Monday, December 5, 2016

Week 172: Paper trail

Lemon's good health on the combination of levofloxacin and Flovent has continued, which we're very grateful for. The levofloxacin will come to an end on Friday (although we'll be continuing Flovent, since it seems to help), so we've been scrambling to get a new treatment plan lined up in case what ever this is comes back again. And we've been stymied so far by that well known delayer-of-things, paperwork.

And, yes, even in 2016 and even in the home state of one of the largest electronic health records companies out there (Epic), I am referring to actual physical pieces of paper. First, there is the actual physical piece of paper that our insurance company requires to be filled out to request authorization to see a doctor who is out-of-network. It's true that you can access this form as a PDF, but that doesn't do you any good because it's not a fill-able PDF, so you have to print it and then write on it (with one of those stylus-type things that contains ink). Second, there is an authorization form for the inhaled antibiotic that we want to try that has to make its way via fax from our pharmacy benefits company (which is distinct from our health insurance company) to the clinic, and then, after completion and signature, be faxed back to the pharmacy benefits company, who can then communicate their decision (with smoke signals, one assumes) to the specialty pharmacy, who will then fill the prescription, assuming all goes well.

Suffice it to say, none of this is moving fast enough. We got a call from the specialty pharmacy on Friday saying that they had received our prescription for Cayston, but that they couldn't move forward without insurance, and that our health insurance company was saying they wouldn't cover it, not because they don't agree with using it, but because they are not the pharmacy benefits company. When we called the pharmacy benefits company, they said they'd faxed the form to our clinic, but to the old fax number that they had for Lemon's former doctor who left in March. And when I asked the clinic if they'd received it, they said no, but helpfully gave me a "newer" fax number that might work better.  Sigh. So, anyhow, with any luck there is a number of phone calls and MyChart messages that will cause all this paperwork to be complete in enough time that something gets approved somewhere so that we will have something useful to do next time Lemon gets sick.

In the mean time, it is clear that winter is fully upon us, with our first (hopefully only) holiday party of the season followed immediately by our first snow. The kids were equally thrilled by both, so that did manage to knock some of chill out of my grinch heart. And, having two toddlers running around like utter maniacs at a party turns out to be a valid, socially acceptable excuse not to converse with your husband's colleagues that you see exactly once a year, at holiday parties. Both kids were really excited about the snow, Lime with a sense of wide-eyed wonder and Lemon with a sense of wild glee that his entire world had been transformed into some sort of fantasy playground. I think his ability to appreciate that there is some wisdom in keeping one's mittens on one's hands has really taken his relationship with winter to the next level!


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