Monday, June 7, 2010

sorry you have cancer - can you fill out this form?

There are lots of things that can keep you busy when you have cancer. Granted, going through 6 cycles of chemotherapy followed by 6 weeks of daily radiation isn't really how I planned to spend my summer and fall of 2010. On the other hand it's pouring rain in Seattle and that's not how I envisioned summer either. Yet there are some small joys in life, like calling the insurance company that authorizes medical disability. I am given the privilege of calling them every few weeks to tell them that I am still being treated for cancer, I am still going through chemo, and I am still going to need time off work. Appropriately sympathetic they give me the same answer each time: "We are waiting for your doctor to confirm your treatment and fax back authorization; I will make a note of all your cycles; good luck, you'll be fine". I wonder how the call center or claims adjudicator at an insurance company knows that I'll be fine, or if it's just written somewhere in their script. Not even my doctor will tell me that I'll be fine more than some statistical probability; so how would someone who's never met me (and whose qualifications I seriously doubt) be able to tell that from a 5 minute phone call? But these calls do warm my heart because it reminds me that they are pushing paper, filling out forms, routing requests and just making the whole insurance and medical process endlessly expensive, time-consuming, and “well controlled”. The other upside is that they are providing jobs for so many people who otherwise wouldn't know what to do with themselves.

So let me familiarize you with the joyous process of getting some well earned disability benefits. I call my insurance company from the hospital to tell them that I am “in for treatment”. About two weeks later, I get a letter in telling me that my claim is in review and that the insurance company is just waiting for my doctor's authorization. A week goes by. I get nasty email messages from my company telling me that I am out of compliance with my time reporting and that my inattention to such important matters will be escalated to the highest executives within the firm. Apparently we take time reporting very seriously (it is an accounting firm after all) and if I miss the cut-off by a second I get at least two email messages. One comes automatically from the system. This one isn't so bad because you can't really blame a computer for not having a brain, sympathy, or concept of extenuating circumstances. The second one comes the next morning from someone who sits in India. He or she runs a report to show everyone who has not submitted their time report for the previous week. They then send a "personalized" email, which doesn't seem very personal at all even though it says things like "it is critical we have all time reported and your compliance is appreciated". I don't mind these insomuch as I totally understand that most people really are just forgetting to submit time reports and need to be sternly reminded. I am however incapable of complying. For the time that I am off on medical disability our national office leaves team has to process the hours in our system. As such, I can't submit my time as work or vacation time. Both would screw something else up down the road. Maybe I should try it and see if something seriously explodes, but chances are that instead I would end up just loosing vacation days because our disability team would somehow be impeded from processing things properly. At this point I call my insurance company again. More of the same. Then they call me and leave me cryptic messages like: “We need some information from you”. No, they don’t specify what information they want or need. Nor do they provide a direct phone number. It’s back to the main menu and to a generic call-center person who will type some notes and forward things on to the case manager. Are you really surprised? About a month after my chemo treatment things start to sort themselves out. Apparently stars align and my doctor’s office has stopped seeing patients, performing surgery, and saving lives long enough to push the right forms back to the insurance company and I get another letter in the mail telling me that I am actually approved for disability. My insurance company then happily marks my case “closed”. In their world once you go back to work you’re “better”. Sweet – if only they could make it so! But alas, by this time I will have already called and started the whole process for the subsequent round. I find it gives me purpose on those days when I really wanted something to do, but didn’t feel like cleaning toilets!

1 comment:

  1. Michelle--I am a friend of Patty's in Socorro--your mother introduced me to your blog when she was here several weeks ago. I am really enjoying the read, because of the insight into the process of dealing with cancer and the treatment. Yeah, as if it isn't enought to know you have cancer, you get to deal with the folks who are the claims people and case managers----your example is exactly why I was never able to agree to a job case managing for an insurance company. Anyway, I'm enjoying following along with your journey. As a nurse, it's moving, it's a very tough place to be and I admire you greatly for posting and letting many people into your world as it is during this time.
    Sincerely, Fran (