What Does It Take To Secure An Implantable Drug Delivery System?

The answer is: PATIENCE and DETERMINATION! 

As stated in my previous post, I am going through the steps necessary to get the authorization for my Implantable Drug Delivery System, hereon referred to as a Morphine Pump.

What are the steps necessary to get the authorization?

One might think it consists of sitting back and waiting while the Primary Care Physicians office does all the work, and be handed the authorization.  Wrong. 

I have done so much work towards securing this very special authorization, I feel as if I should be paid for my time, the calls made, the research I've done, and the constant contact with my insurance company and PCP's office manager.  It has actually been so far off the mark it could be considered a bit funny. 

I'm not laughing.

There have been five authorizations, all of them incorrect in one part or another.  Started off with giving me the OK to see a Pain Management doctor to do the trial, that doctor being my own Pain doc, which would be fantastic; one big problem with this being that he does not do procedures.  Check off the first autho. 

On to the next, this one referring me to the PM doctor that I was first sent to by my pain doc to discuss the Morphine Pump trial and subsequent permanent surgery to implant the device.  I was happy to see his name and excited to call and make my initial appointment.  Found out that he no longer takes my insurance.  #2 authorization--scrapped.

The third authorization was then for a world-renown teaching University Hospital where I was a patient in their Pain Management Clinic for 3 years.  Having had previous procedures there, knowing the doctors and nurses, and having good experiences with them, I felt excited that this was the place.  I had actually done a lot of research on who put in this device, and this Hospital was listed, accepting my insurance, so everything looked good. 

Hold on a sec, the codes were incorrect.  This particular Hospital uses and requires codes that are different from every other doctor, hospital, and provider.  Scrap authorization 3.  But not to give up yet...

I knew it was time for me to contact my insurance myself to get more information on this situation, and a case file was opened for my situation.  I was contacted the next day by a nurse from the insurance, who had a plethora of information for me.  I am very proud of myself for deciding to get directly involved in this extremely important step in my pain journey.  The sweet, well-meaning, and overworked gal at my PCP's office was truly doing her best, yet I realized that she needed some help and more information regarding this not so often requested procedure.  So autho #3 has become autho #4, soon to be #5.  At least we are progressing!   

In the 'middle' of my quest for a Morphine Pump, is the need to also be authorized to see my regular Pain Management doctor.  This was actually authorization #1, but has gotten a bit lost in the Pump hoopla.  Having medical insurance is something that is very important to me, especially since mine was illegally taken away from me through false pretenses years ago, (this will be a future post btw), and I spent years and a LOT of money just to obtain my medical care, needed medications, and procedures being a cash patient.  If anyone has ever had to pay cash for their medical care, and have been a patient that REQUIRES consistent care; you know how quickly the cash literally flies out of your bank account.  This green-eyed monster who was determined to mess up my life as much as possible sure succeeded in their quest to do so.  I had other plans for that money.  I had a long-standing agreement, (that did not involve or affect monetarily this person whatsoever), for my health insurance to be taken care of by someone who pleaded for me to accept their help in an area that was of extreme importance to me.  People that want to truly and deeply hurt another, will do anything to get that person where it will really affect them.  I can only imagine the 'happy', and 'successful' feeling it gave them, no matter how awful the lies and illegal steps used to take it away from me.  I will never understand people like that.  I digress. 

After I secured insurance again, I knew just how important it is to be involved and helpful to those that are trying their best to secure authorizations for me.  Therefore, I will do anything to help out those that are involved in this seeming never-ending authorization process.  We all deserve to have insurance, and it may not be easy to get what we want and need for our heath care, it just takes a lot of determination and an attitude of being positive and helpful in our personal medical cases.

If you are seeking a special procedure, or anything that needs an authorization; which most visits outside of your Primary Care Physician requires, stay on it!  Do not give up!  Contact your insurance directly.  I find the nurses employed by insurance companies to be extremely knowledgeable and very helpful.  Talk to anyone you can in the Physician's IPA.  It takes determination and a lot of time on the phone.  People are there to help us, they want to get involved and have satisfied customers.  It may seem overwhelming at times.  Hang in there--I believe that I will sooner than later be in the hospital with the Pump trial taking place.  Think positive.  As a friend of mine said about this subject; it does get better eventually, that things sometimes seem darkest before the dawn. 

I just hope it is my dawn soon.  

Gentle Hugs..,.