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Friday, September 3, 2010

The Hitchayvut from Hell

In order to receive medical care, our health funds need to provide us with a "hitchayvut," a document committing to pay for the process.

For most procedures, this is a fairly benign procedure, that is time consuming and annoying, but straightforward and not difficult.

It is a bit more complex when applying for some of the more expensive procedures, like a CT or MRI.

Sometimes, the health fund refuses coverage, but usually overturns the decision on appeal.

Recently, they continually refused to cover an MRI of my hip.  First they insisted I do a CT, until I provided them with the documentation that I already did a CT.  Then we sent another letter explaining that an orthopedist, who specialized in orthopedic oncology (or oncological orthopedics), requested the MRI, since the CT showed nothing.  The orthopedist wanted to verify that their are no hairline fractures, and felt an MRI might provide us with more information.

It took three months to get an MRI appointment, I thought I would receive a hitchayvut in plenty of time.

Instead, it took three months of arguing with the health fund, with the dedicated help of my GP and his staff.

As the appointment approached, I got increasingly anxious. 

At one point, I had this crazy conversation with my GP and my oncologist -- both who were convinced they understood the other.  My GP explained that my oncologist no longer thought the MRI was necessary, and my oncologist was convinced that my GP was working on getting the approval. 

I begged my oncologist to write another letter, which I then sent to my GP, who sent it in and.... got approval for the MRI, the DAY BEFORE my appointment!!

What a relief!!

My doctor's office sent the hitchayvut to the hospital.  I called to confirm the hospital received it.  They did.


"The code is wrong," Sharon told me.  "It should be Code 73721, for your "perek yerech" (hip)."

I panicked.

I called my doctor's office.  The secretaries promised to take care of it.  I would have to wait until the offices of the health fund re-opened for their afternoon hours.

Worse case scenario: I could leave a check deposit and they would work out the details afterwards.  The check would not even be deposited.

An hour, or so later, a representative from the health fund called me.

"The code is fine," she told me.  "The code is for your "agan" (pelvis) and your doctor's referal is for an MRI of your pelvis.  Everything is in order."

I breathed a sigh of relief and finally fell into a deep sleep.  My appointment was at midnight, and I needed to get some rest.

Big mistake.  I should have called the hospital again... (hindsight vision is always 20-20)

At a quarter to midnight, I arrived at the hospital and went to register for my appointment.

They could not find the hitchayvut. 

I told them that I had confirmed that afternoon that the hitchayvut was there.  They looked.  And looked.  The did not find it.

Someone else looked.  And looked.  And looked.  He started checking even those unlikely places....

And he found it.

I was so grateful. 

I really did not want to leave a check deposit.  That would be just one more thing to follow up....

The MRI staff took me in right away.

They did not fight with me when I insisted that the technician use the smallest needle they have (the yellow one they use for babies!) 

Then, they lay me down on the MRI machine.  I was so exhausted from the ordeal that, despite the loud banging of the MRI, I fell into a deep sleep.

After the MRI, the technician came to remove the IV.

She noticed that I was scratching my arm, and gave me a funny look.

"Do you itch?" she asked, still giving me that strange look.

I had not noticed. 

I paused for a few moments... then I noticed.  I itched all over.

She quickly gave me two pills (4 mg) of ahisten, an antihistamine.

She kept asking me if it was difficult for me to breathe.

Breathing was not a problem, but I defnitely itched.

"You are allergic to the contrast material," she declared, writing out a note.

She debated whether she should send me to the emergency room.  If she did, I would be there all night.

We waited another ten minutes.  I still itched.  I had no problems breathing.

I went home.

I really did not want to stay.

What a night!

Please daven (or send happy, healing thoughts) for RivkA bat Teirtzel. With love and optimism, RivkA


mikimi said...

OMG_definitely an ordeal! B"H it did not cause you to have a heart attack with all that stress.

rickismom said...

Sorry you had to deal with all that **&%^$#$%#%^#^# !!!!!!

Miriam G said...

And I thought our system was rough! Oh my goodness! Glad it all worked out - eventually!!