#I might have adhd they said but it can't reach me if I deny it

[jester-archive]

I still have no idea what I'm doing but we got funny clips now

A 2017 classic updated for the new game.

[naamahdarling]

So, backstory. Under a cut because long but it is something anyone wrestling with a similar issue might want to read, because we succeeded at something difficult. Maybe it will help someone? Or provide hope?

Boyfriend switched insurance, needed a new PA for Vyvsnse. New insurance wanted him to be on generic, or another stimulant. Name-brand Vyvsnse is in fact the ONLY ADHD med that is available in our area. Insurance wanted him to try non-stimulants. Those made his depression so bad he had to stop.

The clinic has to do paperwork to fix this. We can't, pharm can't.

Clinic is hard to reach, communication within it seems poor, we have to nudge them again and again and again. Endlessly. It becomes evident something is very wrong.

We are both off our ADHD meds so this is very hard to pursue. We keep reaching different names, there is no way to be transferred directly to someone's voicemail or phone, they have to be in the office right then and physically summoned. We get almost no callbacks. Portal messages seem to have no effect. It's INFURIATING.

So at the start of this month, I step in and make them redo the PA. I feel good about it.

And they DID send it!!! They did!

And nothing happened. No response from insurance. This is utterly believable. Insurance is usually the bad guy.

So we wait for the clinic to fix this, and call from time to time. Nothing from insurance. Silence.

Boyfriend is crumbling, unmedicated since December.

Monday, I AGAIN place a firm call to the clinic. I can't reach snyone directly. We get hold of the insurance company. And here's where things get interesting.

The insurance sent a message the day they got the PA asking for one piece of paperwork. When they got no answer, they sent it again. Then again. Three times they asked. Three times. The clinic never responded.

What.

WHAT.

The clinic had 30 days to respond. Now we have a week and a half, roughly, because of their delays.

I go from desperate and sad to Angry. I mean really, really angry. I have been watching the person I love more than life itself dissolving for weeks.

Now I'm angry. Truly and deeply incandescently angry.

I sit down, write everything out, and write down what I need them to understand, my questions, and possible alternate phrasing for things like "what the fuck is happening?" and "have you in fact been pithed like a frog?"

And I call the clinic the next day, yesterday, and I used my last scrap of grit and patience and restraint and said

"Hello, I am a patient advocate for [boyfriend's name], who has been without his medication since December. He is experiencing significant disruptions to his life and his job because of this, and I need to speak to someone who can tell me the status of his PA and explain what is going on."

Now we were off to a good start.

The person on the line was qualified for this so I listened to them explain everything from their perspective, occasionally interrupting to be sure I was "getting everything down correctly". (See "giving them enough rope to hang themselves", followed by "shoot themselves in the foot.")

Bottom line, they said they had sent the PA, and it was denied. We are trying to get them to accept the name brand."

I then hit them with: "They received that. They say they sent you three requests for further information, on [date, date, and date]. They were able to reach you for the initial denial so we know they have the right contact. Can you tell me where the requests went? Were they sent to the right place?"

And the lady did look, and lo, she did see the THREE messages from the insurance company, sent over two weeks ago. It took her about 15 seconds.

That's all.

I tried to light them all on fire with my mind.

So I emphasized that we all have a week and a half to do this before it all starts over again, and that this needs to be done by the end of this week so there is time to straighten things out with insurance if there are more hiccups. I told her to please get it all to the right person, and to make sure that they knew to include the bit about having tried other meds, and said that we would send an email through the portal as well (so they know I am documenting all of this). I was very grateful at her. I said I would be calling the next day to see if they were able to get hold of the insurance company or if we all needed to take "further action" from that angle.

And I hung up, expecting nothing.

But lo and behold, my boyfriend received an email this morning that the paperwork had been sent back, and the approval already received. Less than 24 hours after I spoke to the clinic.

So being a "patient advocate" and using every last scrap of experience dealing with this shit and every shred of my ability to express myself clearly, and every iota of my ability to politely imply I Am Taking Notes And Further Action Is Impending, were all it took, and they could have fixed this in a matter of days if they had just DONE WHAT WE KEPT REMINDING THEM TO DO.

THEY COULD HAVE DONE IT IN HOURS.

Now I get to celebrate joyously until Monday at which point I will become Patient Advocate Entity again and contact management for the entire clinic chain. I am already setting up a call. Because they need to know that this situation was ALLOWED to happen and I don't want it to happen again to us, or god forbid, anyone else. Now I just hope they don't try to retaliate. Documenting all this with upper management now will make that easier to prove if it happens, I guess.

So THAT is the total bullshit I have been dealing with, how hard we, two DISABLED people whose disabilities make this especially noxious and difficult, had to work to do other people's fucking jobs, and what it took to finally fix it.

I am so grateful I was able to do this. I wish had been able to do it sooner. I wish it hadn't come to this, or been hurting us both for so long.

But we won.

December. It's been since December.

And we won.

THE CLINIC SENT THE MESSAGE TO THE INSURANCE.

THE PA WENT THROUGH.

WE WON.

I GOT BOYFRIEND'S ADHD MEDS APPROVED AND WE WON.

THE PHARMACY HAS THEM IN STOCK.

We won!