Saturday, July 24, 2010

Insurance Units

In the mail today, I received a letter stating that my insurance company has, a mere 46 days after being abandoned by my old plastic surgeon, approved a referral to what I hope is my new plastic surgeon, Combat Doctor's Young Partner, now known as Dr. CDYP. (Whose name you wouldn't believe even if I told you.)

The letter states that I am allowed one "Treatment/Unit" and this expires October 7.

A treatment unit?

What the heck is a treatment unit?

Reading further, I see that I am allowed this: Office/Outpatient Visit, New.

I already have an appointment for July 30th.  This Office/Outpatient Visit will be considered my 1 Treatment/Unit.

In a strange coincidence, there was a TV show I liked very much called The Unit. It starred the dreamy Dennis Haysbert, who played a special forces leader who often saved people in peril from evil governments. He also showed up on some of my cancer meds packaging materials.

Is this some sort of sign?

During this upcoming treatment/unit, can Dr. CMYP do some actual treating? Because, I'm thinking about having him remove some of the saline in my expander and relieving the pressure. I've been having some pretty extreme, stabbing pains in that area, especially if I move my arm, likely due to sleeping on it. It feels like it's moved out of place too, so I want him to check that. Would that be one treatment unit, or two?

What about surgery? Taking out the expander and putting in an implant is how many treatment units?

Who requests these units from my insurance company? Oh, the letter says it, sorta.  "When applicable, authorization for additional care or visits may be requested by the specialist or provider above."

Do you know how many doctors' names are "above?" Four, including the doctor who broke up with me. Which one requests these additional treatment units? I hope Dr. CDYP.

The fact that my treatment unit expires is alarming. I have had the damn expander in this long, I decided that I would schedule surgery during a school vacation so as not to impact my job. That means it would have to stay in until Thanksgiving time, or even Christmas. I could, I suppose, surround labor day with surgery and just take two days off - I really would like this thing out of me, especially now that it feels like I'm being stabbed from the inside - but I doubt that things happen that quickly anymore.

But, if these treatment units are going to expire, I may not get a choice.

I wonder if this is some sort of communist plot to ration healthcare. Instead of procedures, surgeries, hospitalizations and visits, we will be getting treatment/units. Breast cancer? That is 5,000 treatment units. Use those up, and you are done.

Where's Dennis Haysbert when you need him?

On my letter



  1. Let me suggest 1 Unit = 1 Boob. When I had a baby many years ago the Dr call my Uterus a Unit.

    Just a thought....

    Judi G

  2. My sister-in-law is an RN. She use to work for an insuracne company making decisions about what they would and wouldn't approve. She is not even a doctor! I think you're right, we are going to see more and more of this and soon they'll view reconstruction as an elective procedure and you'll be getting a letter of denial! Get involved with American Cancer Society's Cancer Action Network, This kind of run around has got to stop.

  3. Gosh ... makes me realise that things are so different over there ...


  4. This is pretty different for me too - never heard of a treatment/unit before. I am going out of network which is probably why they phrased it like that.

  5. OMG - it's crap like this that really makes you feel special, that they are treating you like a human being and not a number, eh? Sheesh!

  6. Long time ago, I worked at a company that did post admission chart review for Medicare in Georgia. The vast majority of the employees were RNs, and all they did was review patient charts and determine how Medicare would pay reimbursement to the hospitals. We've been numbers for longer than any of use want to admit.


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