A January Tale...
Hi it's Trevor, with our first tale of 2019. I thought the title was quite appropriate, since everything I will be sharing, has taken place this month. BOL
Brenda recently celebrated her 59th birthday on January 9th, which was this past Wednesday. She received wishes from all over the world, which included her brain tumor and arthritis friends. She had a quiet birthday, but it was good. She found a wonderful canvas hanging of a golden retriever, that we will share at the end of this tale.
Brenda has been dealing with insurance issues. This has been a challenging past few days for her. She is grateful, that she has had the time off, to deal with all of this. As you know, Brenda has been taking a biologic for almost 18 years for her rheumatoid arthritis (RA), which has been helping a great deal.
Her 5 years was up and now the whole ball has to get rolling again. What we want to know is why it took so long for the game to get started? BOL How's that for a metaphor? The first big mistake was Brenda not realizing that she would have to go through the same channels, as when she was forced to have her medication dispensed at a retail pharmacy. We've shared this saga with you before, and will not go into details.
Now she is currently going through the approval process with prior authorization to be faxed to the same place, that forced her to have her biologic dispensed at a retail pharmacy. Brenda forgot all about that and had her PCP write a letter to the insurance company. BIG MISTAKE!
Her PCP has decided that it would be in Brenda's best interest, to start having her present rheumy, prescribe the biologic. It makes sense, as Brenda does see her several times a year and does monitor her blood work. We need to back up a bit. When Brenda started her biologic, she was not seeing a rheumy. Her PCP was taking care of her medical needs. It was a unique situation. It all boiled down to that her rheumy at the time, was not a very positive person. You need to have someone positive, taking care of issues, especially when it comes to living with a chronic illness.
Her last rheumy was the best, with Brenda having blood work more often, so there were no issues. Her current rheumy is also a very positive person and a lady, who she enjoys seeing. They actually laugh at her appointments.
The downside of this situation, is that she will only be able to get 3 months on each prescription and will have to have blood work in between.
You want to hear the really bizarre thing about this whole situation? She is actually dealing with the 2 local hospitals. Her rheumy is located in the one across the street, from where Brenda is employed. Where she gets her biologic dispensed, is located in the other local hospital, who has been sending Brenda her biologic to her place of employment. This is all because of what are called; Pharmacy Benefit Managers. They call all of the shots. It all boils down to money.
For well over a decade, Brenda has been receiving her biologic from the pharmacy that was located in the building where she is employed. It was one simple phone call, as they always had it on hand. She would stop in and pick it up on her way home. Simple. Easy. Convenient. Not anymore!
She spoke with her rheumy's nurse this morning and they realize, what needs to be done. It's definitely going to be another delay, but it's out of Brenda's hands. She made all the necessary calls, between the insurance company, her PCP's office, and the rheumy's office. We share all of this, because Brenda is herself an advocate. She also does this on behalf of others. Sharing this tale, is a big part of this. This blog is more than a dog sharing his pawspective. See what I did there? BOL
This is serious stuff, folks! You need to have everything in place before the new year. Brenda unfortunately, did not. She's learned a lot from this experience. She now knows who she has to deal with in the future, if they don't change it by the next time.
She's fine and was prepared. You have to be for at least the first part of the year.
Now for the fun part of this tale. We have a new and exciting feature this year titled; "Bark of the Month" It's where we will highlight one special dog each month. It will be a separate blog post, so it does not become so busy. BOL. Be looking for that, in a couple of weeks. We think you'll really enjoy this special feature each month.
Now to share that beautiful canvas hanging that Brenda spotted on her birthday. They are already printing and getting it ready.
~T Man Barking Off~
Courtesy of Teezuely
Brenda recently celebrated her 59th birthday on January 9th, which was this past Wednesday. She received wishes from all over the world, which included her brain tumor and arthritis friends. She had a quiet birthday, but it was good. She found a wonderful canvas hanging of a golden retriever, that we will share at the end of this tale.
Brenda has been dealing with insurance issues. This has been a challenging past few days for her. She is grateful, that she has had the time off, to deal with all of this. As you know, Brenda has been taking a biologic for almost 18 years for her rheumatoid arthritis (RA), which has been helping a great deal.
Her 5 years was up and now the whole ball has to get rolling again. What we want to know is why it took so long for the game to get started? BOL How's that for a metaphor? The first big mistake was Brenda not realizing that she would have to go through the same channels, as when she was forced to have her medication dispensed at a retail pharmacy. We've shared this saga with you before, and will not go into details.
Now she is currently going through the approval process with prior authorization to be faxed to the same place, that forced her to have her biologic dispensed at a retail pharmacy. Brenda forgot all about that and had her PCP write a letter to the insurance company. BIG MISTAKE!
Her PCP has decided that it would be in Brenda's best interest, to start having her present rheumy, prescribe the biologic. It makes sense, as Brenda does see her several times a year and does monitor her blood work. We need to back up a bit. When Brenda started her biologic, she was not seeing a rheumy. Her PCP was taking care of her medical needs. It was a unique situation. It all boiled down to that her rheumy at the time, was not a very positive person. You need to have someone positive, taking care of issues, especially when it comes to living with a chronic illness.
Her last rheumy was the best, with Brenda having blood work more often, so there were no issues. Her current rheumy is also a very positive person and a lady, who she enjoys seeing. They actually laugh at her appointments.
The downside of this situation, is that she will only be able to get 3 months on each prescription and will have to have blood work in between.
You want to hear the really bizarre thing about this whole situation? She is actually dealing with the 2 local hospitals. Her rheumy is located in the one across the street, from where Brenda is employed. Where she gets her biologic dispensed, is located in the other local hospital, who has been sending Brenda her biologic to her place of employment. This is all because of what are called; Pharmacy Benefit Managers. They call all of the shots. It all boils down to money.
For well over a decade, Brenda has been receiving her biologic from the pharmacy that was located in the building where she is employed. It was one simple phone call, as they always had it on hand. She would stop in and pick it up on her way home. Simple. Easy. Convenient. Not anymore!
She spoke with her rheumy's nurse this morning and they realize, what needs to be done. It's definitely going to be another delay, but it's out of Brenda's hands. She made all the necessary calls, between the insurance company, her PCP's office, and the rheumy's office. We share all of this, because Brenda is herself an advocate. She also does this on behalf of others. Sharing this tale, is a big part of this. This blog is more than a dog sharing his pawspective. See what I did there? BOL
This is serious stuff, folks! You need to have everything in place before the new year. Brenda unfortunately, did not. She's learned a lot from this experience. She now knows who she has to deal with in the future, if they don't change it by the next time.
She's fine and was prepared. You have to be for at least the first part of the year.
Now for the fun part of this tale. We have a new and exciting feature this year titled; "Bark of the Month" It's where we will highlight one special dog each month. It will be a separate blog post, so it does not become so busy. BOL. Be looking for that, in a couple of weeks. We think you'll really enjoy this special feature each month.
Now to share that beautiful canvas hanging that Brenda spotted on her birthday. They are already printing and getting it ready.
~T Man Barking Off~
Courtesy of Teezuely
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