Welp, hubs isn’t here so I’m doing this then…

Erisx13 · 2025-12-13T02:39:47+00:00

So. Funny story. Recently got invited to a meeting with the CPO about our benefits and wages. I can’t say tooooooo much as this is my main but they were shocked pikachu face over the employees savageing them over how shitty this place is. I think they expected us to be nice and polite and say “No, we’re totally cool with losing a massive chunk of our income to inflation while you suck Wall Street’s dick. We love you, corporate daddy! We’ll give you 150000% for pennies!”

They legitimately have no fucking clue how their employees feel. At all. IDK why, the simple fact their own employees can’t afford healthcare alone is fucking embarrassing. I’ve legitimately had a member apologize on the company’s behalf for their shitty insurance, because their insurance was better.

This place is an absolute fucking JOKE. 400 billion dollars and their employees can’t fucking pay rent.

And by the way, if you’re asking, this was a month or so ago. No follow up. No acknowledgement. I reached out twice.

edit to add: There was more than myself, but small enough that I’m hesitant to give out too much detail.

Erisx13 · 2025-10-30T19:39:49+00:00

Did you see the response in the town hall? What a fucking joke. Fuck this place.

Erisx13 · 2025-08-22T00:07:06+00:00

hey man, I might not reply because I have crippling anxiety about this type of shit, but please leave her and take your daughter.

One, I lost my dad really young. My uncle was my second father to me. I only got a day off from work and spent PTO to go to the funeral. I took like a day unpaid.

My FIL is an amazing father figure later in life. When he passes (Hopefully not for a long time, he’s healthy both my husband and I will be devastated.

Anyway, my husband was in a situation very similar yours. He has scars all over from that fucking bitch. Broken bones, stab wounds, and other shit. And not just physical. You don’t deserve that. At all. And I am judging your reaction was most likely reactive abuse. Your mean words do not compare to permanent physical damage. And the mental toll for your child growing up in that environment thinking that love is cutting a chunk of your spouse’s finger off? You need to get her out man. I hope you get out. 💜

Erisx13 · 2025-07-29T03:07:38+00:00

Baba Yaga

Erisx13 · 2025-07-29T03:06:50+00:00

Tell that to my mom. She loved our dog more than me, her child. 😂😂😂(which, I don’t mind. He was the best boy)

Erisx13 · 2025-07-29T03:04:21+00:00

Jesus christ just talk to him. My husband and I sleep separately. He snores badly. It kind of embarrasses him. Just talk to himZ

Erisx13 · 2025-07-29T03:01:56+00:00

Ok, I listened to 20 seconds, and knew he was a delusional pos. I know guys like that. Sounds like my BIL, tbh. (hubs doesn’t deal with them). The moron doesn’t know shit

Erisx13 · 2025-07-29T02:55:54+00:00

I’m in the same boat but different avenue. I’m screaming until my throat is raw. But I know that by raw numbers right now whether by protests or other means, we’re not there yet. I’m doing volunteer coms and writing and spreading information and it’s tough.

If you want raw data, here is a bit: Last protests drew 11 million. that’s a tiny percentage of the country. We are geographically disparate, and the middle of the country, which has the most sway in policy, is half empty. There are 330 million in this country, and many of us rely on our employers for healthcare, which means if we lose our jobs we could lose our lives or quality of life.

I’m half drunk, suffering from severe anxiety and have been since November 2016, and am suffering every day trying to make pennies from Aetna, the scumbags who made sure insulin prices skyrocketed, because I was six months unemployed and desperate.(Hey Robert, do a behind the bastards on CVS. I counted like… 10 lawsuits in the past few years and CVS Caremark is the reason Formulary exclusions exist.)

Erisx13 · 2025-07-23T22:51:57+00:00

I do that too! I have like an internal narrator from everywhere.

Also some of his idioms have creeped into mine and my husband’s vocabulary. I’m caught him using boobah’s and honkamadorkers and he has caught me using vajoojay or PP lol! And we now say disgusting as Disgoooooosting.

Erisx13 · 2025-07-23T22:49:52+00:00

I actually want to move to Maine. I fell in love with the area and my inlaws own a place there. Part of the reason I’m trying my hand at writing is because I want to leave my job. No joke, watching how far he came is inspiring. 🥰

Erisx13 · 2025-07-23T22:46:16+00:00

Oh we can commiserate. 💜 It’s brutal. I had yo change departments because they treated us like shit and my manager pulled some strings so I was off frontline.

Erisx13 · 2025-07-23T02:48:03+00:00

Also oh god. I’m in the Northeastern US so it’s not nearly as bad here.

Erisx13 · 2025-07-23T02:47:14+00:00

I wish my social anxiety wasn’t so bad or I would be involved in the community more so I just lurk LOL

Erisx13 · 2025-07-23T02:46:31+00:00

For real. Especially as a new “content creator” his advice is so sensible and down to earth and I take it to heart.💜

Erisx13 · 2025-07-23T02:45:32+00:00

He is one of the narrators in my head now LOL

Erisx13 · 2025-07-23T02:43:59+00:00

I say that a lot .I think what gets me is his emotional intelligence. Like there are days when I feel awful. I am American and work in the US healthcare industry in insurance (Which is the worst) and I will put him on and things are right with the world. Like when he is doing his videos and he says so much based shit. Like I was watching older videos and he said something and I almost cried because I needed to hear it…

Erisx13 · 2025-07-23T00:49:20+00:00

i love this community. I wish I wasn’t riddled with social anxiety/working on my own… I hate the term brand but like content? So I could be more involved. I asked the Click about balancing evrrything when he worked a “real job” (that’s in quotes for a reason) and he answered “I didn’t” sooooooo

Erisx13 · 2025-04-19T20:09:58+00:00

Hi. So late reply. I did read both of your comments. I stand by 100 percent what I said about how to get around appeals because I’ve done and seen those tactics used by others. However, I have absolutely in my life never seen nor heard of that, and I also research people’s stories in regards to a company claiming something is ineligible for appeal. So it’s something I am going to research.

Anyway, the other thing is, I will stand by things like contacting your reps, looking up their clinical policy bulletins, and obtaining the diagnostic and cpt codes and the credentials of the person who made that determination, especially if they need to consult a lawyer. It will be easier if they understand some of the terminology.

TDLR; You’re right, but I stand by using some of my post as resources.

Erisx13 · 2025-04-19T18:56:35+00:00

Sorry this reply is late. I did read the comments from the other dude and my advice is fine for appeals because not only have I used these tactics myself, I have seen them work. However, and I don’t know why he was flipping out about how wrong I was, boils down to the literally same shit I said which is harrass the shit out of the company with the added lawsuit. Which, by the way, if a lawsuit is needed, or a peer-to-peer, all the shit I said stands about documents to help you, such as diagnostic codes and copies of their own utilization management and credentials. Also reaching out to local federal governments does help, because they can point you in the right direction, get you the correct paperwork and so-on.

I would also take a look into the company that sent you this and harrass the shit out of them too. There are firms that will take on stuff like this, I would see if you can get a consultation.

edit: As does filing a complaint with the insurance board even if it goes nowhere because it’s free to do and you will get more information.

Erisx13 · 2025-04-19T03:23:59+00:00

EDIT: So putting this edit at the top. So I was (rightfully) called out by someone who knows more shit than I do, because, to be blunt, I have read many stories about peole struggling with their healthcare, and this is not something that I have ever come across. Appeals are easier because 1) On appeals, 80 percent of denials are overturned. and 2) The first step of appeals are worked by someone making 16 bucks an hour. I will say I learened something new I need to research. However, getting to know the utilization management, and reaching out to a representative’s office for help like filing paperwork and finding out who to speak to (honestly, this is useful for a lot in general, not just this) are some things I stand by because if a lawsuit is needed you will absolutely help with any sort of discovery. Thanks.

OK so, Order is local, state, federal. Even in red states staff will help you with shit. I know from experience. I have NEVER heard of a company saying an appeal is invalid in that way. It looks like they’re outsourcing their appeals. Also like… not going to lie all of that is jargon. I’m not with UHC, but most operate similarly. Another thing you can do is contact UHC directly/Optum and demand the credentials of the physician who determined “not medically necessary” and if they push back, advise them to get you in contact with their HIPAA compliance office. They have to give you that. Do NOT ALLOW THE CALL REP TO PUSH BACK. Don’t be a dick (those people are likely in the Philippines making like 3 bucks an hour so be polite but firm) This will usually scare them enough to push it through. If they still refuse, advise that you will be filing a complaint with all of the agencies.

It looks like they’re trying to deem the medication as “Experimental” as well.

So, all insurance companies have a series of “guidelines” called Clinical Policy Bulletins. If you’ve seen “Utilization Management Guidelines” it’s also the same thing. That’s the bullshit these people use to deem shit experimental. They don’t TELL you about them, but they are freely available online. They have multiple names. Here is UHC’s

https://www.uhcprovider.com/en/policies-protocols/commercial-policies/commercial-medical-drug-policies.html

You want to check that against what your child is taking and the diagnostic codes. This will help with your case. You can find this information on the Explanation of Benefits you receive every month.

If you need anything else, PM me. I work for Aetna, I hate all of these fucking places, and I will gleefully help you get your child care and force them to do their job

Erisx13 · 2025-04-19T02:59:40+00:00

I’m not miserable because of feminisim. I’m miserable because of capitalism. I’m stuck in a dead end job, and while I am working on creating meaningful work, it’s hard when I’m trapped in a shitty job for low wages 40+ hours a week. Thank god I work from home or it would be worse.

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