While I was on hold with Briova RX for the 48th minute, I had an epiphany---
If there is anything I've learned about health care, it's you are your best advocate AND because there are soooo many interconnected parts (doctor, labs, pharmacy, third party billing, insurance company, etc.), do your research, know the system, and make 100% certain you are being charged correctly.
I can give you three examples just today why that's important--
I go in for lab work/check up every three months to check the status of my CML. I've been doing this for the last 6.5 years. I know exactly what type of lab work that will be drawn (CBC and BCR-ABL and can tell you how many tubes and what colors of each and have actually had to tell a phlebotomist that before because they were unsure). The BCR-ABL has to be taken by a certain time to be sent to Louisville to be flown out of state because there isn't any place in Kentucky that can process it. I know this because once they scheduled my appointment after the cut off time and I had to come back a second time the same week to do my labs (AND WHO HAS TIME TO DO THAT?!)
So when I received a letter in the mail stating that my appointment was moved to 11am, I called to tell them that wouldn't work because my lab work has to be done by 10:00am.
Here's the conversation I had--
Me- "Hi, yes I was calling to get my appointment changed because one of my labs has to be completed at a certain time, I believe at 10 or 10:30 am."
Person- "Oh I'm not sure, let me send you to Labs so they can confirm the time". **transfers call**
Me- "Hi, yes I have an appointment next week at 11am. I'll get labs done as well but one of them, the BCR ABL, has to be completed by a certain time so I needed to get my appointment changed."
Labs Person- "Let me look. (brief pause). Oh no, so long as you do it by 3pm you'll be fine.
Me- "Has something changed recently? I've had this same lab done every 3 months for the last 6 years and once came at 11am and had to come back a second time that week because I missed the cutoff time and I can't afford to take off that much time from work."
Labs Person- "Let me call so and so to confirm and I'll call you back."
Labs Peron calls back-- "Oh yes, you are supposed to have this done by 10am but we can be flexible if you get here around 10:30am and I'll get it squared away."
Me- "Thanks". (But what I really wanted to say is why should I have to know this? Shouldn't you all know this when scheduling appointments?! But I didn't.... because I've learned it's just they way the system is)
Then last fall I had my annual mammogram. While I'm under the recommended age to get annual screenings, because my mom had breast cancer at a young age and because I have leukemia, I am a higher risk so I get one every two years. This was my third one. So I was surprised when I got two bills in the mail for about $800. Most people probably would have just paid it but I knew it wasn't right. When I received my benefits statement from my insurance, the reason why it wasn't covered by my insurance is because on the order, it did not indicate as to why I was getting the screening before the recommended age. I had to call the insurance, then the doctor to tell them to correct the order and put 'pre-existing condition' on it, then the billing department which took about an hour total and wait for it to be reprocessed. It took two times over 3 months to get it straightened out.
Then today, I was calling to refill my prescription for my Gleevec. This is the stuff I've been taking for over 6 years, the one I have to take every single day to keep me alive, that one that costs way too much money. My co-pay is $225/month however, I've always been able to find a co-pay assistance card to keep it at $50 or less. Well I learned today it was going to be $200/month. When I asked why, the person did not know but gave me a number to call. When I called that number, that person told me something completely different than the other person. Again, most people would probably would have just given up and paid it. 4 phone calls and 2 hours later, I was able to find a new co-pay card that will drop it down to $100/month. While I'm not looking forward to paying $1200/year on one prescription, it's better than $2400.
So the moral of this story is, do your research. No one will advocate better for you than you. It will take more time than anyone should have to give, you will know more than you should ever have to know about the system, but the return is it will save you your own time and money.
