Thursday, June 30, 2011

Keeping Medicare Happy

I haven't blogged because I've been feeling poorly, so I haven't done anything.  Last night was my sleep study, so that was a change of pace.  I've been sleeping with a CPAP since Feb 1996.  Users of CPAPs are entitled to new supplies every six months.  I haven't taken full advantage of this, about a year ago, my mask and headgear were getting a little ratty, so when the automatic caller asked if I wanted new stuff, I pressed the button for "yes."  Ms Automatic Caller also wanted to know if there had been a change to my insurance.  Well, yes, I went on Medicare August 1 and it became my primary coverage.  Oh.  Medicare didn't care that I'd been using the thing, successfully, since shortly after Noah got off the ark, they needed me to see my primary care provider who needed to let my supplier know that I still used the CPAP and was benefiting from it.  The wording had to be very exact.  So in August, I saw my doctor and told her what Medicare needed.  Not a problem and we moved on to my left heel--see last year if you are really interested in that.  I didn't think too much about it.  Then came September and the fire and I had other things on my mind.  When I got around to remembering that I needed new stuff, I guess it was November.  Called the supplier who said they hadn't gotten the correct wording form my doctor.  I called the office, told the girls what I needed, and waited for supplies.  Another month went by and no new stuff, so I called them back.  By now, I was on a first name basis with the supplier.  She said she would call the doctor's office and tell them exactly what I needed.  Then came December and the bowel obstructions.  When I finally saw my PCP again, maybe even after my surgery, I asked who I had to sleep with to get the correct wording for my CPAP supplies.  She promised she would take care of it.  She must have sent the magic words, because eventually, I got my new supplies.
You would think that would be the end of it.  But no.  I got a call from my supplier saying that they needed a copy of my sleep study.  That was three doctors ago and in the end of 95.  95?  Oh, they are only good for 10 years.  Could I have a new one to make Medicare happy?  So last PCP appointment I mentioned it.  Doctor said no problem, she'd arrange it.  I got a call from Mr. Sleep Study guy a few days later and we set up an appointment for last night.  At least it was close to home.  The one in 95 was at a hospital about 20 miles from home.  This would be in a clinic near my yarn shop.
I got there just before 9 last night.  There was a receptionist and two technicians.  I was shown to my room, got into my jammies, and was wired up for everything.  The whole process took about 45 minutes.  Now relax and go to sleep.  I settled down to read and get sleepy.  The surprising thing is that I did go to sleep eventually.  After two hours, the technician came in and connected me up to a CPAP.  Relax and go back to sleep.  Sure.  It took longer and for some bizarre reason the theme song from Lambert the Sheepish Lion was running through my brain--that was a cartoon from the late 50's or early 60's and I'm pretty sure that the only other person who still knows it is my friend, Roz--and I only knew she knew it was that we saw a play with a character named Lambert when we were in Jr or Sr High School and we both started humming the song.  Anyway, I finally got back to sleep, only to be waken at the ungodly hour of 5 AM and they started disconnecting me.  I still have sleep apnea and still need the CPAP.  They will send a report to my PCP who will send a copy to my supplier, who will have it on file for Medicare, and supplied will once again be available every six months.  Medicare gets to pay the bill for the unnecessary process.  Medicare would have saved themselves money if they had just taken my word and the fact that I've been sleeping with this thing for over 15 years.  It is almost as though the government thinks that the earth only just started rotating when I went on Medicare and so we'll need to reinvent the wheel for a while.
I got home at 5:45 and went back to sleep till 10.
xxooxx

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