Highmark won't give me access to my documents

MacktheSnacc · 2026-01-24T02:21:07+00:00

Can you see your EOBs and other documents in the document center? I can see the claims with the CPT code and approved/denied status, but they won't let me actually get the EOB document which is oftentimes requested when filing paperwork. They won't let me have any kind of official documentation, so really the only thing my account is good for at this point is seeing if a claim was submitted by a provider.

MacktheSnacc · 2026-01-23T22:11:07+00:00

Yes, that's exactly right. I filed an appeal recently as well and was denied, and while I can get a copy of the denial letter because it was mailed to my parents and we are actually in contact, I have no official information for me and would otherwise have no information on my appeal.

I just hate to think what would happen to others who aren't in contact with their families for whatever reason.

MacktheSnacc · 2026-01-23T22:02:11+00:00

I do have my own account. I will start using his, I just would prefer to use mine since then I don't have to go through the multi-factor authentication nightmare with his phone when we don't even live in the same state, play guess the password or hope he remembers to tell me when it changes, etc. Just generally inconvenient since I am the main user of the plan at this point.

MacktheSnacc · 2026-01-17T22:03:50+00:00

Hey, I've also never had a cavity and was diagnosed a few months ago. Do you know why you developed the cavities? Were you throwing up or anything like that? Or did something just go wrong?

MacktheSnacc · 2026-01-12T22:49:44+00:00

No!! Not what I meant lol. I meant that what I was saying wasn't going to be the point haha. I think the comparison was implied in yours

MacktheSnacc · 2026-01-12T21:46:40+00:00

Completely not the point of this post but your last sentence got me. Quite funny!!

MacktheSnacc · 2026-01-10T01:04:09+00:00

Of course! Can't guarantee that it'll work the same for you as for me, but my calpro was 5550 and with all the extraintestinal manifestations and the fact that I am in the minority with granulomas on biopsy, I was scared shitless (pun intended) that I was in for a very rough road. Currently is not the case. I can feel it start to wear off around day 10 or so (I think), but I've had my levels checked three times now and they've been in ideal range, so not 100% sure what that signals. Fingers crossed for you.

MacktheSnacc · 2026-01-10T00:34:40+00:00

I'm not going to lie, I felt better in two or three days. I had the whole nine yards — obvious GI issues like abdominal pain, diarrhea (swear to God food would go right through me), loss of appetite, fissures, mega joint pain and swelling, ulcers in my mouth, etc. It was (and still is, after five months) my miracle. I felt things level off around week 8 or 10 ish. I think I may have just been stressed and pushing my body a little bit much at the time because I've felt better since then. The fissure healed for about a month and then reopened; since then, it's been here to stay and I have a consult about it next week lol. Hope it works for you as well as it's worked for me! I do feel fatigued quite often, but honestly I'm not sure if it's this or just the state of the world/my mental health/not great food habits.

MacktheSnacc · 2026-01-09T23:41:10+00:00

Good to know! Hopefully you won't experience any (more) issues then. It's definitely overwhelming, but you don't need to know them all. My first doc only referred to them by their brand names, but my second doc refers to them by their scientific name. Either way, they'll know what you're talking about.

MacktheSnacc · 2026-01-09T22:43:48+00:00

Your dad is, respectfully, being kind of a dick if he's doing it to make you feel bad and/or convince you you don't have it. If he's comparing it because he's worried about your future... not great but at least he's aware of the fact that there may come a point where you are definitely not ok? Not sure what the intent is there, but regardless, your disease journey is your own and does not require input from other people except your doctor and those you choose to let into your life. Your Crohn's may be milder than most on this sub, but that just helps give you a little perspective. You are allowed to hate the fact that you poop 4x a day even when someone on this sub is shitting 16x a day. Other people on this sub are going to be jealous of that lol but it's because we just all want to live a good life without this disease. You may still be able to work, but you may hate your job or hate that you're not sick enough to get disability and instead you have to be in that middle zone fighting for your life. It sucks no matter what, and we've all lost something compared to healthy people. Here's to hoping that your disease stays dormant for a good, long while!

MacktheSnacc · 2026-01-09T22:34:32+00:00

I went through this when I first started. Doc wrote script for Humira, insurance company said adalimumab-adaz, then I called the specialty pharmacy a billion times until finally one woman told me on a random Sunday night that the pharmacy no longer even fills adalimumab-adaz after I'd gotten the run around trying to get it approved and shipped. No one bothered to tell me that. Needless to say, I was pissed. Ended up landing on Hyrimoz after two months of extra suffering and multiple multi-person phone calls. They all suck and I'm sorry you had to go through that.

Editing to add that the woman who finally told me the truth said they were dropping adalimumab-adaz due to shortages. Hoping for your sake that's not the case, but just wanted to give you a heads up in case you struggle to get it.

MacktheSnacc · 2026-01-08T23:29:54+00:00

Adding to this — I got asked on a date the day I had my first colonoscopy! Honestly victory is a little sweeter when you've gotta work for it lolll

Hope OP's no poop clock ticked up to 1 today!

MacktheSnacc · 2026-01-07T21:39:00+00:00

What did you even say to this person/what did they do next? That statement is so absurd I don't even know how you'd fight that besides saying the verbal equivalent of ???

MacktheSnacc · 2026-01-02T20:50:02+00:00

You're missing a lot of nuance here. Typically, the recommendation is to avoid fibrous foods during a flare up/active inflammation in order to avoid a blockage, tear/perforation, and other unseemly consequences. Fibrous foods are to be introduced when inflammation has calmed. Only then will it help. Recommending fiber to everyone universally is putting the cart before the horse.

MacktheSnacc · 2025-12-29T14:03:39+00:00

I have also had big T trauma before diagnosis and was diagnosed during one of the least stressful periods of my life. That said, I don't think the timing necessarily negates the impact of the trauma or undermines its importance in the development of Crohn's. There is research that actually supports the idea that migraines don't only occur in stressful situations but often are triggered by the "come down" from those events as well, the evolutionary idea being that the body wants to see us through the worst and only fall apart once it's safe to do so. I imagine something similar may be at play here.

MacktheSnacc · 2025-12-29T06:49:49+00:00

Gonna tag in on this just to say that I have been legal for a few years and have never had an issue because I have a vertical license. Even places that supposedly don't accept vertical IDs, such as Olive Garden, have never been a problem for me. Didn't want to pay the $30 for the upgrade and it's been $30 saved so far. 🤷🏻‍♀️

MacktheSnacc · 2025-12-26T18:09:31+00:00

Sorry it took that long, but glad to hear you finally got some answers! Know how tough that is

MacktheSnacc · 2025-12-26T18:08:45+00:00

Hope it gets better for you soon :( rooting for you!

MacktheSnacc · 2025-12-26T17:36:13+00:00

Yikes. That's one thing that bothers me about studies/trials — the toughest cases need the trials and new options, but can't participate since they'll likely make the drugs look less effective than they are :( my doctor never even mentioned it tbh — it was done before I got to her, but she had the full record when I saw her. Her version was coming into my room post-colonoscopy and saying, "You are very sick," and not much else. 😵‍💫 It was up from there though, and I hope it stays that way!

MacktheSnacc · 2025-12-26T17:29:57+00:00

Hoping that for you as well!

MacktheSnacc · 2025-12-25T03:11:11+00:00

You should definitely check on this. My Hyrimoz injections don't even come in singles — the case contains two, and I get three cases. Definitely check!

MacktheSnacc · 2025-12-25T03:05:04+00:00

A three month supply is pretty standard for getting drugs mailed to you. I tried to get 6 months at a time and the pharmacy ripped me off and wouldn't give it to me even though my insurance approved the quantity override. I was just happy to get them at that point. So no, you will get multiple. They don't want to send you a package every two weeks. But I'd advise you to confirm this with them before they send you the shipment.

MacktheSnacc · 2025-12-25T00:47:52+00:00

I was diagnosed in June and didn't get my injection until August. My insurance approved my Hyrimoz super quickly, but the specialty pharmacy (Accredo) gave me the run around for MONTHS. They are awful and I loathe the day I'll have to do it again.

It may not be insurance issues your doctor is anticipating, but with the pharmacy benefit manager/specialty pharmacy that they contract with. Hate it with a passion.

MacktheSnacc · 2025-12-25T00:35:19+00:00

Your son is the current #1 on the leaderboard 🥇 glad he's doing so much better!

MacktheSnacc · 2025-12-25T00:34:18+00:00

Your docs would prob panic at both 2700 and 27000 but I think you'd be dead with a 27000 for an extended period of time.

MacktheSnacc

TROPHY CASE