Roller coaster of emotions

TL;DR: surgeries are happening as scheduled!

Details:

I spent much of Monday on the phone. The short version is below (believe me, it could be longer...as my notes prove, because I'm a note-taker). Hit the jump for the blow-by-blow.

[My thoughts will be denoted thusly]
 



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4/26/2016:
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Call #1: Deal Health Plan

• Objective: determine whether prior authorization for surgeries is approved
• Result: not yet

• Objective: determine whether the office visit and examination procedures planned for 4/26 will be covered
• Result: nope! wording implies that I need to get another auth for further examination, including repeats of the same procedure

• Other details:
• The prior authorization was submitted on 4/20, and is marked as "administratively urgent," meaning I can expect a verdict in 7-10 business days

[So at this point, I'm thinking: it's all off and that I'll be flying back to Madison Monday night, 4/25]

Call #2: Dean Health Plan

• Objective: determine whether new prior auth includes the exam procedures (because they're not covered by the earlier one)
• Result: nope; none of the CPT codes were the same as my original prior auth

• Other details: tons of interesting stuff!
• There are two prior auths, not one
• Each was submitted by a different servicing provider (that's different than the referring provider, in case you're wondering)
• Each contains a variety of CPT codes, which I asked for and was given, then proceeded to google to confirm; all seem surgery-related
• Same info re: urgency and ETA for approval of Friday at the earliest

Call #3: Shields' office

• Objective:determine whether a prior auth for the exam visit was submitted
• Result: Shields' office called on 4/18 and was told that the previous prior auth covers this visit

• Other details: I got the reference number for this conversation

[At this point I'm dubious, but figure it's worth checking once more with Dean]

Call #4: Dean Health Plan

• Objective: disambiguate; does my previous prior auth cover repeat tests on 4/26 or not?!
• Result: um...yes?

• Other details:
• The person I spoke with talked with a utilization manager and made an official note; his professional opinion is that the wording is misleading, but that my previous prior auth will cover repeats of the same exam / tests through 5/29 as I originally thought and as the Shields' office was told
• This person informed me that "administratively urgent" is actually 5-7 business days, not 7-10 (because in his words, "10 days doesn't seem very urgent." I'd agree.)
• My surgery prior auths could therefore be approved by EOD Wednesday
• He advised me that I shouldn't

[Now I'm thinking it's definitely ok to stay for the tests, but maybe even the surgery, too!]

Calls #5-6: Shields' office

• Objective: determine whether knowing by EOD Wednesday is good enough or whether I should postpone now, and if the latter, what fees I'll incur, etc.
• Result: yep, they need to know by Wednesday morning whether to prepare the plaque, so I should postpone now

• Other details: 
• no cancellation fee which is good!
• postponed exactly one week, so new surgery dates are 5/5 and 5/9

[So now it's yes exam, no surgery; definitely coming back to Madison 4/26]

Call #7: Delta Airlines

• Objective: revise my itinerary to return to Madison Tuesday evening, 4/26
• Result: success

• Other details:
• it cost $250...blech
• they waived the $200 change fee because the reason for the change was medical; pro-tip: if the reason for travel or a change truly is medical, call Delta and say so! If you give them the doctor's name, number, and address, you may luck out.

[Phew. It's over. I still need to book travel back here but I'll do that later.]

Then I went with my mom to the fish market and grocery store, came home, and made a salad and assisted my mom as she grilled up some delicious swordfish steaks! Dinner was wonderful.

Voicemail #1: from Dr. Rumery (my eye doctor at Dean)

• Objective: I'd called to express to him my concern about the prior auths coming through for the surgery
• Result:he escalated to the director level at Dean Health Plan and was happy to report that they'd been approved!

 [
<Becca sinks to the ground in exhaustion>
<pause>
Ok, new plan for Tuesday morning: 
1) call Dean to confirm the miracle
2) find out if I can reclaim my surgery slots for 4/28 and 5/2
3) call Delta and probably pay them more money to get my original itinerary back :(
<pause>
<despair at the thought that if I had just done nothing all day, I'd be all set and $250 richer>
<sadness at my negligence in failing to account for the force of nature that is Dr. Rumery's persistence>
]

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4/27/2016:
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Call #1: Dean Health Plan

• Objective: confirm both prior auths are approved
• Result: YES

• Other details: the dates of each reveal to me that one is for the 4/28 surgery and the other is for the 5/2 one; mystery solved!

[Ok, good...a good start. Not that there was any doubt in my mind. Dr. Rumery, if you're reading this, know that you're amazing :)]

Call #2: Shields' office

• Objective: reclaim 4/28 and 5/2 surgery slots
• Result: SUCCESS

• Other details: this was easier as by the time I could place call #1, I was actually in the Shields' waiting room

[<pumps fists in air>]

Call #3: Delta Airlines

• Objective:change itinerary back to schedule my return to Madison for next week after 5/2
• Result: sit tight because this is truly amazing...after a ~15 minute hold *drumroll please*
• I got my original 5/5 flight back, which is DIRECT to Madison
• I got it for free
• I got my $250 refunded

• Other details: DELTA FTW!

[Never thought I'd find myself saying Delta is awesome but these are strange times]

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So there you have it.