Tuesday, June 21, 2011
no way, not a chance, denied
And the things that burns my ass is that I believe their decision isn't in their best interest either; meaning in the long run their decision is going to cost them more money. Then there's the little matter of my doctor who went to medical school and has twenty year of experience being overruled by some bureaucrat who knows nothing about me. I'm infuriated that this could happen.
My leg wound has required considerable medical attention. Since mid April I have needed weekly doctor visits, wound treatments and medications. Beginning in June I have needed home nursing visits three times weekly added to my Monday doctors appointment and NPWT -Negative Pressure Wound Therapy 24/7. All these thing necessary to close the wound which is pretty much a crater in my leg that was caused by an infection after my fall.
Yesterday my doctor decided three more of NPWT and then he thinks I'll be in perfect shape for a skin graft. Grafting will move my healing along considerably; this to me means less nursing, less medication, less doctors visits to the Wound Clinic (which is part of the hospital) and less bills for me to pay. So he contacted the insurance company to find out which biologic graft my insurance allows. Guess what their response was? No. Apparently I am going to have to throw my leg on an open fire and burn the thing to qualify for a graft.
My condition does not qualify for a graft so the solution is for the insurance to keep on paying hospital bills and home health care bills and NPWT rental fee's and medications and doctor fee's for as long as it take for my leg to heal using the therapies they've been using; no rush right?
Why make heal it quicker put a $1,200 graft on it? It makes much more sense to pay a home nurse $400.00 a week for up to nine weeks that's much more sensible. And while that's going on I'll just keep those weekly visits to the hospital's Wound Center and generate some more hospital bills while I'm at it.Oh and lest we not forget the doctor's bills that the insurance company will have to pay.
They're being dumb!
It makes no sense to me at all.