I'm Blogging Again...

Please visit me at my new blog...

http://4mylifefitness.wordpress.com/

Where I talk about my health and fitness and life with my crazy kiddos and loveable hubby!

New Blog

Please visit me at http://thesheertruth.blogspot.com/.

I'm lonely over there.

Conversation with my Insurance Company

I love online help. You can document the convo for future reference. Or for blog posts.

Jolyn> Welcome to TriWest Healthcare Alliance Contact Center, this is Jolyn, Customer Service Representative. How can I assist you?
Sarah26> I have questions regarding referral # 0000000000. There is a car icon on the referral, are my travel expenses covered? If so, does it cover everything, ie food, gas, hotel?
Jolyn> Please wait while I check your eligibility and review your question. This should just take a moment.
Jolyn> TRICARE allows reimbursement of reasonable travel expenses related to health care, for Prime beneficiaries referred to a specialty provider more than 100 miles from the assigned PCM’s office.
Jolyn> Reasonable travel expenses are the actual costs incurred when traveling such as meals, gas/oil, tolls, parking, and tickets for public transportation (i.e., airplane, train, bus, etc.). You must submit receipts for expenses above $75. You are expected to use the least costly mode of transportation, and government rates will be used to estimate the reasonable cost. The actual cost of lodging (including taxes and tips) and the actual cost of meals (including taxes and tips, but excluding alcoholic beverages) may be reimbursed up to the government rate for the area concerned.
Sarah26> Ok. Thank you! Another question, I show that the referral reads as "Point of Service", will I have to pay a deductible or a percentage of the cost to see the doctor and any tests that are done?
Jolyn> Yes it it states Point of service it is a $300.00 deductible and you will be responsible for 50% of charges.
Jolyn> Is there anything else I can help you with?
Sarah26> I am seeing the Doctors at Mayo because they are the only neurologist that really know about my condition, Devic's Disease. My neuro in my area is excellent but I was given the referral to Mayo from that neuro so I can confirm my rare diagnosis. I was told that TriWest prefers I go to the closest provider in order to be covered and when I venture out of network, that's when I have to pay. Even with the Mayo Clinic in Arizona being the closest facility to properly diagnose my condition, the visit will not be covered?
Jolyn> Correct I am showing it was approved as Point of Service.
Sarah26> I don't intend to keep going to Mayo, I just need to confirm what my neuro in my area thinks I have. And with it being quite serious, I want the best. I'm just trying to see if there's anyway to get it covered.
Sarah26> So are you telling me that it's Point of Service and there's no way that's going to change?
Jolyn> Your doctor can write a letter stating there is no one else that you can be referred to in your area concerning this.
Sarah26> Ok. Thank you.
Jolyn> If there is no one else that takes care of this it may get overturned.
Sarah26> Got it!
Jolyn> Is there anything else I can help you with?
Sarah26> One last question, if my neuro writes the letter stating that there is no one else he can refer me to in my area, can that letter be sent to me and I forward it to you guys or does it need to come directly from him?
Sarah26> I know it needs to be on his letter head and all that, I'm just thinking it'll get to you guys quicker if I go up there and have him do it in front of me and then send myself.
Jolyn> I would have them fax it to us. along with referencing the referral number that is already in the system.
Sarah26> Got it!
Sarah26> Thank you for your time.

So there you have it. I have already contacted my neuros nurse and left a message for her regarding my new dilemma. Now I get to wait on them again. Great! They're going to need to perform this duty a bit more swiftly than the last. If they shoot the shit for too long, I'm going to end up needing an updated referral. I hope that doesn't happen.

Finally!!! My Referral to the Mayo Clinic is IN!

What a process! I guess I'm lucky since it took me just a month and I know these things can take several months to get. But it was still very frustrating. The referral reads for a Dr. Maria Aguilar and she is in Scottsdale with Wingerchuk, he's who I want to see. I'm going to try to change the name on my referral, which I am usually allowed to do but if not, I'm gonna see Aguilar.

I'm hoping that if I have to see her, at least he'll be there to assist or available for her to run test results by. You can guarantee, I'll be requesting him to view everything. I've read and have been told that he is the best at the Mayo Clinic in Arizona and you already know, I want the best.

Unfortunately, it looks like my visit will not be completely covered by my insurance company. We're military so our insurance usually covers everything, no co-pay. But since the Mayo Clinic of Arizona is out of my network, there's going to be a hefty deductible and other fees. With all the tests they'll have to run to confirm my NMO, it's not gonna be pretty.

I'm going to call my case manager on Monday and get some facts about everything but, I feel a fundraiser coming on. =)

Referral to Mayo Clinic Update

There isn't one. =( So....frustrating!!!

I called my GP's office again today and asked them if they have received anything from my neuro with the words, "Mayo Clinic" on them. Whether it be a referral or just some sort of correspondent requesting that they (my GP) create a referral for me to the Mayo Clinic and send it to my insurance company.

Nothing!

So I called my neuro's office and guess what... VOICEMAIL! And no call back today. So after giving them a break for a week or so I'll be back on their asses come Monday morning. I do not understand why they can't just pick up the phone and return my phone call. Even if it's to say, "Mrs. Ellis, I received your call and I'm looking into it now." Good grief, these people drive me nuts!

Off Topic - New blog design is up. Hope it's more pleasing to the eye than that last template. =)

Decisions. Decisions.

It's been a busy week and I have been completely ignoring Devic's. Ahhh... it's so nice when this disease goes into hiding, especially when you can also mentally tuck it away and forget about it for a while. I think these last few days have been the first in which I didn't subconsciously let my Devic's control what I do.

I've also been slacking on my doctor stalking. Or referral stalking. Whatever. But I've liked it. Now tomorrow when I call my GP, they better have the damn referral (and the right one!) from my neuro or I'm gonna go ape shit on their asses! LOL! Kidding. Kind of.

So on to my decisions.

On August 24th, I have my first Neuro Ophthamologist appointment. On August 24th, I also have the opportunity to appear as an extra in a movie. Not a big deal, but the experience would be nice and I get to look like crap in the movie so no need for beauty products. YES!!!

I haven't made up my mind yet. I know my health is important and this appointment is very important to my health, so I'm sort of stuck. However, if my appointment were pushed back a week, or even a month, will it hurt me? Probably not. I'm going to call the Neuro Ophthamologist office tomorrow and see if they have any availabilities on any other day in August. Maybe I can get lucky and push it back by a few days or even a week. Not likely though.

BTW... Things have been going well for me lately. I'll update on diet, exercise, and everything in between very soon.

Chasing A Dream

Since I was a young teen I had always wanted to be a SUPERMODEL! I've let the "Super" part go and now I just want to be a model. And.... maybe do a few commercials here and there. Ya know, if I'm lucky enough to get that opportunity. What better way to make money than doing something I've always loved and something that seems to be a pretty cool job.

When I was 18 I got pregnant with my son, who will be 9 in October, and needless to say, mommies dreams got put on hold. Between then and now, I have given birth to two children, acquired about 50 stretch marks, gotten married, moved to three different states, gained a good 40+ pounds, lost a good 40 pounds, and now here I am.

I live close to one of the biggest cities in the industry so just this week I decided, I'm gonna dive right in and see how long I can swim before getting spit out. Well, as it turns out, I was spit out pretty quickly.

(Quick note: Modeling has always been in the back of my mind and it's always been something I wanted to do. For a while, I was not satisifed with my size and I was probably even too large to be considered a 'Plus Size' model in the industry. Even though I think their idea of plus size (a 10) is ridiculous, it is what it is. So I've been working really hard to get in shape not only for my disease and to make myself feel better, but I've also been doing it for the hopes of one day being in front of the camera.)

On Wednesday I went to an open call at Wilhelmina. I was so nervous the night before and for that entire day. I drove almost 2 hours to LA and made it to the office with 30 minutes to spare. I sat down, a man came out, he grabbed my photos along with two other girls, and took them to the back. Not even a minute later, he came back out and passed each set of photos back to us while simultaneously saying, "We'll pass".

I wasn't upset though. This is how the game works. It seemed to have made me even more determined than I was before. I came home, had my husband take some natural photos of me (the two above are a couple of them) and I sent them off to Ford. Ha!

I also started searching for all the modeling, talent and whatever else agency's in Los Angeles, San Diego and surrounding areas. I have contacted many people and a couple of days ago I even lined up an interview with a promotion company. Then today I got news of two more companies that are interested in me. One is for an independent film company in San Diego that wants me to come down and test shoot for a commercial and a catalog, the other one is also in San Diego and they are a modeling and talent agency that want to do a face-to-face interview.

Yay! and Whew! I'm feeling a bit overwhelmed at the moment. And it'll really suck if none of these opportunities follow through because now I've just aired everything to the world wide web. We shall see.

Sometimes, dreams do come true. Other times, you have to make them come true.