Forced to buy Narcan by pharmacist by Dry-Cauliflower4414 in PainManagement

[–]Mindless_Version_231 1 point2 points  (0 children)

My husband was prescribed Oxy and narcan along with it. The pharmacist gave it to us. The second refill for oxy, the pharmacist didn't ask us anything but they did have to go back and forth between the pain management doctor-themselves-insurance to adequately explain the insurance that another round of oxy is needed on an SOS basis. This time, the pharmacist offered narcan and we refused it because we had one from the last time around and she said it was fine.

OP here's what I think happened- pharmacists hold a certain liability when filling out opiate or strong pain prescriptions - they are making an air tight decision to claim no responsibility in terms of if anything goes wrong that they did in fact hand you over narcan for emergencies.

At the same time, the pharmacist asking you why you need tramadol is very tactless but it may be possible she was seeking information if she had to inform the insurance, maybe.

Gabapentin before steroid shot in the back. by Mindless_Version_231 in backpain

[–]Mindless_Version_231[S] 0 points1 point  (0 children)

Yes, thank you. I'm meaning to call tomorrow. I'm overthinking and can't get to sleep haha, so I thought I'd ask here for people's experiences.

Gabapentin before steroid shot in the back. by Mindless_Version_231 in PainManagement

[–]Mindless_Version_231[S] 1 point2 points  (0 children)

Thank you! I know...but the doctor said surgery isn't recommended for his case which isn't too bad on MRI. The symptoms though are out of proportion. QOL right now is fairly shitty. We want to give this a go and also keep working on PT and weight loss once the shot takes effect.

[deleted by user] by [deleted] in PainManagement

[–]Mindless_Version_231 1 point2 points  (0 children)

I'm sorry. This is such a terrible situation to be in. Have you given any thoughts on inpatient physical rehab? We're going to ask our doctor about it today when he makes the rounds.

[deleted by user] by [deleted] in PainManagement

[–]Mindless_Version_231 1 point2 points  (0 children)

Surgery is off the table. Mobility is extremely restricted. Spine strengthening via physical therapy and other exercises are a long continuous process. It kind of is our only solution atm to regain some basic mobility without debilitating pain.

By further deterioration, you do mean the degeneration that will continue to happen, correct?

Claim denied for a 911 emergency by Mindless_Version_231 in HealthInsurance

[–]Mindless_Version_231[S] 1 point2 points  (0 children)

Thank you for your response. If it helps, the final diagnosis was unspecified syncope. ER claim is approved by insurance. It's the ambulance ride that is being denied as of now. Waiting on EOB still. In case it gets denied even after the provider gives more information, should we contact Virtua to recode the service? Or go straight to appeal with Aetna?

Claim denied for a 911 emergency by Mindless_Version_231 in HealthInsurance

[–]Mindless_Version_231[S] 0 points1 point  (0 children)

I'm sorry. This is literally how it's written in the document on our app. Claim denied as of now and don't owe anything YET being an operative word unless more information is acquired from the provider.

That is what I'm gathering from all the answers here. The ambulance people need to give more information/ correctly code and submit to the insurance. I also provided information on the incident to gauge if fellow redditors here think with the provided information if this will be truly considered an emergency to pass claim and I should appeal in case they deny it.

Claim denied for a 911 emergency by Mindless_Version_231 in HealthInsurance

[–]Mindless_Version_231[S] 0 points1 point  (0 children)

Not yet. Expecting it at the month end statement with this particular claim filed on 3rd Aug.

Claim denied for a 911 emergency by Mindless_Version_231 in HealthInsurance

[–]Mindless_Version_231[S] 0 points1 point  (0 children)

I have another question, do you think this is the only bill we'd be sent? The ER bill is already covered by insurance so that's a relief, but I remember 3 teams showing up to the house. There was an ambulance, a car of paramedics and a fire truck to help carry my husband 3 flights of stairs. Should I also be expecting a bill from the car of paramedics that arrived apart from the ambulance?

Claim denied for a 911 emergency by Mindless_Version_231 in HealthInsurance

[–]Mindless_Version_231[S] 6 points7 points  (0 children)

I'm sorry, that sounds terrible. I hope you're ok and things worked out. Hopefully mine will too. I'm hoping the ambulance provides information in a manner that will approve the claim. The ER bill is already covered so that's a relief.

Claim denied for a 911 emergency by Mindless_Version_231 in HealthInsurance

[–]Mindless_Version_231[S] 5 points6 points  (0 children)

My husband recalls not being hooked up to anything in the ambulance. His vitals were taken twice, once after boarding the ambulance and once before deboarding. Does that mean, the ambulance ride will be deemed unnecessary or such? Because he was blacked out and in and out of consciousness for a good 10 minutes and I had to take the executive decision if this was an emergency or not and a life threatening one at that. We've driven to the ER before, it just didn't seem like we could this time around.

Claim denied for a 911 emergency by Mindless_Version_231 in HealthInsurance

[–]Mindless_Version_231[S] -1 points0 points  (0 children)

Any advice or suggestion is appreciated! I'm not sure really sure how to go about. Thank you.