From time to time, I like to provide a public service announcement for the greater good. In other words, I learn the hard way — the expensive way — and share my lesson in hopes that some diligent reader out there in the blog-o-sphere heeds my words and avoids the painful/stressful/costly conundrums in which I tend to find myself.
Today’s PSA does not concern courteous driving (although perhaps it should, based on the overwhelming number of idiot drivers I’m surrounded by every time I venture out of my house). Today’s PSA will not address healthy living or how to fortify your liver for maximum alcohol consumption. Today’s PSA won’t even mention Pinktober, pinkwashing, or how misguided The Susan G Komen for the Cure organization has become. Today’s PSA doesn’t have anything to do with our little piggie (pity that, as she is infinitely entertaining).
I recently had a surgery that, lo and behold, had absolutely nothing to do with breast cancer or breast reconstruction or breast reconstruction revision. How refreshing! I did my due diligence in researching a specialist who was the right guy for the job. I asked before I even made the appointment if he accepted my insurance. I provided all the nitty-gritty details insurance details before I saw the doc (ID number, group number, 800 number for claims). The benefits coordinator at the surgeon’s office reviewed everything on her checklist and assured me that we were good to go.
I saw the doc, he confirmed that the surgery was medically necessary and with just cause, and we scheduled a date. I paid my co-pay for the office visit and filled out all the paperwork, including multiple recitations of the insurance company details. I paid for my portion of the surgery well in advance. I followed all the rules (so I thought), and like a veteran soldier readying for battle, I eschewed any aspirin or blood-thinning products that can promote bleeding during surgery; I drank plenty of water the day before surgery to aid the anesthesiologist in finding a good, plump vein; I ate a healthy meal that would hopefully see me through being NPO the night before surgery; I washed the area to be sliced & diced with Hibiclens in my paranoid ritual of warding away any bacteria that might host a party in my surgerized body; I procured prescriptions in advance for the 2 antibiotics that are forever a part of my arsenal since that pesky post-mastectomy infection; I showed up before the crack of dawn on surgery day with an empty stomach and a powerful ache for my usual cup of coffee. I know the drill; been there, done that, multiple times. I got this.
Surgery was uneventful, recovery was long for my impatient self, but there were no complications.
Until I got a bill from the surgery center for more than $20,000.
20,000 clams for a surgery that was on the up-and-up and had been cleared for take-off well in advance.
After suffering a minor heart attack, I called the surgery center and was told to take it up with my insurance company. I called my insurance company and was told to talk to the doctor’s office. I called the doctor’s office and was told to retrace my steps and start over with the surgery center. Egads.
After spinning my wheels and listening to untold atrocious Muzak songs while on hold for what seemed like forever, I remembered that my insurance company provides a patient advocate service. I’d used this service with my previous insurance company and was forever grateful for my advocate, a former RN, who checked in on me post-mastectomy and throughout the course of the year-long infection battle. She intervened when the insurance company said it didn’t want to pay for the $5,000 Oncotype test, which dissects my particular cancer to determine the best way to treat it and determine how likely it is to recur. She helped me navigate the pages upon pages of medical bills that weighed down my mailbox in the early stage of my cancer “journey.” She was very helpful.
The new insurance company could take a lesson from her. Their patient “advocate” department sucks. I can barely stand to use the word advocate in relation to them (hence the quotation marks).
The first “advocate” I dealt with on this issue did some research and determined that the surgery center my in-network doctor used is out-of-network. So my surgeon is in-network but the surgery center is not.
Oh, and by the way, it’s my responsibility to check to be sure the surgery center is in-network.
Again I say Huh??
After all the checking and double-checking and verifying and pre-qualifying and certifying, I’m supposed to ask about the surgery center? How in the world would I even know to ask about this? What fresh hell is this?
Oh, yes indeedy, the “advocate” told me, I should have checked on that. And I should have known to check on that by reading the Standard Plan Description, a bazillion-page online document that details the ins and outs of my coverage.
While I’m grateful for the coverage I do have, I’m pretty sure my insurance company hates people like me who ring up millions of dollars in expenses for a disease they did nothing to cause and for which they actively tried to prevent. I imagine my file has a big red X on it to denote all the trouble I’ve caused and money the company has had to spend on my behalf. I’m guessing that when I call the insurance company with a question, the phone has a special ring, sorta like the Bat-phone, to alert the poor sap who answers it that I’m a raucous troublemaker who is bleeding their employer dry.
I get it. I’m not the ideal customer. But expecting me to verify that the surgery center is in-network is absurd. I don’t care what the bazillion-page online document says. If the doc is in-network and no one raises a red flag about the surgery center, then I assume I’m all clear.
A $20K bill and an instant heart attack are rather the antithesis of all clear.
And that, dear readers, is why I’m here today — to lead by example, to inform by the hard lessons learned. The word to the wise, learned expo-facto, is this: even if your doc is in-network, the surgery center may not be. Even if the doctor’s office staff have dotted every i and crossed every t, it may not be enough. Your insurance company my turn on you like a hungry dog on an alley chicken-bone and try to chew you up and spit you out. Consider yourself forewarned.
Our little piggie Piper turned one on Sunday, and we went a bit hog-wild celebrating her first birthday.
My favorite girl is quite the party planner, and this shindig was top-notch. She started planning the menu a week or so in advance and it underwent several revisions before she settled on grilled fruit kebabs, BBQ chicken sandwiches, twice-baked potatoes, Ramen-almond salad, and carrot cake.
Now, if you’re inclined to leave any comments pertaining to bacon bits or pulled pork, resist the urge or I’ll set the birthday pig on you, and let me assure you that she has no mercy when it comes to porky jokesters. She’s vicious when it comes to that.
Party preparations started early and lasted all weekend. The first order of business was to make a party wreath for the front door. We are fortunate to have an artist at the ready, and he created the focal point of the wreath. He’s also the creative genius behind the logo that graces the front page of this little blog.
Next came the gathering and placing of various pig-related decor:
And the custom-made bow for the birthday girl. Amazing how cute it turned out considering it was made from a $1.50 bow from the grocery store, a flower clip from the clearance aisle at Hobby Lobby, and a candle sticker from the scrapbooking aisle.
Making the party favor goodie bags kept my little social butterfly busy for awhile, and she was quite pleased with the results. She decorated the cookies herself with a pig snout and pig-shaped sprinkles delivered across state lines from Pennsylvania to Texas by our uber-thoughtful friend, Debbie.
Birthday gifts for our little piggie included all of her favorites: cucumbers, wasabi peas (yes, she likes it spicy!), and strawberries. Part of her birthday feast was a chunk of watermelon, which she thoroughly enjoyed and hastily demolished.
Two thumbs up for the twice-baked potatoes, which disappeared before I had a chance to snap a photo. My favorite girl has always had a huge love affair with potatoes, so it was no surprise to find them on the menu.
And then came the highlight of the evening: the birthday cake! We scooped out a little of the cake batter and added extra carrots to bake a special (and portion-controlled) cake for the birthday pig. Miss Piggie needed a little help blowing out the candle; we were afraid she’d eat the whole thing, flame and all!
Friday was a very exciting day for my favorite girl and her little piggie. They were asked by our fabulous school counselor, Mrs Prine, to be the Grand Marshals for the annual kindergarten Pig Parade at our school.
This is a big deal, as everyone in our school looks forward to the Pig Parade. We have a rather large school, with more than 800 kiddos, which meant a lot of exposure for our little piggie. Lucky for Macy and Piper, Mrs Prine is an animal lover with great ideas! Sadly, Mrs Prine missed the parade because she was a teeny bit busy welcoming her first grandbaby into this world. So Mrs Prine, this blog is for you; one day when Baby Jude is a little bit older, you can show him these pictures and tell him that this is what was happening in one corner of the world on the day he was born.
I had hoped to chronicle this special day earlier, but am having epic computer problems. I’m a Mac girl through and through, and something is seriously wrong with my iPhoto. This troubles me greatly; :iPhoto won’t import my latest photos because it doesn’t recognize them. Before my in-house IT guru could figure out the problem, I resorted to emailing myself each and every photo you see here, then manually importing them into my blog. Tedious and time-consuming, to say the least, so please…humor me and gaze upon these photos.
Letting our little piggie loose at school could have been a big ol’ mess, but instead it was a great time with just a little big of mess involved. This is a live piggie, after all, and our little piggie is a bit opinionated and sassy (we’re still trying to figure out how that could have happened).
So the deal is that every year, the kindergarten classes at our school have an at-home project to create a pig. Once everyone has created their porcine masterpieces, the piggie projects are carted up to school and the kindergarteners parade through the entire school carrying their creations while the rest of the school gazes appreciatively from a seated position in the hallway. Every single one of the kids in grades 1 through 5 sit in the hallway in a single-file line and watch the kinder kids proudly walk by with their pigs.
When it was Macy’s turn to take on this project, nothing could have tickled her more. She’s been a pig-lover her whole life, so having the chance to make and present a piggie was her idea of heaven. Being the queen of accessories, she gave her pig big hoop earrings and giant kissy lips.
This year’s crop of pig projects were mighty fine. I especially liked the eyelashes on this one.
This guy was very proud of his curly-tailed pig, and wanted to be sure I noticed his pig’s fluffy legs. He told me in a very loud voice that his pig has THE FLUFFIEST LEGS IN THE WHOLE SCHOOL! Indeed it does.
Just before the parade began, this guy was crying on the couch,unable to find his pig head-dress. After I inquired about his wooden pig, he cheered up and even managed to smile, although he never did find his head-dress.
At long last, it was time for the parade to start. Getting multiple classes of wiggly, excited 5- and 6-year-olds lined up and orderly seemed like an impossible feat, but those wonderful teachers at Austin Parkway Elementary know what they’re doing, and in short order the kids were ready to march. Note the long line of pig owners decked out in their head-dresses behind the Grand Marshals.
Piper was nonplussed about the whole affair. She was likely wondering how to get back into the hallway that contains all the lunch boxes and snack bags.
Hold the phone — in addition to the Grand Marshals, there’s another special guest: a certain middle schooler who made a return visit to his alma mater for the big occasion. This Big Kid walked the entire parade route in lockstep with his little sister, stopping to greet his former teachers and answer questions such as, “You are making straight A’s, right?” and “How many girlfriends do you have?” The best moment for him, however, came when the parade passed by the 2nd grade hallway, and one bold second-grader called out to the Big Kid, “I like your pig, little boy!” The Big Kid and I are still chuckling about that.
The parade meandered by each grade’s hallway, with our little piggie leading the way. Macy carried her most of the way, and yes she is a bit of a load. Our little piggie walked some on her leash, but made too many unscheduled stops to sniff and root at the carpet. She also proved to be a bit too tempting for some of the audience members to resist, and more than once a pair of small hands reached out to touch her before being reprimanded by the sharp-eyed teachers.
One of the moms directing traffic for the photo shoot decided it would be fun to have Piper in the picture, too, so she joined the kids on the hay bale. She was a very good sport about it and wasn’t the least bit bothered by all the hub-bub. In fact, she was so relaxed she took care of her morning doody off the back of the hay bale without hesitation. A bit later, she relieved herself on the hay bale, as well, thankfully in between photo opps and discreetly enough that no one noticed, and no one asked why I was flipping the hay bale over, either. Once her business was concluded, it didn’t take her long to realize she was on a giant block of hay, and she started chomping away. Each photo snapped by the kinder moms shows her stuffing her face with hay. She is a pig, after all.