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Rude comments about recovery! Rude comments about recovery!

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Unread 01-02-2005, 02:55 PM
Rude comments about recovery!

Juliebooly - from someone who spent almost 20 years in the business, as an adjuster and an agent - I'm not talking lawsuit so no one get freaked out.

You might check the website for your state government and see if there is a section regarding insurance codes. Health care insurers are regulated by the Department/Commissioner of Insurance just like all the others. I would be very surprised if there is not a dispute process. Most states have fairly punitive penalties for insurers who wrongly deny necessary services.

Another avenue would be to get every opinion you can find - your primary care doc (who's the "gatekeeper" for most HMOs), your GYN and then another GYN. When I got my approval for my hospital stay, there was a disclaimer at the bottom that said they would only pay if it was determined AFTER the procedure that it was medically necesssary, so I made sure to get all my ducks in a row.

If you have specific questions, I'd be happy to research for you; send me a PM if you want to know more. Good Luck and God Bless!
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Unread 01-02-2005, 07:42 PM
Rude comments about recovery!

I can totally relate. The nerve of some people. I put in for my "emergency" sick leave from work on 12/2/04 to begin on 12/22/04. I spent 3 weeks of listening to my coworkers complain about my being off for Christmas. They even stooped so low as to say that I planned this all along just to have the holidays off. One of them asked me how I was doing and I made the mistake of saying that I was tired, she snapped back at me "well you'll have plenty of rest while you are off". Finally I had enough of their attitudes and smiled sweetly and told them all that I was very sorry that my uteris was such an inconvenience for them. At first I was hurt and upset at the lack of support from my coworkers but now I feel sorry for them. Their lives must be way worse than mine for them to treat others that way.
I hope that knowing that many other people have also encountered "rude" people helps you to be at peace with yourself. You don't owe anyone any kind of excuse or explanation for the way you feel.

29yrs old, TVH 12/29/04 due to excessive bleeding caused by bloodthinners for my hypercoagulation disorder.
Unread 01-02-2005, 08:08 PM
Rude comments about recovery!

Well ladies I am adding my opinion to the mix.
All the ladies at my office have been WARNING me to take 8 weeks and strictly follow the dr's orders (teachers). They all said that they tried to do too much and rush back and they relasped. Needless to say, they all made me scared to death (first surgery EVER). I resigned my position on Tuesday and I am only 2 weeks (ALMOST-Tues) in.
Today was a terrible day. I felt so bored. I went for a short ride in the car with my mom (it said I could on my paperwork) and when I got back I was so tired. My fiance had a cow and is honkerblonked that I left the house for anything other than a dr's appointment. He said that the car is shaking up my insides and is going to do more damage (NURSE Marian is that true?) Is anyone else in a car???
So luckily he gets it BUT what are you guys doing to settle the stir craziness??? HELP!!!!
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Unread 01-02-2005, 08:10 PM
Rude comments about recovery!

Hello Sisters

I took almost 3 months off after my two surgeries in one day this past July. When I returned to work I was asked about my "VACATION"! This was by a male co worker! I wanted to slap him into the next century but said nothing. This went on for several days when I finally replied, that I would be more than happy to let him have cancer, have his entire reproductive system removed along with a rib and part of a kidney and then call it a vacation. He said nothing, the next day his wife had her first c section. When he returned to work he apologized and said he had no clue HOW I SURVIVED what I went thru....

Yes, while at home I did go to the beach daily -- all I did was sit in my chair the whole time while my 13 year old was able to have some fun, it was bad enough that she was doing laundry and cooking and cleaning she should at least have part of her summer.

It just amazes me what some people think that they are able to comment on-- as if it is anyones busisness anyway.
Unread 01-02-2005, 10:29 PM
rude coments about recovery

I work nights 12 hour shifts, so we are a close bunch of co-workers. When 1 co-worker found out that I would be off 4-6 weeks and not 2-3 as the doc orginally stated, she had the nerve to say" you had better not screw up my vacation plans"! I'm a nurse and do alot of heavy lifting, and as you'll know, we only have 1 chance to heal right. Thanks for listening.
Unread 01-02-2005, 10:55 PM
Rude comments about recovery!

As soon as I was told I was going to have surgery due to cancer I immediately informed my male bosses at my job. One of them I overheard saying "its only CERVICAL cancer" like I had a cold or something. I gave them updates telling them even before i was told I needed surgery. I would say "I will need to take 4-6 weeks off if this comes back positive". Then when I was told I had the big C I told them I would be off starting Dec 5 (my surgery was 12/06). Since there are only 2 people who know how to do my job I told them they better start training. None of the male managers know how to do my job (cash office). So when I told them to find a temp. replacement they told me my job was really easy and that it would only take 3 days to train someone. (aside from the fact that it takes longer than that to do a background check, I handle around $50K of cash everyday). I kept telling them and telling them to get someone in there. The other girl I work with is not as dependable as I am. Finally black friday they brougth someone else in for ME to train. This meant I worked 8 days striaght before my surgery. Not that 8 days is alot, but I had so much to do in preparttion for the cleaning and I had to make sure ALL my x-mas shopping was done. I worked 8 days to train the new girl and she showed up only 3 of those days. When I brought this to the managers attention the one younger guy told me that "my mom had skin cancer and she went back to work in less than 2 weeks, is it really going to take 4-6 weeks for you?" My reply was "It may be longer...I can get a doc excuse to say I need to be out for the whole 12 weeks if I want so don't push it" (my DH is a doc). That was my last day before surgery. No manager wished me luck or anything. One of them did ask if I would be available to answer any questions they may have if they called me after I got home. Being the nice person I am I told him OK. Guess what??? 2nd day home from hospital I got a call at 7:30am. No one had showed up to work in the office. I think manager expected me to say I would be right in (as I have done so many times in the past). So I had to spend like 45 minutes talking him thru step by step on how to work my computer and how to set the tills! Finally several hours later the other girl did show up otherwise I would have feilded 30 calls that morning. Then when I did show up to get my pay check a few days later (holding my side, looking like I was ready to pass out) the same manager who called me at home asked me if I thought I would be back sooner than 4 weeks!!! HaHaHa...I have not been cleared to work for another 3 weeks, making it 7 weeks total!!!
Unread 01-03-2005, 08:07 AM
Rude comments about recovery!

It is so hard to not go stir crazy. I have a bunch of good books and at four weeks I am trying a bit of yoga for the stretches, nothing that stretches the tummy.

Makes it even harder with these people that don't understand. I finally got the pictures of an actual surgery and showed my family. I will show the next neighbor or "friend" that says anything rude. The latest comment for me was "it's been almost a month. How long are you going to play this?" does make you think and wish mean thoughts. I found the pics in the For Men part of this site. They are very graphic, so be careful.
Unread 01-03-2005, 09:07 AM
Rude comments about recovery!

To Juliebooly,
Having worked with nine doctors in the Health Insurance Industries, who's jobs are to review denied cases and go through the appeal process, let me offer some advise.

First, read the denial letter that you received. Your doctor should have also gotten a copy. On the letter, it will outline who you need to contact for an appeal. If there is no information, the back of your medical card should have the number for your customer service representative.

Second, have your doctor send more information regarding the current state of your health, what he/she has tried in the past, and any other information that will help.

IF, you are denied a second time, you are allowed to appeal in person. This is when the Medical Director, the claims lead, your doctor, and yourself sit down and go over the details.

Many times, in the age of automation, it's a coding issue. Example. Breast enlargement is not covered. Breast reconstruction because of the removal of a breast due to cancer is. It's all in the coding, and the additional information added. You are allowed TWO final appeals. Use them!

To Missie: Your story reminds me of when I was pregnant. I told my boss at 4 weeks I was pregnant, and when the baby was due. I reminded her monthly that time was getting short and we would need to think about replacing me for that six weeks. The day I left, she finally said "Oh, I guess we need to hire a temp" . . . dahhhh! A week later, when I came in with the baby, I actually sat down to answer the phones, and instructing the temp on what to due, while nursing!! Luckily it was only a few calls, and then I got up and left.
Unread 01-03-2005, 09:29 AM
comparison to C Section

I am so glad you wrote this., I have had so many people tell me my abdominal radical hysterectomy will be a piece of cake because they had a c-section and they were fine in a few days....I have to believe that my procedure will be a bit more than a c-section!!!!

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