Steve Watkins

So. This saga started in January of this year. 4 months later, today -- I got the check for my wheelchair.

It took 30-40 phone calls, an equal number of emails and two complaints to the state insurance board. But we got there.

After a bit of back and forth -- the nice man took a copy of my invoice and I was promised a call first thing in the AM. I endeavor to persevere.

Look, I'm not mad at you -- I'm mad at the process. But I need you get a supervisor on the phone.

I'll have to email him.

I'll wait.

Few minutes later I ruined the afternoon of a very nice man. Apparently this is the third time he's seen this from that same HMO.

We approved it, now the HMO has to buy it for you.

They said the insurance company has to do that. We've been going back and forth like this for weeks.

I don't have any way to do anything else. I'll send an email and we'll get back to you.

No, get them on the phone.

I don't have a number

So Friday, they gave approval for the wheelchair. The HMO told me to order it. So I did. I was told by the HMO to contact the insurance company for reimbursement. They said the insurance company has to pay you. So I left a message. Got a call back today

If we want to win, we need to show up. Not just on general election day, but to every party event leading up to it. That's where the decisions are made.

Far left shows up to rallys. Doesn't show up on election day.

Scared old people are who show up, and they're scared of the far left.

Centerest try to appeal to the old people. Which at the same time appeals to the corporate world -- so it's a no brainer who gets elected

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Son: Are we better off now?

Dad: Well son, mom & dad have both lost their jobs. Our savings are gone, gas & grocery prices are up. We did, however, save you from drag queen story time.

Son: What's that?

Dad: A mythical thing they said was happening in your school, which we can't afford anymore.

Continuing the saga -- It has now degenerated into a finger pointing match between the HMO and the parent insurance company. Insurance company says the HMO has to fill out some forms. HMO says they have nothing to do with it anymore. I got both on the phone at the same time yesterday

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There was a moment -- when I found a chair that would almost work and was on ebay for cheap -- that I almost gave up. But in my case I have the luxury of waiting this out while I fight it out. The thing going through my mind is how many people gave up who needed help. I can fight this and will.

it has been an adventure

So it's now been weeks. It supposedly has been kicked up the chain and I should get an answer next week some time. That answer will probably be "We need to look into this"

"You aren't supposed to have to do anything. The doctor orders the chair, they get you the chair. All of this should be taken care of by the HMO. It's their job"

"Yeah, that's how it should work. But they tried to tell me I was out of luck and couldn't have a mutant chair"

With a promise from her to look into the matter, I went back to work. Then I got a second call. Someone had read my email, and wanted to assure me that the HMO would take care of it all -- they had been given this form.

So we went through the whole thing again, and she was quite apologetic.

"Hi, we got your message. We had already sent the HMO a form, and as soon as they get it back to us..."

I called and gave her the bad news. The HMO was confused by the form. There was no form forthcoming. We're on our own.

She was somewhat taken aback.

"I don't know how to do this. You need to call the insurance company. Here's the number, and leave them a message. You should email them as well. Here's the email address"

So I call and leave a message, and email them. I'm not hopeful.

Next day, I get a voicemail from an insurance person.

Next day -- I get a call from HMO lady.
"That company doesn't take insurance. and there is no CPT code. I can't fill out this form they sent me."

"I can just order it on a credit card and the HMO can reimburse me. I just really want to get this done."

A couple of days go by. HMO lady gets me on the phone with her, and calls the insurance company. They send her a form for an out of network referral. Next day, she calls in asking for the number of a company that sells the wheelchair I need. I give her a few different ones.

Next day I get a call from the HMO. "What chair did you find that worked again? I'm calling all of our in-network DME suppliers and they all say they didn't have anything."

"Imagine that."

"I guess these are all the same people you called"

"Yep"

I listened in as the insurance lady asked the HMO lady "Why can't he have his wheelchair?"

HMO lady got really defensive. And then embarrased when she realized I was also on the line. It was agreed that they would look into it.

They also said I should call the insurance company because it was all their fault. So after I hung up the phone, I did just that.

The lady at the insurance company was incredulous. "The doctor said you get a wheelchair, you get a wheelchair. That fits your needs. I'm calling them"

My Dr asks about the appeal process.

The HMO responds with "No. No appeal. It's not covered"

So I call the HMO referrals department. I asked to speak with whoever re-defined my medical needs as conveniences. I was told they would try to have that person call me, but they usually don't.

They went on to say that wanting a chair that I could actually use for something other than lawn-art, or a chair that was powered so I could do something other than just go in circles (powering it with my one good arm) was just asking for a convenience and they didn't have to be convenient.