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3 trips to the doctor, 3 prescriptions, 3 denials by the insurance company

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liberal N proud Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Mar-19-10 05:56 AM
Original message
3 trips to the doctor, 3 prescriptions, 3 denials by the insurance company
I have made three trips to the doctors office to treat a diagnosed ulcer, the doctor has prescribed a different medication each time. The Insurance company has rejected each and every one. One of them I was on for more than a year following the original diagnosis, it was working keeping my stomach acids under control.

Each denial, the insurance company direct me to take a cheaper less effective medication, each time, I must comply in order to have any relief. In order to have any comfort at all, I have to supplement the prescription medicine with over the counter acid controllers of which is 100% out of my pocket.

Why do I bother going to the doctor for diagnosis or treatment, I could just call the denial squad at the insurance company and ask them how to treat ulcers. They seem to know better than my doctor.


So here I am again, no prescription, my gut burns and I get to make another doctors appointment. For what they think they are saving in drug cost, I am spending on office calls.

And no one thinks we need reform?

:wtf:
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RC Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Mar-19-10 06:13 AM
Response to Original message
1. ulcers can be caused by bacteria and can be treated with antibiotics.
Maybe that is your real problem?
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madokie Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Mar-19-10 06:20 AM
Response to Reply #1
2. The nobel prize in medicine was given to the men who discovered this fact
A quick google brought me this
http://nobelprize.org/nobel_prizes/medicine/laureates/2005/presentation-speech.html

Your Majesties, Your Royal Highnesses, Ladies and Gentlemen

Napoleon Bonaparte was not poisoned, but died of a stomach ulcer that had been transformed into cancer. Author James Joyce, still disappointed at the poor reception of his latest novel Finnegans Wake, died of a perforated ulcer. Ulcers don’t strike only the famous. They are one of the most common afflictions of humanity. For a long time, ulcers were regarded as being a result of stress and improper diet. Barry Marshall’s and Robin Warren’s discovery that ulcers are caused by a bacterial infection was therefore completely revolutionary and was initially met by great skepticism.

Robin Warren, in his professional role as a clinical pathologist, observed spiral-shaped bacteria in tissue specimens from the stomachs of many patients who had undergone gastroscopy. These bacteria were abundantly present, associated with the epithelium of the stomach and shielded from dangerous hydrochloric acid by a thick mucous layer. Warren saw that the underlying mucous membrane always showed signs of inflammation and therefore suggested that the spiral-shaped bacteria caused gastritis.

Barry Marshall became interested in Warren’s findings and decided to culture the bacterium. Many fruitless attempts were made. During the Easter 1982 holiday, the agar plates were left in the incubator by mistake, and when they were inspected after the holiday they contained numerous colonies consisting of the same bacterium that Warren had observed under his microscope. Soon it became clear that a whole new bacterial genus had been isolated. It was eventually named Helicobacter pylori.

Marshall and Warren now conducted a large clinical study, which showed that Helicobacter pylori was found in the stomach of most patients with ulcers either in the duodenum or the stomach and that the bacterium was always associated with inflammation of the mucous membrane.

More: http://nobelprize.org/nobel_prizes/medicine/laureates/2005/presentation-speech.html
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liberal N proud Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Mar-19-10 06:21 AM
Response to Reply #1
3. The doctors don't believe so
Each trip they check for h-pylori. They think it is the wonderful stress of trying to keep things going at home and keeping a job these days.

I have had ulcer flareups periodically for more than 25 years. Over the counter acid blockers don't do it.
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Caretha Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Mar-19-10 08:19 AM
Response to Reply #3
6. It will not hurt you to try
the anti-biotic regimen. I had ulcers for years, took medication daily but it still got worse. Finally my doctor decided to try this treatment on me. The cure was had! I've been ulcer free for 20 years.

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Rosa Luxemburg Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Mar-19-10 06:28 AM
Response to Original message
4. is there an Ombudsman for your state that you can appeal?
make an appointmnet with the CEO of the ins company and explain the problem.
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cdsilv Donating Member (883 posts) Send PM | Profile | Ignore Fri Mar-19-10 08:02 AM
Response to Reply #4
5. I'd go ahead and do this .....
"I could just call the denial squad at the insurance company and ask them how to treat ulcers. They seem to know better than my doctor."

ask what they recommend and where to send the bill for your time spent on the phone with them.....
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liberal N proud Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Mar-19-10 08:51 AM
Response to Reply #5
7. Skip the middle man (the doctor) go straight to the decider's
I suggested that to my wife too.
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NightWatcher Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Mar-19-10 08:52 AM
Response to Original message
8. cant wait till we all have that kind of insurance forced upon us by law
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timeforpeace Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Mar-19-10 09:07 AM
Response to Original message
9. You think that will get BETTER? Holy cow, you'll be calling this the good old days.
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