Molina and the Mayo Clinic are driving me insane
Posted: Sun Mar 04, 2012 7:52 pm
At the end of July I 2011 was in a motorcycle accident that ended with an avulsion of the Brachial Plexus C5 – C8 and T1 of my left. After research and surgical suggestions from all of you I self referred myself to the Mayo Clinic, scheduled a consultation for the middle of Dec. and gave them all my information including my insurance. The week before I was scheduled to go I made 1 final call to Mayo Clinic to make sure everything was in order. They looked it over and found that my insurance (Molina) had not approved the consultation. The trip was cancelled and the fight with Molina began. After many letters and phone calls from me and my family Dr to Molina they finally agreed the consultation and would approve the surgery based in the outcome. When I arrived at Mayo Clinic they sent me to the business office who informed me that they do not have a contract to bill Molina in Washington State and that I would have to pre-pay $7,000.00 and bill Molina directly for a reimbursement. My mom (best mom ever) agreed to pre-pay. The team at Mayo Clinic deemed that surgery was needed and set a surgery date for Mar 4th. The appointment desk referred me back to the business office. They told me that I would need to pre-pay $150,000.00 (like we have that kind of money laying around). I contacted Molina to get surgery approved. I also informed them Mayo Clinic wanted the $150K cash deposit. Molina told me that per medicade/medicare rules No monies were to be paid by me and if we pre-paid we most likely won’t be refunded. Why they didn’t tell us before the consultation I’ll never know. So now we have 2 weeks to get Molina and Mayo Clinic to agree. I was thrilled when I got a letter from Molina approving the surgery. Airline tickets paid, hotels paid, shuttle service paid, I’m ready to go. 4 days before departure I called Molina to make a final check and that everyone was doing their job. I was transferred around a few times before I got an agent that said payment had not been approved. I told them that I have a letter saying surgery is approved. Apparently just because you have approval for surgery doesn’t payment was approved. 2 separate approvals. WHAT! 4 days before I leave and this hadn’t been taken care of. 3 days before departure: frantic phone calls from me to Mayo Clinic, Molina and my family DR that resulted in a conference the next morning @ 8:30am. 2 days before departure: Friday conference call, meetings behind closed doors. Result: Molina and the Mayo have not reached an agreement so 3:00pm Friday surgery was officially canceled…again. I was told by the surgeon’s secretary that this was not a time sensitive operation and that they would work together to try to get this resolved. It might take a couple week maybe months. Well, this might not be time sensitive operation for them but IT SURE AS HELL IS FOR ME. So now it’s Friday afternoon and instead of packing I’m cancelling plane tickets, hotels, shuttles. Sorry for the rambling and trust there is a lot of other crap that went on during this time. I could be writing for days.
So in the end as I sit here on the sofa feeling sorry for myself I cry for all the loses in these past months: The use and feeling of my left arm, my motorcycle, my part time job that I had been at for 10 years, my second part time job that I’d been at for 3 years (now I have no income. unemployment and social security denied me. Both are in appeals). I also broke my car (bad reaction to one of my meds, I tried to drive it into my office-new meds now). In 8 months I’ve gone from being a successful single mom to welfare standing in line at the food bank.
I know that everyone here has a story to tell and I’m not alone in this fight which is why I post my story here. You are the only ones that understand not only the physical but the inner turmoil we endure. Pity party will be over tomorrow as I have a 3rd attempt at surgery to prepare for. I’m not blaming Mayo Clinic or Molina, rules are rules. I am however blaming, after repeated calls from me, both of them dropped the ball and didn’t do their jobs. It's just that simple. It's what they are paid to do.
So in the end as I sit here on the sofa feeling sorry for myself I cry for all the loses in these past months: The use and feeling of my left arm, my motorcycle, my part time job that I had been at for 10 years, my second part time job that I’d been at for 3 years (now I have no income. unemployment and social security denied me. Both are in appeals). I also broke my car (bad reaction to one of my meds, I tried to drive it into my office-new meds now). In 8 months I’ve gone from being a successful single mom to welfare standing in line at the food bank.
I know that everyone here has a story to tell and I’m not alone in this fight which is why I post my story here. You are the only ones that understand not only the physical but the inner turmoil we endure. Pity party will be over tomorrow as I have a 3rd attempt at surgery to prepare for. I’m not blaming Mayo Clinic or Molina, rules are rules. I am however blaming, after repeated calls from me, both of them dropped the ball and didn’t do their jobs. It's just that simple. It's what they are paid to do.
There is a real emotional Harm in the lack of direction We find ourselves in dealing with the injuries latter in life or at birth. The lack of help and direction or how to deal with the situation , Will leave you in despair till you can find a direction to move forwards. Determination to over come or a disposition of never giving up is real for US, so is the compassion we have here. Sometime we do get overwhelmed by the situation of lack of direction for sure. But we forget the value of how far we have come by trying. A moment of Peace is a great to, by remembering what you have done in-spite of limitation of injury or the Lack of finding direction.