Kickas.org Forums Ankylosing Spondylitis General Discussion #1 AS Web Support Group Simponi tastes bad

Meggie, that's whacky. I would insist on answers to the point of showing up at their offices with your approval in hand!!!

Oh I'm in just the mood these days to give them what for!

Warm hugs,

The (nurse and rheumy) verbally said I should go for it (I have nothing in writing - not even sure what they write in my chart) and that they'd complete the paperwork for coverage. Problem is, they haven't gone through with it. The pharmacy keeps trying to put the simponi through Blue Cross, and it's not working, saying the paperwork hasn't been submitted yet.

This happened before when I wanted to try remicade. It just never happened. They didn't bother getting around to submitting the paperwork... they explained it to me (and they were pretty angry when explaining it to me) that there were people worse than me, and they only have so many hours in the week to do the paperwork, and I just was never a priority. Not for months. Nice.

I keep calling and it goes through to voice mail (I think it's set up like that because no one has ever answered the phone before - all they do is call back).

Hesitant to get my GP involved because when he does, it really seems to tick off everyone at rheumy's office. I'll give them a couple more weeks and then maybe ask my GP's office to help out.

Sorry for whining about it - I just was so excited to finally try something that might help.

keep the hope alive! i think you have a good plan, just don't let them force you to give up trying it.

your rheumy and office sound like the rheumy i've been seeing here in town. most of the time the decisions don't come down to medical ones but rather the rheumy has stated many times over now when i ask for something: either: 1) "i guess i can do that, its cheap enough, the insurance company will probably let it go through." or 2) "i just want you to know, i'm not gonna be spending time talking to the insurance company in your behalf, i just don't have the time." or 3) "well, if you'll pay for it and it doesn't have to go to the insurance company for approval, then i guess i can do that." really never does the choice seem to be a medical choice, every time he brings up "the insurance company", not sure if he's merely using them as a scape goat or he just doesn't feel like talking to them anymore, at least for patients like me who aren't at home bed bound. at least once it would be nice not to hear the word insurance company when he prescribes something. like he prescribes prednisone cause its cheap and the insurance company won't mind (his words not mine) over say the dmards or biologics or even trying more nsaids; and yet pred is probably the most dangerous of all the drugs he could prescribe. so when he uses "dangerous" as his rationale for the other drugs, its just hard for me to buy that since he'll keep writing the pred scripts.

long way of saying, sounds very familiar, but i'd keep at them, wear them down if need be; but yet that fine balance not to [*bleep*] people off so they stop helping you all together. ah yes, the fine balance........but you will be trying simponi, just maybe will have to wait a little bit longer. but don't give up, never give up.

Grrrrr

don't every worry about whining, we got family connections to people in the wine business (just as long as you aren't terribly choosy, the vineyard is in South Dakota, not the South Of France )

Getting ready to ask Kat to join me on a gang-up at your rheumy's office, with Bridget along in case we run out of good curse words!

Meggie, your rheumy's staff have put you in an untenable situation and, frankly, it's pathetic of them. I wonder if a call to the College of Physicians isn't in order.

Hang tough, sweetie. Which I know you will. But honestly, it's abysmal of them to treat someone the way they treat you.

Love and hugs,