Faithful readers know that the toe in question is actually my big toe, which I first wrote about two weeks ago. Thanks in part to the amazing power of the Internet, my blog about my toe has already fomented change...on a personal and national level.
I'd written that Aetna wouldn't cover the toe joint replacement surgery I need because they considered it experimental, though the procedure is FDA approved. Another blog picked up the discussion.
Later that day, I got a call from Aetna's executive response team! My contact was very helpful, and sounded truly concerned about my case. And, he actually followed up on everything he said he would. Then the people he spoke with followed up in a timely fashion. (Having had a couple of frustrating experiences with customer service at large corporations recently, I am a bit skeptical about the quality and speed of response.)
One week later, my doctor had sent my information and discussed the procedure with a doctor there. The week after that, Aetna decided to cover my surgery...and to cover it in the future! They've already updated Clinical Policy Bulletin 0708 to reflect this change.
My feet and I thank Aetna, my doctor, and everyone involved for being open to taking action, and doing so quickly. But of course every insurance company won't and can't decide to cover every procedure because someone blogs about it.
P.S. How many people could be impacted by this policy update? I'll keep looking, but haven't yet found a statistic saying how many adults suffer from hallux rigidus, or degenerative arthritis of the big toe...
Wednesday, September 24, 2008
Thursday, September 18, 2008
Too many irons?
Sometimes when I talk to friends I haven't seen in awhile, they say they're amazed by how many things I'm doing:
--taking improv classes
--singing in a chorus
--working on both new fiction and non-fiction projects while submitting completed manuscripts and proposals
--editing published friends' proposals and manuscripts
--freelance editing
--marketing to get more voiceover/on camera clients
--handling my dad's estate matters
--auditioning and completing acting jobs
--serving on the national board of an organization w/10,000 members and on the editorial board of the CBA's magazine
--etc.
Of course I'm not doing all these things at once, plus I have the eight hours a day most people spend in day jobs to fill. I'd bet if you listed all the things you do, you'd be surprised at how many you came up with.
Can you have too many irons in the fire? Would you get better results if you focused on a few things at a time?
Should I, for example, stop pursing acting opportunities so I have more time to spend on writing and marketing my writing? Or vice versa? If I gave up the chorus and improv classes, I'd have 4.5 more hours each week, plus the time it takes to get there and back, to work.
For the Gainfully Unemployed, finding the best balance between work, activities and social life can be a challenge. I have actor friends who I don't think work hard enough, but complain that they aren't getting enough auditions/jobs/money. Yet I think I put forth a lot of effort to get those things, and I sometimes have the same complaints. Will my hours spent pay off in the long run because I'm building contacts and making connections? Or do I need to work harder?
--taking improv classes
--singing in a chorus
--working on both new fiction and non-fiction projects while submitting completed manuscripts and proposals
--editing published friends' proposals and manuscripts
--freelance editing
--marketing to get more voiceover/on camera clients
--handling my dad's estate matters
--auditioning and completing acting jobs
--serving on the national board of an organization w/10,000 members and on the editorial board of the CBA's magazine
--etc.
Of course I'm not doing all these things at once, plus I have the eight hours a day most people spend in day jobs to fill. I'd bet if you listed all the things you do, you'd be surprised at how many you came up with.
Can you have too many irons in the fire? Would you get better results if you focused on a few things at a time?
Should I, for example, stop pursing acting opportunities so I have more time to spend on writing and marketing my writing? Or vice versa? If I gave up the chorus and improv classes, I'd have 4.5 more hours each week, plus the time it takes to get there and back, to work.
For the Gainfully Unemployed, finding the best balance between work, activities and social life can be a challenge. I have actor friends who I don't think work hard enough, but complain that they aren't getting enough auditions/jobs/money. Yet I think I put forth a lot of effort to get those things, and I sometimes have the same complaints. Will my hours spent pay off in the long run because I'm building contacts and making connections? Or do I need to work harder?
Thursday, September 11, 2008
What does YOUR health insurance cover?
My health insurance, for which I pay $395 per month, will not cover the foot surgery my doctor says I need: a toe joint replacement that is supposed to last 20 years and which will restore mobility and reduce pain.
Aetna won't cover this; according to them the procedure is experimental, though it has been FDA approved. Aetna will, however, apparently approve two other procedures: fusing my toe to my foot so it would never bend again, or removing the joint so the toe sort of flops around. Yuck. But both options are supposed to eliminate pain.
I'm going for the surgery. Just how much does foot surgery cost, per foot? Despite numerous phone calls, calculating the exact total remains an unsolved challenge, because so many entities and individuals are involved: the Dr, the surgery center (which at least offers a 20% discount for patients paying out of pocket), the anesthesiologist, physical therapy (no clue yet what that'll cost). Then there is the boot I'll need to wear, plus pain medications and??? I don't know what I'm missing.
Can you imagine a cost conscious consumer going into a department store and buying a dress without knowing precisely how much she'll pay? How can you dispute a charge after the fact, if you've been given and then used a product or service?
Can any government fix problems like this and make it easier for patients to be informed?
Anyone who is happy with his or her insurance provider, feels comfortable with finding out accurate information, understands those Explanations of Benefits and has needed procedures need covered effiiciently, let me know!
Aetna won't cover this; according to them the procedure is experimental, though it has been FDA approved. Aetna will, however, apparently approve two other procedures: fusing my toe to my foot so it would never bend again, or removing the joint so the toe sort of flops around. Yuck. But both options are supposed to eliminate pain.
I'm going for the surgery. Just how much does foot surgery cost, per foot? Despite numerous phone calls, calculating the exact total remains an unsolved challenge, because so many entities and individuals are involved: the Dr, the surgery center (which at least offers a 20% discount for patients paying out of pocket), the anesthesiologist, physical therapy (no clue yet what that'll cost). Then there is the boot I'll need to wear, plus pain medications and??? I don't know what I'm missing.
Can you imagine a cost conscious consumer going into a department store and buying a dress without knowing precisely how much she'll pay? How can you dispute a charge after the fact, if you've been given and then used a product or service?
Can any government fix problems like this and make it easier for patients to be informed?
Anyone who is happy with his or her insurance provider, feels comfortable with finding out accurate information, understands those Explanations of Benefits and has needed procedures need covered effiiciently, let me know!
Thursday, September 04, 2008
What do you love?
In our busy busy world, sometimes we neglect to make time for activities that don't contribute to the bottom line but are still important to us. For me, one of those things is choral singing.
I actually got paid the first time I sang in a choir. Fifteen dollars a month, in 5th grade. We sang for women's groups. I cried when the director told me I had to be an alto. I thought singing harmony was a demotion. Later, of course, I realized that holding your part is more challenging than singing the melody.
By the time I reached high school, my main goal in life was to get into the Viking Choir. They sang on television, toured Europe every other year, made albums, and had lots of parties. And you couldn't be in school musicals unless you were in choir. Finally, it was an honors class, which meant an A was worth more.
But a grueling audition with our strict choral director, Walter Rodby, was required. You had to sight read--he gave you a piece of music and the starting note, then you had to read the rest off the page with no accompaniment. You had to repeat back patterns played on the piano, sing a variety of scales and chords, and hold your part in the Star Spangled Banner. Voice quality, not my strong suit, counted too. Scoring was kept secret, but rumor said that over 40 out of 50 meant you'd probably get in.
So I took voice lessons. My teacher said, "I have a good track record of getting people into choir. But I don't know about you." I scheduled a lesson right before my audition. I cried in the car on the way to school. The girl auditioning before me came out of the room crying.
I survived the audition. By squinting at the piece of paper on the piano, I could see that my score was 43. I got in. In addition to loving the process of learning new pieces and singing them, many of the best moments of my junior and senior years were because of choir...touring Greece, having a half hour Christmas special on WGN-TV, making friends.
I just loved choral singing. So I sang in a symphony choir in college for a couple of semesters and an oratorio society in law school, and sang some amazing music, from Vaughn William's Dona Nobis Pacem to Mahler's Symphony of 1000 to highlights from Philip Glass's Satyagraha. It's not every day you get to sing in Sanskrit with music that, instead of having every measure written out so you can follow along, had a bracket over a group of measures with a number on top, such as 9. Meaning you had to count while repeating that phrase 9 times.
I remember the thrill of singing Beethoven's 9th under the direction of the late Christopher Keene. There was something about the energy in the air during one of our performances...as the final chords echoed through the hall, the audience jumped to its feet.
But when I started working, choral singing fell by the wayside. Until a couple of years ago, when the Chicago Bar Assiation formed a chorus. I joined with a friend. We sang Beethoven's 9th at Navy Pier for 1,100 people. We sang the National Anthem at a Sox game (which can be heard on the CBA Web site.) Now we're starting Haydn's Creation.
I'm really enjoying singing again. But all of us...from young to retirees, must make time in our schedules for rehearsals and performances.
What, pun intended, strikes a chord deep within you?
I actually got paid the first time I sang in a choir. Fifteen dollars a month, in 5th grade. We sang for women's groups. I cried when the director told me I had to be an alto. I thought singing harmony was a demotion. Later, of course, I realized that holding your part is more challenging than singing the melody.
By the time I reached high school, my main goal in life was to get into the Viking Choir. They sang on television, toured Europe every other year, made albums, and had lots of parties. And you couldn't be in school musicals unless you were in choir. Finally, it was an honors class, which meant an A was worth more.
But a grueling audition with our strict choral director, Walter Rodby, was required. You had to sight read--he gave you a piece of music and the starting note, then you had to read the rest off the page with no accompaniment. You had to repeat back patterns played on the piano, sing a variety of scales and chords, and hold your part in the Star Spangled Banner. Voice quality, not my strong suit, counted too. Scoring was kept secret, but rumor said that over 40 out of 50 meant you'd probably get in.
So I took voice lessons. My teacher said, "I have a good track record of getting people into choir. But I don't know about you." I scheduled a lesson right before my audition. I cried in the car on the way to school. The girl auditioning before me came out of the room crying.
I survived the audition. By squinting at the piece of paper on the piano, I could see that my score was 43. I got in. In addition to loving the process of learning new pieces and singing them, many of the best moments of my junior and senior years were because of choir...touring Greece, having a half hour Christmas special on WGN-TV, making friends.
I just loved choral singing. So I sang in a symphony choir in college for a couple of semesters and an oratorio society in law school, and sang some amazing music, from Vaughn William's Dona Nobis Pacem to Mahler's Symphony of 1000 to highlights from Philip Glass's Satyagraha. It's not every day you get to sing in Sanskrit with music that, instead of having every measure written out so you can follow along, had a bracket over a group of measures with a number on top, such as 9. Meaning you had to count while repeating that phrase 9 times.
I remember the thrill of singing Beethoven's 9th under the direction of the late Christopher Keene. There was something about the energy in the air during one of our performances...as the final chords echoed through the hall, the audience jumped to its feet.
But when I started working, choral singing fell by the wayside. Until a couple of years ago, when the Chicago Bar Assiation formed a chorus. I joined with a friend. We sang Beethoven's 9th at Navy Pier for 1,100 people. We sang the National Anthem at a Sox game (which can be heard on the CBA Web site.) Now we're starting Haydn's Creation.
I'm really enjoying singing again. But all of us...from young to retirees, must make time in our schedules for rehearsals and performances.
What, pun intended, strikes a chord deep within you?
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