Xchanging sends the debt collectors

I am furious, frustrated and about to take a baseball bat to my head. Xchanging, well, I guess my case manager from hell, has been refusing to settle a blood test account since 5 September, and as a result I have now received a final notice of the -now long overdue account- stating that if the account is not paid within 7 days (I have 3 days left) the matter will be referred to the debt collectors, yohoo!

As you can clearly see from the request form for the test as prescribed by my treating surgeon, the blood tests were requested for “acute pain and swelling of  R shoulder“. This basically means that we were -and still are- very concerned about an infection in that shoulder (osteomyelytis) and for that bloods are needed to that we can monitor the progress of the infection with infection markers (such as the white blood cell count etc.) Right… So what is there so obscure about this account that Xchanging refuses to pay for it?

As you can see from the final notice account, the bloods were requested (prescribed) on 24 August 2011 and the test was done on 5 September 2011. Interestingly the test was done on the same day as the technetium bone scan I had done, and Xchanging had no problem with paying for the bone scan (also to look for the infection).

My case manager from hell also has a copy of the bone scan results which shows significant crap going on in the entire R shoulder and nowhere else in my body – so to try and pinpoint the blood test on an ‘infection’ elsewhere in my body would be , at the very least, very deceitful. (Mind you they tried it n to deny me the surgery!)

bone scan results: note scan done on 5 September

And, if that’s not enough evidence, Xchanging (my case manager) has also sent me to an IME (Orthopedic surgeon) the day AFTER the blood test and the bone scan. In his report, the IME describes in detail the status of my shoulder, upper limb, elbow, hand, fingers and there is no mention whatsoever of any infection in the finger or anywhere else, but the IME describes a “grumbling infection in the R shoulder”.

Xchanging refuses to pay again for reasonable and necessary medical care

So, tell me why is it that Xchanging refuses to pay for a blood test that:

  • was prescribed by an upper limb specialist surgeon
  • for the sole purpose of evaluation infection in the shoulder
  • but they paid for a bone scan to investigate the infection
  • they paid for a gallium body scan (after some fighting) too for the purpose
  • they recently, after a 2 month delay, finally approved my surgery for biopies, clean out of infection
  • but hey, they refuse to pay for the blood tests -obviously an “unnecessary medical treatment?”

Have a look at this:

my red shoulder

swollen & reddened

Nice, huh… Especially if you see how the redness is progressing / has been progressing over the past 2 months,because Xchanging has been unnecessarily denying and delaying my surgery and treatment. Because of that I have now developed a fever, excruciating pain …I can’t even describe it, I have lost over 6 kilos over the past month and really don’t feel all too good. Thank you, Xchanging! Maybe – should I believe your sick opinion- it’s only a case of psychosomatic disorder and a bit of VALIUM cream may just help, can you send me some to try please 😉

This morning I had to have some more urgent blood tests done to further look at the infection markers given that the shoulder has worsened again over the past few days and I am not sure that I can hang on until next week for the scheduled surgery. I should have the results tomorrow. This time we had no option but to cheat the system and bill Medicare out of FEAR that the bastards would refuse to pay for this account as well – isn’t that terrible and unfair to the tax payers?!

In any case, what I wanted to get off my chest is that, yet again, here’s a beautiful example of another delay, deny, stall process on the part of Xchanging, who, like all other workcover insurances, is required under the law (the Act) to pay for all reasonable medical care and treatment/procedures. Now you tell me the reason(s) why a blood test to evaluate the infection markers in this shoulder is not reasonable!

We all know that any infection, especially a joint infection can potentially spread to the blood stream and make you septic (that’s what they call septiceamia) or blood poisoning and that’s a very serious matter, from which you can die if not treated promptly, hey! But who cares?!

I did include the blood account issue in my complaint to WorkSafe on the 4th of November… haven’t heard a whisper as yet….

Any suggestions?

I have sent a letter off again to my case manager demanding immediate settlement of the account. I have told her that if I do not hear from her my tomorrow lunch time I would, regrettably contact WorkSafe again as I do not want the debt collectors knocking on my door for an account for which I am not responsible.

Why must we deal with such a trivial crap when we are under stress already… I mean I have enough on my plate at the moment with this infection and my upcoming surgery of next week (provided we can wait that long) and dealing with the fear and the consequences of such an infection….

 

16 Responses to “Xchanging sends the debt collectors”

  1. Look what Xchanging managers do to their staff when they try to help their coustomers, they seen to be aboth any law?

    http://www.pirate4x4.com/forum/showthread.php?p=14456193

    • Thank you, what an eye-popper – we may have to write an article about it!

      workcovervictim3 July 5, 2012 at 9:10 am
  2. Not talking to my ex about it (at her request) caused her to “not understand” what was going on as much and blame me personally for more of the problems.    I think talking about it is really important, but it also has to be “not the only thing that’s talked about” …. which is hard when it kind of affects everything in your life so dramatically, but make every effort you can for him.

    Impossible set of tradeoffs.

    Ben.

  3. Indeed, correct.   Got inadvertantly junked.  Nicely done 🙂

  4. Funny, I just tried the “notify me of further comments” button, and it works – you do have to wait for an email though and then click on the email’s link to confirm that you wish to receive notification of further comments. Maybe the email got sent into your spam box?

  5. Make the call to live cheaper earlier.

    At some point your biggest supporter, your defacto, will walk away as it not being worth it any more.  Mine did.  Everyone will.  I thought I’d be different, but unfortunately the world doesn’t work like fairy tales.  People get forced into shielding themselves from the abuse inflicted on you by removing you from their lives.   I’m sure you’ve experineced this already.

    You have to live within your means for the rest of your life – if the system won’t pay you to live in a house, you have to live on the street.  You’re getting 80% of your pre-injury salary, so it sounds likely you should be able to minimise costs, and make some progress.  It’s not fair, but continuing to go backwards as you say is not an option for you, and when the sherrif turns up to evict you from your home is a bad time to start making spending cuts.

    I don’t even have that 80% funding, so I can focus on medical, my health, or anything, I’m forced to work even though it’s massively painful, massively stressful, and has lead to me seriously considering suicide more than once.   Suggesting a shrink doesnt’ help, as it’s just more time, more effort, more money and makes my long term life problems worse.  The abuse needs to stop, not “my attitude needs changing”   …. and I’m sure people not suffering will come up simple excuses why the slick PR where “psychological disturbance” is solved symtomatically with psychs.  It’s not, it’s solved by stopping the abuse inflicted on people.   Remove the knife from your back, don’t take pain killers for it.

    I gotta stop ranting.   I’m sure I’m getting less rational the more I push my pain limits.  Sorry if this upsets anyone, it’s not intended to.

    Ben.

    • Ben, I am very very sad that your partner chose the easy way out. Saying that many many marriages and relationships do break down post accident (workcover / TAC) and that’s a fact. Saying that, my defacto has also been struggling to ‘deal’ with me and my injuries, physical and mental. And I understand that. I am not the same person anymore since the accident (the bubbly, sporty, extremely active, adventurous and independent person) and all the beatings taken from Xchanging, the system, the financial ruin, the failed surgeries etc. I am also a disabled person now who needs a lot of help and defacto needs to do it, this is tiring and frustrating for defacto. Washing, bathing, doing all the household, playing taxi etc etc AND then comes the true fact that I am NOT in the MOOD for any fun (yep, including that kind of fun – all the drugs, the sheer fear of dislocating my arm during etc etc). This is a huge problem for defacto indeed and I understand. Going on holidays/weekends is impossible because of either financial hardship or the fact that I am in too much pain to take the drive and to sleep in someone else’s bed and to have to “socialise” when I feel really bad. Causes FRICTION again. Defacto does not understand the effects and after effects of such a major injury on your body but also on your psyche. Depression… another thing defacto gets ‘angry’ about and “I just need to snap out of it” and “get on with it”- well I TRY, I TRY and TRY. But every few months another f*cking BRICK falls on my head, whether it’s a serious issue with the insurer (denying me for example surgery), or whether it’s having to undergo yet again more surgery, more complications,more physical pain and in turn more mental anguish. We are in a vicious circle (at least I am). Then  there is the ANGER and the RAGE. Not just because I have lost my arm, but also because of the system and the sh*t load of pain and suffering it further inflicts on me and all of us (I am one of those  born people with a natural very strong sense of justice). Defacto does not understand this either and would prefer me to be an ostrich…. There are many many things that affect an existing relationship no matter how much “love” “caring” there is or was. The fact is we change after such an injury. We have to admit that we are not the easiest people to live with post injury and going through what we go through. I think you can only understand this when you personally go through it yourself. I do benefit a lot from seeing my psychologist though, even if it’s just to vent and ramble and whinge about the whole system and the injustice. That way I don’t need to annoy defacto with it and try and talk about other non related matters. I also very much encourage defacto to ‘carry on’ and have weekends away, holidays, whatever alone or with friends instead of with me. I encourage defacto to live to the full whilst giving me the time “to heal” as best I can. And I think, so far, our relationship has (barely) survived because we have, finally, given each other our freedom (both ways)

  6. (fyi, the “notify me of further comments” button doesn’t seem to work)

  7. I’m still going backwards, a little more liquid than you but not much, and still have family support.  Shouldn’t have to pay for it, because it’s a never-ending black hole.  Medical providers never fail to put their prices up year on year consistently above inflation either.

    Can you do anything to live cheaper — I’m  living homeless to try and stem the flow of money to keep affording to pay for medical out of pocket.  They’ve paid a fraction of my medical expenses, and 1 months loss of earnings, and that’s it, everything else has been out of pocket and are forcing me through years of drawn out court proceedings to claim anything back (and of course will offer me only a fraction — i’ve heard 70% is the standard cash-offer, despite accepting full liability.  This should be a clear area the ombudsman should be able to get clear data on assymetry of power being used to create a negotiating position for a corporation that outright abuses the intent of the law (unless of course one wants to admit the intent of the law is to abuse citizens — I’m also happy for them to argue that, as that should really wake “the people” up in demanding better rights – I hope)

    Writing a letter to medicare telling them there were “fraudulant expenses” resulted in them sending me a stamped, self addressed envelope that had nice easy checkboxes to tell them which ones to bill to TAC.   Easiest process in the whole damn mess, actually.  Shock horror, an insurance company with a chance for “more money in” has easy processes, eh….   End result was a bunch of denials from TAC, and so far medicare hasn’t come after me for it.

    I haven’t yet got around to insisting medicare refuse to accept “denied” for an answer – that’s my damn federal tax money the TAC are fraudulantly spending and profiting off, when it’s wholly and practically undisputably the TAC’s liability (though, of course they’ll dream up some bullcrap excuse why they shouldn’t have to pay so it can drag through court for 13.5 years before there’s a court-order issued – there really should be a million dollar fine or something for each and every single medical bill that’s falsely denied).

    I intend to follow up, but haven’t thus far had time between everything else on my plate, trying to hold things together with very little support from the system (more true to fact, active combativeness and abuse from the system which would have me immediately filing a workcover stress claim if the TAC were seen to be my employers – basic “human rights” should be sufficient to get similar protections that employees (are supposed) to get from companies.

    Ben.

  8. The stanford prison experiment is an interesting one that shows you put normal people in a position of jailors, and they play the part.

    The point being, that while it may seem she’s out to get you, she’s probably a lovely person put in a position where it’s her job to abuse, and she’s been given enough “excuses” to justify her behaviour.   Now I understand that’s shitty, but while you’ll probably deny it, if you were in her shoes pre-accident, it’s pretty good money you’d act similarly to her.  (I’m talking statistics, not casting personal aspersion)

    The point being, I’m unsure it’s in your interests to think it’s personal.  Everything I’ve heard is exactly the same shit that every single case manager I’ve had does.  (One of the TAC’s tactics is constantly rotating you through new case managers, sometimes on a fortnightly basis, so you’re always talking to someone new, so they have an excuse to get you to explain teh whole situation again, in the hopes they’ll frustrate you, you’ll slip up, and they’ll get case-notes to cruicify you with)

    I’m suspicious if this girl didn’t have your goat, they’d rotate case managers until they found someone who did.

    Stay calm, use the legal process that exist to demand your rights.  Make the point through this website and your submissions to the ombudsman about how this treatment constitutes an abuse of assymetry of power on australian citizens, way more dramatic than any that would be tolerated if reasonable advocacy existed for victims rights, and that it needs to be dealt with at a legislative level as the judiciary are clearly incapable of dealing with anything other than “allowing citizens a drawn out legal framework” that is being abused by the comission to abuse citizens.   The ombudsman isn’t supposed to act by law if the citizen has a legal remedy.   He can claim that, so he doesn’t even have to investigate, and will focus solely on the “administrative” aspects of the case, but leave the system largely untouched and abusing people.

    It must be a legislated change, the system must have it’s incentive to abuse, and profit at the expense of “the people” removed.   Non-profit, with much more clearly defined *minimum* service standards with a stated goal of *maximising* those services to victims.   Victims should be able to make a claim, and be *paid by default* within 24 hours for any claim they could legally make.   And have a fraud detection process that has an onus of proof on the accuser, and a consequence of fraud to the victim of “pay it back like a hecs debt plus interest” if they cannot reasonably afford it.  Cheap for the system, discourages fraud sufficiently to basically eradicate it, and make it “cheap enough” for the state to sustain the amount that does happen.  Paid for by the people, financially underwritten by the state, no investments within the scheme for future debts allowed – the cumulative costs of the system should be represented in the premiums paid by the people.

    Sorry for spending so much time on your Soapbox.   I’ve also a lot of anger to vent and never found a way of expressing myself without a catalyst.  Your posts are such a great catalyst for me, I hope you don’t mind my comments and can forgive me if I get a bit crazy at times from pain, frustration and anger.

    Ben.

    • Ben, I LOVE your comments and find them most enlightening and enriching – please write and vent as much as you want, that’s the purpose of this blog! I am sure that many if not all of our readers equally enjoy your writing, commenting, thoughts and valuable insights into the issues presented. In fact, when I don’t see your name on the blog for more that one day I really miss you!

      Defacto and me have already moved to the sticks to a very modest and really cheap (pretty crappy/shabby) house. He pays most of the rent but I pay as much as I can on my just-under-$30,000 annual workover pay. Defacto has also experienced nearly 2 years of unemployment (made redundant without a redundancy package) during the last 2 years that I was still working (when I shouldn’t) with this injury. He’s got 4 kids from a previous marriage (heavy child support to pay) although the kids live with their mother…. Defacto carries a large debt from previous marriage and divorce settlement…. and I am still paying off my car(!!!!) which I have not been allowed (or able) to drive for well over 2 years….before I am even allowed to sell it!

      Hard times, mate. But at least,unlike you, I manage to get most of my medical care (or what’s left of it) paid by the workcover insurer and I am “lucky” enough to still get my meager weekly payments because I am deemed “f*cked”.

      I think anyone who’s on workcover or TAC faces financial hardship one way or the other. It is about your livelihood that gets taken away, not only by your injuries but also by the insurer.

      Could be worse…. at least I don’t have kids of my own (another sad thing this injury took away from me though )…

       

  9. I am very sorry to hear that Xchangiing is treating you so unfairly. This situation is getting out of control.

    Can your solicitor now intervene? Are you able to get the interest of local media? Are you able to make an appointment to see your local MP?

    WorkSafe Victoria has a lot to answer with regard to how its agent is treating an injured worker.

    Please hang in there — these look very much like tactics — unfair tactics by your case manager to kill off your claim.

    • Hi there, thanks for your heart-felt empathy. The going is really tough at the moment with Xchanging and this case manager from hell… I am 110% sure she has a personal vendetta against me. It is even tougher for me to ‘deal’ with this very stressful and most frustrating crap, given my current physical condition – I am having surgery in a few day’s time and I am obviously worried sick about what they’re going to find in there (infection wise) and if they’re going to have to cut out my entire shoulder.

      There’s not much my lawyer can do either apart from writing nasty letters which get ignored half the time (re my surgery denial I was the one who managed to get approval, not my lawyer, although his letters may have helped).

      It does help a lot to find and receive support on the blog, thanks 😉

      Keeps me “going” somehow.

      Thanks again.

  10. Right, just spent the entire morning writing my formal complaint letter to WorkSafe. I will publish it later today, need a rest, way too sore 🙁

  11. DO NOT SUBMIT IT TO MEDICARE.

    It’s federal fraud, and if you allow them to force you to submit it to medicare, *you* are the one commiting fraud, and will be up on charges for it, not them.

    The mess of paperwork to send letters to medicare to tell them which ones were falsely billed to them and then have them send it to xchanging, and them deny it to medicare, and go around in that circle is not worth it.   If you have to, pay for it yourself and SUE THEM IN COURT.  (and most importantly, keep publishing everything here.

    Don’t stoop to their level, and start exaggerating things, lying, or stealing just because they’re doing it to you.  You’re better than that.  Fight the good fight.  There’s not many of us left.

    Ben.

    • I just can’t afford it, Ben, I am totally broke and carry a debt of more than $20,000 already that I am trying to “pay off’ by $25 monthly installments! I (hence) have no credit facility and no family support either (you know how it goes). I really struggle to feed myself and keep the (rented) share of the roof over my head. Do you know how stressful it is to have debt collectors in your neck?  It’s not the first time that Xchanging is or has been doing it to me, you know. And in the past I have paid for such accounts myself in the end to avoid prosecution, the end result, never got the money back! And I am talking account for $400, $600 at a time. Going to court for that, right, no one wants to support such a “trivial” matter which ends costing the tax payers even more (court time, dispute over cost etc, and I still have to pay upfront, HOW).

      But I see your point and it’s absolutely valid. We knew yesterday that we were committing federal fraud by billing medicare for the urgent blood tests which Xchanging IS responsible for- fuck my life depends on it, mate. Being ‘black listed’ by the pathology sevice provider – FAT chance they would agree to even process my bloods… No real choice. However I am going to get onto WorkSafe this morning and again submit and urgent complaint, I will include the request (slip) for the bloods I had done yesterday and have them “approved” as well and inform Medicare that they need to bill Xchanging (and that I made a ‘mistake’). I surely want to rectify this issue, but you have to understand what those scumbags do to me (us) and how they force us to abuse the Medicare system to get our much needed treatments –  it is a well known dirty tactic of them (all insurers), hence their modus operandi of SSS (starve,stall, settle)…..