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!)
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:
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….
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….