I didn't sign this post to Jude.
Patti - Mid Michigan
- [EMAIL PROTECTED] wrote:
> 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
> >
> >
