Wow, bad news and good news.

[ThomCat]

I spoke to my insurance company and found out what hoops I have to jump through to get them to pay for an "electric mobility device" aka Durable Medical Equipment. I have to go to a supplier that is on my plan. And my doctors have to convince the Medical Management Department that I really, truly need this and can't function without it. If I can do those two things then they'll cover 100% of the cost, up to some unspecified cap.

I called every on-network Durable Medical Equipment provider in Manhattan. The bad news is that only one of them handles electric wheelchairs and scooters. The good news is that there is one that handles electric wheelchairs and scooters.

On wednesday of next week I'll have the prescription. Then I'll find out how long it takes for the Medical Management Department (aka, the Medical Claims Rejection Department) to give in and approve it. And then I'll be able to go more than 100 feet without agony again.

It'll be nice to not have to pay for a cab every day.

Now I just have to figure out NYC paratransit.

[GreenPartyVoter]

1. Your're making progress. That's a good start.

[ThomCat]

4. I'm a project manager by profession, and I'm too stuborn to fail.

So making progress is a given. It's just a matter of how persistant I have to be and how many walls I have to tear down. :P

[GreenPartyVoter]

14. Heheh :^D

[JustABozoOnThisBus]

32. Project Manager, eh? We expect daily status reports on this.

Best of luck with the various "customer disservice" departments of your health plan provider.

[flvegan]

2. Good deal! Let the ride pimpin' begin.

Congrats on this.

[ThomCat]

5. It's a bit early for congratulations, but this is definitely movement

in the right direction. :)

[flvegan]

8. Well

if the script is a lock, then it seems inevitable. Gotta be positive.

[_testify_]

3. Some good info here, it seems.

http://pubadvocate.nyc.gov/services/transportation_disabled.html

[ThomCat]

6. Thank You Very, Very Much!

That is exactly where I need to go next. :)

[_testify_]

13. No problem.

I'm sure there are other good resources out there too.

[redqueen]

7. ...

:loveya:

[malta blue]

9. Glad you are able to get things started so quickly Thom.

:hug:

Hang in there my friend.

When do you leave for your trip?

[VenusRising]

10. Here's hoping it all goes off without a hitch.

Or at least with no major hassle.

:toast:

[billyskank]

11. It sounds like you decided against the drugs then.

I cannot even imagine. :hug:

[ThomCat]

17. Even if I go with teh drugs

It will be a while before they can get me started on them, and I need to get around in the meantime. So I'm going to rent somethign short term.

[FloridaJudy]

33. What kind of drugs?

Opiates are actually very. very safe if taken as directed. If your docs are concerned about addiction, there are sustained-release formulations that avoid the "high", but give great pain relief.

I also have a chronically painful condition - nothing near as bad as yours - that responds nicely to low-dose anti-depressants, so I haven't had to confront that option. This whole "War on Drugs" nonsense has doctors understandably skittish about prescribing narcotics, even when they're clearly the best choice for pain relief. It gets a little weird at times: for a while I was taking a non-narcotic drug that actually worked really well. It was abruptly yanked from the market when it was discovered that it also had the unfortunate effect of killing the liver in the occasional patient. Now my response to anything brand new is "Thanks, but I think I'll wait a few years. If it's still on the market then, I'll give it a try".

In the meantime I hope you get your wheels. Something permanent would be nice: then you could get it customized to your taste. Do they come in purple psychedelic paisley? There's a real market there for an entrepreneur; it's getting harder to get around for a lot of us who came of age during the sixties. A "Candy-Colored Tangerine Flake Streamlined Baby" would be a big hit. Something like this:

[Deep13]

12. Do the insurers think we are all just lamanting the fact...

...that we can't get electric wheelchairs to drive around in?

Wow.

[ThomCat]

18. Insurance companies lament the fact

that we use our insurance, instead of just handing them money free and clear. x(

They'll do anything to rationalize not paying out.

[KamaAina]

15. In the words of the immortal Charlie Brown, "Aaaaauuuuggggghhh!"

The red flag there is "on-network". A bas managed care! :grr:

What about suppliers in the other boroughs? That seems like the kind of space-intensive busines there'd be more of in the outer boroughs.

Now I just have to figure out NYC paratransit.

The following is a PSA from your local Center for Independent Living: (this post comes to you from a cubicle deep within its Hawai'i equivalent):

http://www.cidny.org/cidny/npo.jsp?pg=about

CIDNY Advocacy and Outreach: Throughout our history, CIDNY has advised government officials on ways to make public services, like transportation, health insurance, education and entitlements work better. We monitor public and private iniatives that affect people with disabilities and offer constructive solutions to problems we see. CIDNY conducts an array of training and technical assistance activities for public officials, health care workers, and other service providers on disability awareness and disability-related issues. CIDNY also provides information and workshops for its consumers on everyday skills, such as searching for housing, budgeting, transportation, housekeeping, self-advocacy, goals planning, and attendant management. For more information, click here.

And if you're wondering why you have to jump through so many hoops to get what you need, meet your friendly local scam artist (okay, this one's in Atlanta):

http://www.myfoxatlanta.com/myfox/pages/Home/Detail?contentId=4978763&version=1&locale=EN-US&layoutCode=VSTY&pageId=1.1.1

http://www.myfoxatlanta.com/myfox/pages/Home/Detail?contentId=4987043&version=1&locale=EN-US&layoutCode=VSTY&pageId=1.1.1

:grr: :banghead: :nuke:

edit: header

[ThomCat]

19. Thank you.

I am very familiar with teh Independent living centers in western new york, but I have to find them down in NYC.

Thank you for the links.

I was pricing scooters and wheel chairs today, and I was thinking that the price difference was ripe for abuse.

[cutlassmama]

20. That is why it is so hard to get Medicare to pay for one now...

because of the abuse that went on.

[LynzM]

16. That's good and bad news, for sure.

Ugh to the process... I went through similar to get my insulin pump, including lab tests and doctor's certifications. I hope that part goes quickly for you. I'm glad you have a supplier available in the area! :)

[ThomCat]

22. Hi LynzM!

I'd love to talk to you some time about the process. I'd love to hear anything you can tell me about what to expect.

:hug:

[KitchenWitch]

21. May the red tape be minimal and the fulfillment be rapid

:hug:

[ThomCat]

23. May it be exactly as you say!

:loveya:

[La Lioness Priyanka]

24. thom i am sorry that you have to suffer so much

i wish it happened to someone less nice and adorable.

why cant this shit happen to some asshat?

[ThomCat]

25. I'm know a few people who think is IS happening to some asshat.

:P

:shrug:
I'd rather that it happen to me than to someone else I know and love.

I hope your Thanksgiving goes well and is a lot of fun. :hug:

[La Lioness Priyanka]

27. i wish you were here. i am sorry i hadnt told you about it earlier

it was just very last minute as all my stuff is

[ThomCat]

28. Next year, if you think you'll do this again, I definitely would

like to be there. :)

I understand why it was a last minute thing. You had a lot of other stuff requiring your attention. So that's totally okay.
:hug:

[La Lioness Priyanka]

30. heather is coming so i am making a bunch of vegetarian things.

its why i miss you more :hug:

[ThomCat]

31. Please say hello to her for me.

And tell her I'm sorry we never got to check out some of the vegetarian restaurants together.

[Fire Walk With Me]

26. flvegan is right. Sorry it's come to this, but look to DU to pimp your ride.

Start by selecting which fine air freshening product we can send to you, and we'll take it from there. Do you want hubs that spin?



Sorry for making light; I'm sending good vibes and wish you the very best.

[ThomCat]

29. Making light of this is absolutely, totally okay!

:)

I make jokes about my disability quite a lot. It's the serious, unpleasant stuff that we all need to joke about.

I'm wondering what kind of sound system I'm going to install. :P

[Fire Walk With Me]

34. Nakamichi, which the writer Mr. Bonsai says translates to "Give us all your money"

:7

[FloridaJudy]

35. There's a whole site devoted to pimping wheelchairs

http://www.pimpmywheelchair.net/

Where do you think I found that picture? While I'm no fan of Jerry Lewis - I hate the way he infantilizes people with disabilities - these guys do some cool customizing for him. Now all it needs is a set of fuzzy dice and some rude bumperstickers.

[ThomCat]

38. That looks like an awesome organization.

It's not so much about how to "pimp" your wheelchair. It's an organization that customizes wheelchairs as gifts for people. That's really wonderful!

I'm going to look around for other sites that are more about hands-on instructions. :)

[YellowRubberDuckie]

36. I thought you weren't going to be able to get one...

...because of the grandfather clause there are no ramps anywhere. :shrug:
Duckie

[ThomCat]

39. There are a huge number of places I will not be able to go.

But if I don't have any choice but to use one, then I don't have any choice. :(

I'll also still be able to use my crutches for short distances, and hopefully on good days I'll be able to use my crutches more.

[proud2BlibKansan]

37. I am sorry this is such a hassle for you Thom

but glad you will soon have an easier time getting around.

Have a great holiday weekend! :hi:

[ThomCat]

40. Thank you!

:hug:

I hope you're having a great holiday too. :hi: