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Reflex Sympathetic Dystrophy (RSD and CRPS) Reflex Sympathetic Dystrophy (Complex Regional Pain Syndromes Type I) and Causalgia (Complex Regional Pain Syndromes Type II)(RSD and CRPS) |
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12-01-2014, 08:44 PM | #11 | ||
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Junior Member
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Thank you LIT LOVE for all of your information. I will read all of it and see if I can make sense of it all. I have an update which I will post in just a second.
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12-01-2014, 09:05 PM | #12 | ||
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Junior Member
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An update: I had a rough time last night with ringing in my ears at around 3 a.m. and a pounding headache. I started making phone calls early at about 5 a.m. First to the number that Walgreens was calling for an approval to see what time zone the 888 number was in and to see if someone was already there. Someone was and said they were in Mountain time zone. Then I called my 24 hour Walgreens and asked them to call the number for approval because someone was there now. Walgreens phoned me back a few minutes later and said that they phoned Timesys the third party processor, and they said that they are waiting for the adjuster for workers comp to approve it, then Timesys calls Walgreens back and says go ahead and process the prescription. Well the adjuster wasn't in yet, as it was about 5:30 in the morning on Monday. My attorney phoned me at 7:30 a.m. this morning and I was so glad to finally get in touch with him. He phoned the adjuster and found out that because of the holiday the adjuster wasn't there to approve the request but has the information and will be processing it in the next few hours. Even though this sounds somewhat logical, it confuses me because I will go to walgreens sometimes in the evening when it is quieter there to get my medications and this is the first time in a while I have had a problem. Certainly the adjuster isn't there at 8 or 9 p.m. I don't get how the process works during those hours, but if I need to change when I go to the pharmacy I can deal with that. I just need to know what has changed and what i need to do to make sure I don't go through this hell again. I decided to write down my questions in a letter to my attorney, perhaps tomorrow when I am feeling better. I ended up picking up my prescriptions at 1 p.m. today and finally fell asleep for about 4 hours. I was exhausted after having a panic attack in the morning on top of being cold and hot, ringing in my ears, pounding headache, achey all over and an increase in my crps pain. I am slowly feeling better and greatly appreciate being able to talk to you all during this. Thank you very much.
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"Thanks for this!" says: | CRPSsongbird (12-04-2014) |
12-01-2014, 10:43 PM | #13 | ||
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Magnate
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What I suggest is that you always TRY to have a weeks worth of meds ahead at a bare minimum, in anticipation of delays. WC allows you to submit your scripts to the pharmacy 21 days after your last Rx's were filled. But, they can delay you every month if they want to! So if you turn in at 21 days, you might get lucky and have an approval by day 30. With the holidays coming, you might even need to get in really early this month, if the doc requires an appointment for your Rx to be written. (And how stupid is it to deny a CRPS patient meds when going without can cause spread, forcing WC to spend more on additional procedures! The last time they did "reforms" it reduced our quality of care and costs went up 30%. They just don't learn.)
They are definitely trying to encourage people to settle the med portions of their old claims by making things nightmarish. I've had 3 new adjustors in the past year and they don't send notification to me or my attorney. (Each time I figured it out by talking to Express Scripts, the 3rd party biller.) Verify your doc is submitting both required forms. Avoid the IMR process if at all possible. They have massive denial rates and like I said before, you're stuck with the decision for 1 year. |
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12-02-2014, 12:24 AM | #14 | ||
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Junior Member
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Quote:
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12-02-2014, 12:31 AM | #15 | ||
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Junior Member
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Quote:
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12-03-2014, 01:39 AM | #16 | ||
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Junior Member
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Thanks for the advice, Lit Love. Having an emergency patch supply is a good idea. Even if all I had were 2 patches, which is what I wear every day, it would give me 3 days to sort out any delays. A week supply even better. So exhausted today.
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12-03-2014, 04:27 AM | #17 | ||
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Magnate
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Hope you get squared away! It's a good idea to be a bit ahead anyway. I've had issues with pharmacies not having access to meds all of a sudden and as my mom says, "What if there was a natural disaster? Not a time you want to be going into withdrawals."
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12-04-2014, 04:17 AM | #18 | ||
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Member
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Quote:
What were they able to do for you? Did you get your medication? Or at least a replacement? |
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12-12-2014, 01:46 PM | #19 | ||
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Junior Member
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Hi LisaR624, just realized I never responded to you. My apologies. I am in California, in the San Francisco Bay Area, which is raining hard at the moment. How is your week going?
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