Physical Rehab, Reinvent, Retrench-Insanity

January 20, 2012 at 8:17 PM (Uncategorized) (, , , , , , , , , , , )

My legs are not wrapped.  This vital process will not happen the way I was told.

Because of my cerebral palsy, I cannot wrap and unwrap by myself.  there may be a way to figure part of the unwrapping, which I will work on tomorrow, but the wrapping is flat out impossible.

I was told my aftercare until I graduate to compression socks would be covered under Medicare part A.  That someone would come to the house and unwrap my legs, help me clean them (not entire bathing, simply my ankles and feet. Rewrap my legs since they would be certified to do it. )

Now, the home health care agency will not wrap my legs (its a non-skilled service)

There is no way to send someone certified to wrap that would be covered under Medicare part A

I’m supposed to be set up with an outpatient clinic instead, that Medicare may not cover, even under part B.   I advised of the transportation problem making the cost of that prohibitive, they said then I’d have to be in a rehab place or an SNF [ even tho medicare wouldn’t cover a return—-] until I graduated to compression socks, or live with someone who could transport me.  I won’t go into details here, but living with my parents would be, um…problematic and risk my mental health.  I don’t mean that snarkily or as satire.  It’s a real issue.

I am not leaving my home.  I worked too hard to get here.

I AM NOT LEAVING MY HOME!  Not over a 45 minute process.  I AM NOT LEAVING my home.

So, it’s be institutionalized or lose all the progress and leave myself at risk for congestive heart failure, or come up with a way to be transported to these lymphadema clinics every day, pay for that, and pay for either 20% or 100 % of those costs.  Even having Medicaid waiver fixed would not necessarily solve this problem.

I’m contacting the patient ombudsman for Medicaid in my state, to get the transportation set up, at least.  I’m also contacting my church.

But that has to wait til Monday, and the damn legs have already begun to ‘reinflate,’ because all the home care folk can manage is a simple ace bandage.

And yes, I’ll be dumb enough to stay at risk to stay in my home.

There’s such a thing as quality of life and I will not surrender it to bureaucratic forces that cannot speak to each other or bend to necessity.

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Bad Connection

September 6, 2011 at 8:34 AM (Uncategorized) (, , )

The epic amount of bullpuckey phonecalling necessary to get a straight answer from Medicare and/or “H” the company that made my power chair regarding a repair issue amazed even me.

I began this morning at 8:00 and ended @ 11:00 or so.

It’s very, very difficult to piss me off if you’re a phone customer service person,

because I’ve done the job and heard so many of my co worker’s get *incorrectly eviscerated,* that I really don’t go crazy on them. (Any nightmare phone stories anyone’s got, I can almost guarantee you that that particular rep did not make it past their 90 day review…the ones that remain…there’s a substantial percentage that actually know what they’re doing. )

I know some things take time to resolve.

 

At issue is a four page fact sheet on who has to replace batteries and tires on existing power wheelchairs   The fact sheet was put out in December of 2010 just before the competitive bids on repairs started.  the website HME news states in a Feb 02 2010 article…

What we’re finding is that when a beneficiary calls up and says, ‘I need a new battery,’ contract suppliers say, ‘I don’t have to do that; you can go to any supplier,’ and non-contract suppliers say, ‘I can’t do that,'” said Cara Bachenheimer, senior vice president of government relations for Invacare. “So there’s a lot of misunderstanding out there.

At the center of the confusion is a four-page fact sheet on repairs that CMS released in December, just before competitive bidding kicked off. In one breath, it states that any supplier can perform repairs.

In another breath, however, it states that only contract suppliers can provide the following replacement parts while performing repairs: batteries, tires, seat and back cushions.

The chair people were more info-heavy, but weren’t clear that The company I purchased my chair from (Start’s with H” said “Your zip code is in a competitive billing area.  That means you will have to contact Medicare for a list of companies that can put your batteries in and get reimbursed by Medicare.” I left them realizing without the cash my chair was about to become a permanent piece of decorative furniture.

Oh and the guy at Medicare was beaucoup unprofessional.  “H” has specialized equipment and there are no contractors that can put in your batteries so  H has to do it.  I asked to speak with a supervisor. “Well, *that’s* not going to happen…etc. There’s saying, “Unfortunately, you will be on the hook for 380 for those batteries,” and then there’s being arrogant and thinking I’m stupid. He explained I was going to have to pay, but then went further, was arrogant and thought I was stupid.

Uh, wrong thing to think

I asked to speak with a supervisor and was denied.

Denied??????????????????????????????????????

Brother. Back when I was in a cubicle taking calls that was not how it was handled at my desk. At all.

 

 

After further reading of the article and discussion with company H my power chair is about to become a piece of decorative furniture. That’s it. Period. But I can order a brand new chair from any company I wish. In November 2015.
and Medicare will cover everything, batteries and all.

No more easy access to bank, church, stores etc.

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