now. Tomorrow will be a breeze. ann in Virginia
Re: [TMIC] HMO's
The only medicine that work for me is Bisacodyl (suppositories) I can last 9 day with no bowl movements, but daily use of bisacodyl is helping a lot it work among 30 min to 1hr, and am always ready with it starts doing its job, sitting on my specail chair, spend almost an hour but most of the time works great for me. Juan In a message dated 8/8/2006 2:39:30 P.M. Pacific Standard Time, [EMAIL PROTECTED] writes: I had one of those a couple of years ago. I was s glad they offered pills instead of the liquid. As Ann said -- the "fun" part starts with those pills. :-) The procedure itself is a breeze. I was afraid of having an "accident" on the way (though I didn't see how anything could have been left) so took a change of clothes and a towel to put on the seat of the car "just in case," but all was ok. From the time I started the pills I tried to stay no more than 3 steps from the bathroom. I put in a video I had been wanting to see for a while to help take my mind off things, which helped, except that now whenever I see that video I think about getting ready for a colonoscopy. :-) But just for a few minutes. Hope all goes well tomorrow and that everything is fine! Barbara H. http://barbarah.wordpress.com/ In a message dated 8/8/2006 4:30:47 PM Eastern Standard Time, [EMAIL PROTECTED] writes: I am having a colonoscopy tomorrow due to awful bowell problems for over 1 month. I start my funlaxative pills (no more nasty liquid) in one hour. Have been fasting since 9:00am. Procedure tomorrow at 11:40am My probs are probably antibiotic related (antibiotic colitis caused by being on antibiotics for over two months), but doc wants to do one anyways for precaution. This should be fun. HaHa -Sandy B. in Charlotte Juan M Flores11773 Two Towers Dr El Paso, TX 79936Tel: (915) 856-3392
Re: [TMIC] HMO's
Title: AOL Email What state do you live in? (besides the state of frustration?) It might make a difference in what advice any of us might be able to give you to find you help Sorry about that. I live in Michigan and have Blue Care Network insurance through GM.
