UJRefugees.net

Antknot wrote: ↑Fri Jun 14, 2024 6:37 pm

disco.moon wrote: ↑Fri Jun 14, 2024 5:34 pm ^^^ that's crazy! All insurance sucks.

Well I put together a really great email yesterday and then I had a team's meeting. I told them I want to start with one Clinic learn it really good and then I will move on to the other clinics. They were all very happy that I was not leaving. It's kind of crazy the giant machine really sucks but sometimes the people in the periphery are pretty decent. Today has been much better and much more calm. I got to admit I would have definitely missed out on having a corporate paycheck every two weeks LOL

Hope your work life continues to improve.

Thank you!! I don't think it hurts that the district manager is a guy and he seems to be a lil sweet on me .... I'll take it to get ahead!! #girlboss

It sounds like you're dealing with a really tough situation, and it's completely understandable to feel frustrated and overwhelmed. If you're feeling burnt out and unhappy in your current role, it might be worth exploring other career options that align better with your passions and interests.Ik it's corny but sometimes a fresh start can be exactly what you need.

hawkfan8812 wrote: ↑Wed Jun 12, 2024 3:09 pm I know you know HIPAA

For most government acronyms that people insist on pronouncing like a word, and you have to type it out.....

If it looks right - it's wrong

So now that it's been a good while I know exactly what it is and you all are gonna know too because I'm going to actually help you out on this....

I'm a pre-certification specialist for Specialty Pharmacy medications; things like Dupixent, Xeljanz, Taltz- mostly biologic medications for things like psoriasis, alopecia, and vitiligo. But also injectables like GLP ones. So that being said I'm the person that receives the prescription from the doctor and if it requires a prior authorization I submit a form and it either gets approved or denied.

When it gets denied I get to argue with the prescription benefit management plan for your insurance companies. So if any of you have had to wait for medication and they tell you it needs a prior authorization it's because someone like me is dealing with thousands of these a month.

Pro tip make sure every single piece of your address, phone number, zip code everything is perfect and matchable. So many people have a different fucking address or there's some fucking problem with you know their insurance having a slightly different name than their actual name at your doctor's office that kind of shit slows the process down so much. Also if it's taking a long time to get your medicine don't call your doctor's office, don't call the pharmacy, call your insurance company!!

Antknot wrote: ↑Wed Jun 12, 2024 1:11 pm Cheesy‘s advice is good. All I can I add is don’t make a decision right away.

Realizing that this thread was made like the second week of June blows me away because I feel like I've done a tour in 'Nam.

But God damn it you guys I hate the insurance companies- I'll show you an example tomorrow when I'm on my work computer of the forms that they make people like me fill out. It's like a take on those tricky personality tests that they give you when you're applying for a job sometimes. Were they ask you the same question just in different ways to throw you off. I have seriously gotten to where I will just write 'PLEASE SEE THE ATTACHED VERY DETAILED CHART AND CLINICALS' lol.

One question the other day was "Has the patient recently ben hospitalized for more than 10 days?" Y _ N

I answer N then a fucking box shows up with a calendar and it's a "hard stop" which means I HAVE TO ANSWER IT. Even though I answered N.

Different prescription benefit management plans use different forms. It's a whole thing - like I've asked everybody I say "So this is a trick right? Like this is a trick question right? They want me to mess up!" And the answer is always the same. And it's not like the person on the other end is like a trained medical professional. They're also just filling out a form and they have the buttons on their end to say yes like it's no skin off their teeth if they say yes you can have this medication but it will show in analytics that they've not denied enough claims.

The only time an actual medical professional gets involved is when it is in the appealing stage for instance there was a girl 12 years old who has really bad psoriasis needed to fix it actually they had already given her injections in the office so she was just wanting to reimbursement the insurance company said no twice so then I got turned over to some higher ups in my company to draft a wonderful letter you know stating medical necessity yada yada. After about 20 days it was approved the appeal was approved. The letter that I received was by a medical doctor with credentials and whatnot so he just looked at a medical chart that a doctor sent him and he said yeah okay.

So they just want to see if someone's going to go that far to get this medicine. Cuz a lot of people give up you know they'll just give up and take whatever their prescription benefit plan wants them to take. And if they have to have a copay or whatever I am the person that can get them the forms for the savings cards or a Year's worth of medicine you name it.

It's just a big racket though it's unsettling it makes me angry and Incredibly stressed out sorry I'm just rambling cuz I'm on three gummies and it's late and I am using voice to text. At least you guys will have a lot to read in the morning!

Also if anyone knows law - am I whistle-blowing?!

I’m not a lawyer. And I didn’t stay at a Holiday Inn express. But I don’t think you broke the law.

Those trying to get reimbursement from Delta for the CrowdStrike fiasco can relate to this...

Antknot wrote: ↑Sun Aug 11, 2024 3:15 am I’m not a lawyer. And I didn’t stay at a Holiday Inn express. But I don’t think you broke the law.

Damn.

WarmBidetWater wrote: ↑Sun Aug 11, 2024 1:02 pm Those trying to get reimbursement from Delta for the CrowdStrike fiasco can relate to this...

What's crazy is that did not affect my company or my region. The hospital system I work for covers Jersey, New York and Connecticut and I don't think we had any issues.

Everyone I tried to do business with that day on the other hand....

i bought a protein tub for cattle from Tractor Supply that day and their cash registers were down. I had to pay cash and the guy had to figure out the amount on his phone. Fortunately I had a tax exempt certificate so he didn't have to do percentages. I hope this helps.

Animal wrote: ↑Sun Aug 11, 2024 11:19 pm i bought a protein tub for cattle from Tractor Supply that day and their cash registers were down. I had to pay cash and the guy had to figure out the amount on his phone. Fortunately I had a tax exempt certificate so he didn't have to do percentages. I hope this helps.

Hmm it might. I'm adding it to my spreadsheet nonetheless.

I hate to hear it's been so rough lately Disco. Other than the gummies are you doing anything to blow off the stress?

Blast wrote: ↑Mon Aug 12, 2024 12:31 pm I hate to hear it's been so rough lately Disco. Other than the gummies are you doing anything to blow off the stress?

This summer has been incredibly tough. Family (boyfriend's) issues that have altered everyone's life. And this goddamn job. I haven't been swimming at all this Summer which is probably the first summer ever, legit ever that I've not been in water. I'm losing it.

disco.moon wrote: ↑Mon Aug 12, 2024 12:53 pm

Blast wrote: ↑Mon Aug 12, 2024 12:31 pm I hate to hear it's been so rough lately Disco. Other than the gummies are you doing anything to blow off the stress?

This summer has been incredibly tough. Family (boyfriend's) issues that have altered everyone's life. And this goddamn job. I haven't been swimming at all this Summer which is probably the first summer ever, legit ever that I've not been in water. I'm losing it.

Take a mental health day and go

Blast wrote: ↑Tue Aug 13, 2024 2:54 am

disco.moon wrote: ↑Mon Aug 12, 2024 12:53 pm

Blast wrote: ↑Mon Aug 12, 2024 12:31 pm I hate to hear it's been so rough lately Disco. Other than the gummies are you doing anything to blow off the stress?

This summer has been incredibly tough. Family (boyfriend's) issues that have altered everyone's life. And this goddamn job. I haven't been swimming at all this Summer which is probably the first summer ever, legit ever that I've not been in water. I'm losing it.

Take a mental health day and go

Hmmm. God that's a great idea.

I'll take one now and then to get my house caught up and spend the day in the shop, always worth it. Take the time, go hop in some water and spend the day only worrying about sunburn on your buttcheeks.

^ I wish! Part of my lameness this year is that I don't want to spend any more time in the sun. I have Irish heritage which means at this stage in the game I am pretty much covered in freckles LOL something happened in the last couple years and I look exactly like my ginger family.

I've covered myself in sunblock this year - zero tan lines!!

On a side note they gave me sort of a promotion because I've done so well at organizing this hairy situation they were in that I got a new title instead of specialist I am now representative and starting in September they're going to bring on two to three people and I get to teach them what I learned and I will lead meetings!

Dammit why did I sleep my way to the top so hard!!!1?

Wasn't it Gloria Steinem who said ~if women only sleep their way to the top why aren't there more women at the top?

disco.moon wrote: ↑Thu Aug 15, 2024 11:22 am ^ I wish! Part of my lameness this year is that I don't want to spend any more time in the sun. I have Irish heritage which means at this stage in the game I am pretty much covered in freckles LOL something happened in the last couple years and I look exactly like my ginger family.

I've covered myself in sunblock this year - zero tan lines!!

On a side note they gave me sort of a promotion because I've done so well at organizing this hairy situation they were in that I got a new title instead of specialist I am now representative and starting in September they're going to bring on two to three people and I get to teach them what I learned and I will lead meetings!

Dammit why did I sleep my way to the top so hard!!!1?

Trying to figure out how to properly comment on most of this post without sounding creepy as fuck...
Anyway, congrats on the job modification.

So, I did so well at my job that the corporation laid off $180 something people on September 13th. I have been receiving normal pay every other week until my Severance in december. So there's that!

Fuck. Sorry to hear that? Granted you did hate what that job had become. Are you looking already or enjoying the time off?

disco.moon wrote: ↑Mon Nov 04, 2024 3:24 pm So, I did so well at my job that the corporation laid off $180 something people on September 13th. I have been receiving normal pay every other week until my Severance in december. So there's that!

Damn. You’re smart. I trust pull land on your feet.

Blast wrote: ↑Mon Nov 04, 2024 5:16 pm Fuck. Sorry to hear that? Granted you did hate what that job had become. Are you looking already or enjoying the time off?

I am 100% enjoying time off and receiving my normal pay. I've already decided that I am absolutely not doing anything with a computer anymore. I have stared at a computer and worked on a computer since like 8th grade. I'm over the stress. I'm looking for a job, like, bog witch.