Medicare & HMO Part II

So. Have you noticed how many people start their explanations with the word “so?”

So keep an eye or ear out for it.

So anyway, if you read the previous diary entry, you’ll see that my nursing aide faxed back the TERMINATION OF HMO form and got a receipt.

Then I called Mt. Sinai Hospital (a few days later) to find out if my HMO had been canceled because they were making it impossible for a stroke / crohn’s patient to see his doctors, and I was told they still had Mt. Sinai HMO as my go-between.

Do you begin to get the idea? Something somewhere in this system is seriously broken. In the meantime, while waiting for the HMO to be canceled I get a request for payment from the HMO.

What do they want payment for? The usual thing: some procedure that they say wasn’t covered because the doctor who did the procedure didn’t accept something, either Medicare or the HMO I was trying to cancel.

It was around that time that I began ripping all bills dealing with my stroke in half and placing them in a large black plastic trash bag. The kind you might use for raked leaves.

Within a week it was full. I never opened the letters any longer. I just ripped them in half and tossed them.

Eventually, everything worked out. I called one day about two weeks after faxing the form and was told by the hospital that I was welcome back. My doctors could now see me with straight medicare.

So, as Robert Blake used to say, and that’s the name of dat tune.


One of the things that reminds me of that tiny HMO incident is that for 4.5 months in the Castle (as I call Assisted Living) I’ve been working on getting the $250 in supplemental state income, they promised when I was sitting at the intake meeting, as well as the Medicaid money to pay the rent here.

That process also involves a bunch of missed faxes, and screw ups on all sides. A few minutes ago, there was a knock on my door. It was the INSPECTION CREW.

I knew they were coming at 9:30 a.m. because someone left a xeroxed piece of paper on the outside of my door: INSPECTION. 9/18 9:30.

I had had an inspection a few months back, but must have been outside when it happened. I always pictured a sort of prison inspection where they’d flip over your mattress and pull everything out of your drawers looking for contraband.

Or maybe (as they did at Cardinal Cooke) tell me the few things I had on the window sill were a fire hazard, and had to be moved. In that case I had a few pats of butter and they were kept by the window to keep them cold (it was winter).

But back to a few moments ago: I say, come in. It’s the head nurse (who I like), the one social worker that’s remained here, and Dot who walks and acts like a model om the Price is Right.

The nurse just looks around. Asks where I keep my medicine. (I have a single joint in that drawer, wrapped in saran wrap, in a tine cigar box, in a tupperware container, all enclosed in a green bag.

It’s not that I’m trying to hide it, it’s just that there is a blue shirt here who can smell a whiff of unsmoked pot at 200 paces.

So she looks around the room. I offer her a cup of coffee which I’m sipping. And she says, can’t get anything done without coffee.

I tell her a story I heard about the French author Balzac. Apparently he drank something like 70 cups of coffee a day. Chewed coffee beans. And wrote tons of novels and short stories.

She laughs and says, I could do that here?

And then the Social Worker says, I just talked to Sterling [Bank]. They said your debit card (the thing that lets you actually take money from the Sterling ATM on level C) will be here in 7 to 10 days.

Why is that the magical number: 7 to 10 days.

Are those business days, or any kind of days? I don’t bother them with the dumb things my mind circles around. The model turns on her heel and leaves, followed by the Social Worker, and it’s all very pleasant.

She and I began on the same day.

She’s Polish (I think) with bright red hair, and I say to her, so how has it been going.

And she fires back: oh fine. (Laughing) I’ve been behaving myself.

Me: I don’t believe you.

Nurse: Well. Not totally behaving myself. Life’s too short. You know that, don’t you?

Me: Yep.

Nurse: I’ll see about those beans.

And the door closes. I go to the phone, to see who called. I can’t understand the voice at first. I listen to the recording which is mumbled three or four times until it dawns on me what the woman is saying:

Hello. This is (garbled) from Terrance Cardinal Cooke for Mr. Beck[garbled]. There are initials on the call: LTC. I know, they want a few hundred dollars from me after abusing me for a month. A cold day in hell…

WhatIsItt

Anyone happen to know what these things are called?