Mandi - what you said happened with your first experiences with the home care nurses is inexcusable. You are right - you should call that insurance company AND also the home care agency. You need to report to their managment what happened with the other nurses. If you don't feel like you are getting anywhere with the home care agency, you might want to try another one - if your insurance company covers several. Get a referral from a physician you trust, or someone you know that has had good home care if you can. You need help and if you can get the RIGHT help, it will be a lifesaver. Don't let them get away with that kind of incompetence!!!

Mandi: Give us an update as to what was accomplished today...

Hey, Mandy, along with the Bitch Britches [i LOVE that!} put yur Nurse from Hell hat- or Wife from Hell hat - on also- it completes the outfit. I still don't know what your Ins situatin is, but, as Ginny M. and Margaret said, we also had an Ins. case manager, who was wonderful. I requested one AND I made sure she came to our house and met John in person[after she saw the condition he was in, I never had another problem getting her assistance] AND I had our family physicial recommend the Home Health people he had the most trust in and they turned out to be really good. You really need to be the person in control here. Take a deep breath and an hour or so to write down what you really need in the way of help to get you both through this phase- then get on the phone and raise hell until you get it done. Remember, your health as well as Dennis's is at stake here. Incompetance is not acceptible. Sending you strength to deal with this- Amy in the Ozarks

With all respect, I've asked, whined, pleaded, and begged for help.

I totally agree when it comes to asking for help with sugar before vinegar. It made no difference, at least with the case worker who was representing him, and corresponding with the insurance co.

She tried.......they all did at the nursing home, but they were blindsided when it came to working with UnitedHealthcare.

The insurance, point blank, said that he could "make do" with the supplies he had, and left it at that. When he was done with what he had already been sent, they would send more.

I did manage to find a kind soul on the phone today who agreed to write up the order as a "swapout???" and get him the Jevity that he needs delivered tomorrow. But, I had to go through an ordeal of explaining how this was affecting him, not just physically, but mentally, before she agreed. Can you imagine being hooked up for 8 hours a day, just to maintain....not even considering trying to gain back the 30 lbs. he lost in the past six weeks? Let alone the wound packing, suctioning, dressing changes, trach care, etc.....?

He was esentially pushed out the door of the nursing home, b/c he was there for rehab after the stroke....yes, but it was the only place that was approved, b/c he wasn't approved for a longer hospital stay.

Insurance said he had to leave Hopkins. When the physical therapists discharged him at the nursing home b/c he could walk, dress, wash....etc.....the insurance co. wouldn't even listen to the nursing notes. (These were the original concerns for wanting to keep him in the hospital. Keep in mind he lost the use of his right arm.........he's right handed........not only did he lose his voice, he can't communicate at all now). They could care less at that point whether he aspirated, didn't care whether he had a suction machine. In their opinion, he didn't need rehab, so he wasn't worth paying for a bed in the rehab.

I'm telling you.........I'm a patient person, but this was b*llsh*t!

Thank God, I have a good nurse this time (only after threatening the head of the agency). We had to use the same facility that initially sent out the first two losers, b/c that is the only facility nearby that our insurance will recognize. (We are 15 minutes from DC and Annapolis.....go figure) He is the first who understands that a caregiver can't run on air alone.

He called the insurance himself today, and requested that I have a nurse a minimum of 4 hours a day. It is apparently something that I'm entitled to, but nobody will tell you about. With Dennis having a trach and PEG, it is protocal that it be provided. How can you be so money hungry that you don't let patients who need the services know that they are available?

I don't get it. Why?

Love,
Mandi
aka BB

Hi Miss BB. ( i will always and forever call you that now)

It seems like you did get some things accomplished today, which is a good thing. Keep pushing and keep at them.

I worked for one year in Med Review (i'm a nurse) for Trigon/BCBS here in Portsmouth Va. It was the WORST job I ever had and it left me feeling heartbroken each and every day. My job was to review and determine if the test, medication, service, etc., was needed and would it be covered under insurance. Now, the first thing you are taught when you walk through their doors is that you work for THEM and NOT for the client. offer information to a client about services that are provided under their policy that they might not be aware of..................HUGE NO NO. Never, ever, ever do that! Deny the 45 year old the second mammogram, even though her mother and older sister died of breast cancer. I could go on and on. My point to you is this, they are not going to offer you the info on services they provide. That's going to be up to you. Call and request lit. and paperwork on EVERY SINGLE SERVICE THEY PROVIDE FOR UNDER ANY CIRCUMSTANCES, and then read through it with a fine tooth comb. It will be the best thing you can do.

Much luck and much love,
Minnie

Mandi (BB - I love it!) - I am glad you finally got a good nurse sent out and that he realized the situation. I hope that they continue to provide you with smart, caring nurses to help you with Dennis and provide some relief for you... and you continue to call that agency head if you need to... Sorry you are going through all of this, I just hope and pray that things will start to improve for both of you.

Thank you all.......you don't know how much it means to be able to share all this with you and be understood.

I know everyone on the outside means well, but if you have never faced this situation, you don't have a clue how frustrating the whole thing is.

I finally had an insurance RN call me this morning.......no, they don't cover at home nursing for the caregiver to do what else might be needed. They are working on giving me a list of non-profit facilities that offer respite care.

Sigh........Dennis is not going to go for that, I'm afraid. He already has so many issues that he would rather be left alone than depend on a volunteer.

Still waiting for the Jevity to be delivered....I swear, if I have to call them again, it will be ugly.

Also called to make a follow-up appointment with the neurologist........first available is JANUARY 25. Transferred to his answering service and nobody answered. Called for a follow-up with his ENT surgeon........got voicemail but no call back.

DAMN!!!!

Love,
BB

wish i could join in here but it is like a foreign language to me!!Would just like to say i am thinking of you

love Liz

Dear Mandi- those BB's are not quite tight enough yet:D . You still have some battles to do. It will take more energy than you think you have, but fighting "UP the line " with United Health Care could get you where you need to be in terms of assistance- keep asking for the supervisor- if that person turns you down- ask for his\her supervisor-bottom line-don't take No for an answer unless it's to a question you can know you can deal with. You all have paid the company good money, in good faith. They do not have the right to be the sole determiners of Dennis's health care. Ask for another case manager-one who has experience with oral cancer. If they say they don't have one, then tell them they are deficient in their knowledge and you won't accept that. You all bought that Ins. plan in good faith.I know you don't want to have to deal with this because you want to spend your time with Dennis- it's crap [that's a southern term]. What can we do to help? We could bombard United Health Care with ugly letters for starters.Please don't let yourself get sick- you don't have time for that. Amy in the Ozarks.

Mandi: I managed a law firm for several years, and my experience in dealing with UHC was truly a nightmare! I will tell you that there are more complaints about UHC than all the other healthcare providers combined!

Write or call the Dept. of Insurance in Maryland and DEMAND that someone listen to your plight! Raise HELL, gf!