And so it continues…Centene

an outloud journal entry

Last night I got the call from Northwestern Physical Therapy, Meridian, my Medicaid — I’m on SSDI, disabled due to a congenital defect in my spine spinal failure from that and autoimmune issues. In October I had major surgery on my lumbar spine, and ended up with it being far more involved than anyone had planned on -

The holidays were tough. After two weeks in a hospital came months with trying to keep my spine straight but also get through just manuvering the home. It’s been painful mentally and physically, but I’ve done everything I could do to try to keep my spirits up and push on because I want to make all of this a distance memory and soon —

I want to not rely on this system that has caused me so much pain. Delays in getting healthcare and approvals almost had me on the streets living, thank God for my kids. Then the delays of preauthorizations denials cause took my down a spiral of unrelenting pain, the type of pain death is a dream.

Top it off with all I discovered about the so called safety net of a system, including the Goliath of Medicaid, Centene, to say right now I am frustrated would be accurate ..

You see, after weeks of wearing a corset to keep my back straight after surgery, I was finally able to have physical therapy. Two weeks before surgery my right lower leg had intense pain and half of it went numb. Surgery did not correct it, I have nerve damage. It makes mobility tough as walking with a leg, half numb and gives out, create fall hazards for a spine that has a lot of destruction in it and considering I just had surgery, my core has been slashed and damaged. I need to build myself back up to make what I just went through with surgery, worth it all.

We tried land PT but with all of that, and having active Rheumatoid Arthritis and severe cubital syndrome in both arms and hands, it was decided that aqua therapy would be the way to go.

Make sense, doesn’t it? Highly skilled and respected, neurosurgeon endorsed, too. And considering Dr. Brayton is the one who had to dig out my dura, I think he knows what he is talking about, ya know?

Evidently — Meridian and Centene know best.

They’ve been playing poker with those aqua therapy sessions. It is called a partial denial. My doctor requested a certain number, they provided a portion. My PT provider has to keep detailed records and ask questions that are almost impossible to answer as they don’t take in the individual situation, and then beg Wall Street’s baby to give me what the doctor ordered.

It’s degrading for all except the ones making a profit.

Last night I got the last minute call from PT telling me that Merdian denied my last five sessions and they will have to file appeals. We knew it was coming as last month I was told the partial denials were because “you can do them at home.” I don’t have a pool. I don’t even had a tub available to me on the downstairs level where I exist. I have a small standing shower with a mobility shower chair in it so I don’t fall. But the healthcare experts over at Centene with all their data say I can do aqua therapy at home.

Laughable, yes.

But it is more barriers at getting my life back — maybe that next to last visit would have been the one to release what was needed to bring back my nerves so I don’t have all these weird numb sensations creating hazards in my life. Maybe that would happen and I can drive again because the muscle spasm eased and I can feel the pedal. Maybe that would gain me freedom and a chance to be out in the world, rather than stuck in a makeshift bedroom, in the middle of rural USA, reliant on others for little things most take for granted. Yeah — maybe one of those last 5 visits would have been the one. Now I will never know.

Now there are new delays in treatment.

There will be catch up needed but what does that means for me? Who the hell knows.

It is either that or say fuck it. Give up and just deal with what life is slamming on top of me.

This is why they do it. They know it defeats those patients who don’t even know they can fight because look at what it is doing to me, someone who knows how to fight a system. Less than 12 percent of patients appeal denials.

I’m not going to give up. I know what this is all doing to me and the domino effect it has created in my life and the lives of those who love me. I know I am just one story of many but because of who we are and who provides the money for our care, we are ignored. We are seen as lesser — just take what you can and be grateful. We are seen as the outcasts — we got what we deserved.

I’m not settling for that those labels and this treatment, especially knowing all the money being made off of the vulnerable suffering. The elderly, the disabled, those in dire poverty and children. Myself included. Then knowing both sides of the aisle pocket PAC funds from Centene knowing about all their scandals? Knowing that the opposing side is also getting the same donations? Knowing all that money fuels division and builds profits for Wall Street?

I can’t shut up. I can’t give up. Nor should anyone reading this…

What options are left if I did?

Nope, can’t do it.

GOP and DNC — Please return PAC funds and Prove you’re not there for profit over people and greed. Stand with those who need you most and do so with pure hearts and clean hands. If not, why not?

Simple questions.

There should be simple answers.

Silence.

Happy Tuesday.