Three Years

        Medical insurance and coverage is a major topic right now.  Obama Care has created many changes and requirements for individuals and doctors alike.  Costs have risen, rather than dropped as promised.  Folks are now being fined for not having insurance.  Some politicians are trying to get rid of it.  It is a mess.
          Doctors are now required to invest in complex computer systems and must enter all the data into expensive software during each patient contact.  Our physical therapists now carry their computers with them and add notes after each exercise.  While this might be a good thing, it sure does take up much of the time that they would spend talking to patients in the past.  It would also make some sense if all the doctors were tied into the same portal.  But they aren't, so sharing data isn't happening. I presently have four different portals that I must consult to get my information and this information isn't shared with doctors not in the same system.  For example, our family doctor's portal does not  even indicate that Dianne now has a pacemaker or the results of her recent blood tests.  These are in a different portal with a different doctor.
         And medicare rules have changed as well.  Now at every visit the doctors and nurses have a series of questions that they must ask medicare patients.  Your answers must also be typed into their computer.  Oh yes, one more interesting requirement.  If at least 20% of medicare patients don't send a computer update to the doctor after a visit, the doctor or his group are penalized financially.
          So what happens as the government takes control of medical practices?  Probably more regulations, greater expense and more chance of governmental errors, waste and incompetence. On the other hand, I have been on medicare now for a number of years and actually have had little trouble and many good experiences.   That is, except for one situation.
          Back in 2011 my gastroenterologist recommended that I have a dexascan done because research was showing that one of the side effects of a med I was taking was bone loss.  My family doctor agreed and I had the test.  Fortunately the results were fine.  Ironically, Dianne had the same test about the same time just because, as a woman, there was a chance of bone loss.
         Then a few weeks later we received notice from medicare that her scan was covered but mine wasn't.  I owed $280.  My doctor was surprised by this notice and resent the information with a personal letter of explanation.  Again it was rejected without any reason.  So the doctor changed the diagnosis code and sent it in a third time.  Again it was rejected, just saying that I wasn't eligible.  Gender discrimination?  I can't help but wonder.
         So I sent in the $280 and also decided to begin the appeal process.  I gathered all the information and data required for an appeal.  I went to the medicare website to find where it was to be sent.  And in February of 2012 I submitted the appeal. I was within the required time limit to submit an appeal and felt that I had a good case.  Months went by without any reply.  And as time went by I just assumed that my appeal was rejected and I finally just gave up and reluctantly accepted the fact that I had reached the end of the road with this issue.
          Then in February of 2015 - three years later - I receive a letter from medicare informing me that my appeal was sent to the wrong medicare address and that they couldn't process it.  They returned my appeal data which they even stamped, "received February 2012".  So where was my appeal for three years?  Why wasn't  it returned to me promptly when I was still within the time limits?  Why wasn't it forwarded for me to the right building?  Why?  Why?  The only answer I can give is ... incompetence.
           Now I have written to the correct address and resubmitted my appeal with a cover letter stating what had happened.  I have again heard nothing and I don't expect that I ever will get an answer.  If my letter is even ever read, I assume that they will just say that I've missed the deadline and there is nothing they can or will do about it.  And what more can one expect from our dysfunctional government.
          So I guess I am convinced that if Obama Care doesn't ruin our health system, then incompetent government workers will.
          UPDATE - First, a few days ago I received another letter from Medicare telling me that my appeal has now been sent to another agency, even though I had sent my second attempt to the one Medicare lists on their current appeal process.  In addition, I sent copies of my recent appeal letter to Senator Toomey and Representative Pitts.  I have heard back from Toomy's office and they are following my appeal.  Pitts office has done nothing.  Stay tuned - who knows what will happen next, if anything.