June 10th of 2005 was a day that changed my life forever. It was the day that I was diagnosed with multiple sclerosis. Back then, I didn’t handle it well. There were too many unknowns: How was MS going to affect my career and marriage? Did people with MS have a shortened life expectancy? Was I going to spend my remaining days like my Aunt Loretta, who had MS, confined to a wheelchair? How am I going to pay for all my medical bills?
The questions were unending. It was like I was learning to live all over again as a new person. The more interactions that I had with the health care system, the more frustrated I became with all the hoops I had to jump through to get the care that I deserved. I felt like there was no roadmap to get the services I needed while protecting my interests.
My breaking point came when I was ordered a home traction device for a bone chip I had in my neck from a fractured vertebra caused by MS. My kids were just little at the time. My oldest was two and the baby was just learning to crawl. I had to lay on the floor with the kids crawling all over him so the home traction device could relieve the pain from the potentially paralyzing bone chip. This traction device was ordered by my physical therapist as a way to hopefully avoid surgery.
A couple of days into using the traction device, my insurance company called. They stated that my policy required prior authorization for DME (durable medical equipment) and that I had two options: return the device to the physical therapist’s office or pay for the device in full. Neither option was satisfactory in my mind. Returning the device meant surgery was probably in my near future and I couldn’t afford the cost device. I thought my insurance was supposed to help me get well, not force me to get worse. I wasn’t even sure what prior authorization anyways entailed. No one had ever explained it to me.
I returned the traction device to my PT and it fractured our relationship. I blamed her for not knowing the terms of my insurance policy. Because after all, I was under her care and doing what she instructed me to do. In the meantime, the bone chip caused severe spinal stenosis and was cutting my spinal cord little by little with every movement. The decision was made to go under the knife and fix the problem before it became more complicated.
It was also about this time that I decided to become educated to the health care system. I felt like I was being taken advantage of and had no way of protecting myself. I returned back to school and pursued my Master of Public Health Administration. Through my master’s program that prior authorization is prior approval from you insurance company based upon medical necessity documentation and that there are over 880 services that require prior authorization. DME was one service in my policy that needed prior authorization and had I read the terms of my policy, I could have asked my PT if she had submitted the prior authorization form to my insurance company.
When I was diagnosed, I had no roadmap. Luckily, you now do. I am excited to announce that my new book, 7 Steps to Living Well with a Chronic Illness, has been published. I compiled all the knowledge and experience from my personal life, as well as, what I have learned from my chronic illness health coaching and created a simple, easy to read guide on living well with a chronic illness. Topics that I cover include: navigating the healthcare system, dealing with emotions, managing finances, goal setting, building successful relationships, living a happier, more content life, developing healthy habits and a positive attitude, and so much more. 7 Steps to Living Well with a Chronic Illness delivers simple, easy to follow steps, as well as, personal examples from my life to help you reclaim control and live your best life possible.
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