Category Archives: It's Not a Living

Three Months to the Day

For the past couple of months, I’ve been updating from my private group on Facebook. It’s not the same, but honestly, that’s not necessarily a bad thing. Since we last talked, Aitch turned five; Doodicus started the sixth grade and his grades half-way through the first quarter were all As; and I found out that November 1st will be my last day at work for the surgeon as he has opted to retire early.

I’ve been a little consumed by the last point because I hate job-hunting. I mean, who doesn’t hate job-hunting, but for me, I hate it to the point I cry and get heart palpitations. Administrative jobs in a town of 20,000 are as rare as hen’s teeth.

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In the past two weeks, I’ve applied for one position for which I really don’t qualify, but I figured what the hell. Actually I think the worst part is the interview. All those canned, pointless questions that the interviewer has written on a form and they write down the answers without truly even listening to what I’m saying… It’s the worst. I wish that they would just invite me out for coffee and just see if we like each other personally. Speed-interviewing, if you will.

Without my job, we will also be without health insurance. For our family, the ACA is a godsend. My apologies (insincere though it may be) to those of you who disagree. I’ve never pulled punches before and I won’t start now, but the only people I’ve heard vehemently appose the ACA are those who have had their coverage provided by their white-collar employer with little or minimal contribution from their paychecks. My husband and I make a decent living and have basically been responsible for a premiums. We are a blue-collar family that pays our bills. When I was diagnosed with cancer in 2010, we paid our medical bills in full and on time. And then after that, I was uninsurable unless through an employer, and I had to wait a year to even be eligible for benefits. I’m tired of hearing from friends and family through my social media contacts that the ACA is meant for deadbeats and people who don’t pull their weight economically. They are narrow-minded, candy asses.

With that, I bring you this in keeping with current events. It’s brilliant. It comes from Brian Krewson at “the metric ruler“.

So, Imagine that the company you work for held a poll, and asked everyone if they thought it would be a good idea to put a soda machine in the break room. The poll came back, and the majority of your colleagues said “Yes”, indicating that they would like a soda machine. Some said no, but the majority said yes. So, a week later, there’s a soda machine.

Now imagine that Bill in accounting voted against the soda machine. He has a strong hatred for caffeinated soft drinks, thinks they are bad you you, whatever. He campaigns throughout the office to get the machine removed. Well, management decides “OK, we’ll ask again” and again, the majority of people say “Yes, lets keep the soda machine.”

Bill continues to campaign, and management continues to ask the employees, and every time, the answer is in favor of the soda machine. This happens, lets say… 35 times. Eventually, Bill says “OK, I’M NOT PROCESSING PAYROLL ANYMORE UNTIL THE SODA MACHINE IS REMOVED”, so nobody will get paid unless management removes the machine.

What should we do???

Answer: Fire Bill and get someone who will do the fucking job.

Bonus: Bill tells everyone that he was willing to “Negotiate”, to come to a solution where everyone got their payroll checks, but only so long as that negotiation capitulated to his demand to remove the soda machine.

Bill is a fucking jackass.

That’s Bressels. Not Brussels.

I’ve been training temps this week and I am trying to be sympathetic about their individual plights, but one of them has just rubbed me wrong from Day 1. The temps were really brought on in a rushed manner, and apparently my boss seems to have approved the first two applications that fell across his desk.

Here’s an interaction that took place within just a couple days of Temp Z’s training, which took place when I popped my head into where they were working to talk to a fellow employee:

Me: "Blah blah blah patient is blah blah blah and Doctor wants to reschedule to…"
Temp Z, interrupting: "Where did you get your top?"
Fellow Employee and Myself, awkward silence.
Me: "Uh, I don’t know. I’ve had it for a couple years."
Temp Z: "I think it came from The Store."
Me: "It could have."
Temp Z, defensive tone: "Well, I guess I got MY answer!"
Confused look exchanged Fellow Employee and Myself.

I won’t even go into her voice, which has been described by more than one person as "bored" and "disdainful".

And just because you know I’ll never lose that last edge of my Bitter Infertile, she announced she was pregnant and due Christmas Day, and she made that announcement April 20th. YOU do the math.

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The Fellow Employee’s last day was Tuesday. She left me a note to read to the entire staff at our morning huddle. It expressed the hurt she felt over something a couple of other employees did and the backstabbing. While she ended it on a positive note, I decided that I wasn’t comfortable reading it. I know it will get back to her and it’s unfortunate that her anger may end up getting diverted back to me, but I selfishly have to look out for myself as I’m the one still in the office dealing with the Backstabbers.

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On a more humorous note, my daughter, Aitch (who I may have to re-nickname after I discovered that "H" is actually a street term for Heroin, and here I am calling out to Aitch in public settings…More hip listeners might think I’m a soccermom addict), was instructing me in the ways of womanly attributes last night.

As I was tucking her in she poked my stomach. "That’s your belly." "Yes, it is." "And this is your chest." "Yes, it is." "What are these?" as she poked me directly on the boob.

"Those are called Breasts." "They’re Bressels." "What??" "Bressels are Spanish for breasts." I’m laughing now, "Hmmm, okay."

"I don’t have bressels. I’ll get them when I get bigger. I’ll get a Patch, too, right?"

All I could do was laugh some more and answer, "I suppose you will!"

Zinger

Well. Shizzle just got real up here where I work. The new specialist corporate had been courting decided not to accept so we have no one to take the place of our current surgeon if he retires.
Except he IS going to retire. While he hasn’t “officially” announced it, he told me personally that it would be at the end of the year. The kicker is that he must have mentioned it to someone else as now his referrals are onto the rumor and our schedules have been negatively affected. Productivity has dropped to half in the past couple of months of what we’ve done at this time of year.

On top of that, the Scheduler and Receptionist both announced that their last day in the office will be the end of the month. Their timing not only couldn’t have been worst, but it shows an utter lack of respect for the surgeon, especially since one had been with the office for 30+ years, and the other was a friend she arranged to get hired. This leaves me as the remaining clerical staff member until we can get someone trained.

I was asked if I was going to arrange for their going away party by one of the staff in a satellite office. My retort, “Hell no!” may have been just a tad brusque.

I’m also having a hard time not rolling my eyes at the person who has been selected as the “obvious” replacement for the Scheduler. She’s currently a surgical assistant and although she hasn’t even started training, she has announced that she never understood why there were two people doing what surely she alone will be able to do. I’m going to sit back and enjoy the hell out of that one in a couple of weeks.

In other disappointing news: Those UGGs I bought my daughter that I raved about? Exchanging due to defect, but had to pay the difference between the sale price and the current price at Zappos. And I had to exchange my Sven clogs, too! They had a chip in the toe that they tried to fix before sending to me that I didn’t immediately notice. That wasn’t such a big deal because they did it quickly, without any hassle and the weather last week was crap so I couldn’t have worn them anyway. And finally, my MIL said we are raising “heathens” because we don’t take them to church…or did I already tell you this?

Oh, and because this is one of the few places I can talk unabashedly about what my uterus and ovaries have been up to, there’s this anecdote Last week I was sure that my period was going to show up at a most unfortunate time since it’d had been almost a month from the last one on March 8 (remember? It was on the day of my mole check?). I made sure to be prepared at the Visitation and Funeral. However, it did not make any kind of appearance, and it didn’t several days later. And then I started to wonder if FINALLY I was hitting actual menopause after all these years of having defunct ovaries. AND THEN I remembered that March 8th was the day I had my LASIK, not my mole check. My mole check was on the 21st of March so I still had another week to go. Except it showed up YESTERDAY! A full flippin week early! I HATE MY OVARIES!!

This post is just to remind you that just when you think it’s safe to gloss over and skip to the end, it isn’t.

Your Insurance and You: As Told By Me

Did you know I got a job? Yep, way back in May. It’s a wonderful fit for me, but not unlike any other job, it has its moments where I’m panting “TGIF TGIF TGIF” by Thursday afternoon.

First of all I work for an o r @ l surgeon. I’m not just talking a fancy dentist, I’m talking maxillofacial surgeon, the peel-the-face-off-of-someone-to-put-their-bones-back-together-if-in-a-disfiguring-accident type of surgeon. But as exciting as that might sound, those cases are extremely rare around here. Generally speaking, the main thing we get to do around here is surgically remove teeth.

My responsibility is the handling of the insurance and finances, and in today’s insurance climate, it’s fraught with issues and policy holders are left either dumbfounded in confusion or boiling over in indignation.

First of all, I am going to preface this with a statement I have to tell clients every day: I don’t know what your insurance will cover or pay. Policy holders who get pissy about this really need to take a look in the mirror. If YOU have an insurance policy and YOU are paying the policy and YOU elect to take the coverage, then YOU are ultimately responsible for knowing what your insurance will pay and what they won’t. As a courtesy, I will verify coverage, remaining deductibles, coinsurance and even get a quote of benefits for you, but, and that’s a mighty big “But” (…I like big BUTTS and I cannot lie…) the information I obtain from YOUR insurance company and pass back to you is only as good as the representative I talk to on the phone at YOUR insurance company.

If you are referred to my boss for “0ral surgery”, that term does not always mean what you think it means. If you said “0ral surgery” to your medical insurance, that could be taken to mean to mean something as complicated as an osteotomy, which is where a surgeon breaks your face and realigns it. Then your insurance company may believe that it’s to give you a physically more appealing profile (like in a case of “weak jaw”) as an enhancement. OR, it could mean correcting a congenital defect or even a progressive defect in which the lower jaw is undersized or doesn’t grow at the same rate as the rest of the face.

On the other hand, 0ral surgery could mean the surgical removal of a tooth instead of simply extracting it with some fancy pliers.

And that’s why your medical insurance doesn’t normally cover 0ral surgery because they consider it dental. BIG TIP #1: To find out if your insurance will cover 0ral surgery, call and ask them: “Are there any benefits for the SURGICAL REMOVAL of a tooth?” Now they may ask you if it’s impacted or erupted. If you can see all of the tooth, you can pretty much assume it’s erupted. At that point, 90% of all insurance companies will tell you no, there are no benefits. If you are not happy with that answer, then just ask if there’s a difference in benefits depending on whether your tooth is erupted or impacted. That should help you in case you really can’t tell either way.

When it comes to your dental insurance, benefits for the surgical removal of a tooth is almost usually there. ALMOST. Same question to your insurance rep can be asked. BIG TIP#2: If they ask you if you have a code (which who the hell would know the code for the surgical removal of a tooth unless they actually work in a dental field?), here’s a safe bet: D7210 – surgical remove of an erupted tooth. There you go. You’re welcome.

The bigger problem with 0ral surgery is the anesthesia. We don’t use “gas” here so I’m not even going to go into that as I have no idea if dental insurance covers it or not. We use IV sedation or local anesthesia (the numbing shot to the mouth). Local anesthesia will be covered and is included in the surgery. Logically, what kind of sadist would ever surgically remove a tooth and NOT numb you?? Therefore, there shouldn’t be a separate charge for local.

As for IV Sedation, only a licensed professional can provide this service, so be advised. IV sedation, or “going to sleep” as it’s commonly referred to, is rarely ever considered “medically necessary”, so for those people who say “The tooth is infected and a friend of my cousin’s brother-in-law who works for a veterinarian told me it would be medically necessary for me to go to sleep!”, well your argument is moot.

With that being said, that doesn’t mean your dental insurance won’t cover it. Don’t walk into the surgeon’s office and announce, “I have to go to sleep or I’ll rip the door off the wall when the doctor touches me!” when all you are having done is taking out one abscessed, erupted tooth. You’ll get no sympathy from me or your insurance. Of course, we’ll go ahead and put you to sleep if that’s what you want, but I’ll warn you ahead of time your insurance isn’t going to pay for it and I’m going to collect the charges for it before they even take your blood pressure. If you seriously have a dental-phobia, then you should be willing and able to pay for the “luxury” of going to sleep. And if your insurance does indeed pay towards anesthesia? Well, alleluia! You have excellent benefits. Here’s your refund! BIG TIP #3: if you don’t have the finances to go to sleep, but you don’t like the sound you hear when someone is working on your teeth and mouth? Bring your MP3 player and plug in.

Here’s where things get complicated. Do you know what your Third Molars are? They are the wisdom teeth. The surgical removal of the wisdom teeth breaks all the rules when it comes to insurance benefits. Some medical insurance plans provide benefits specifically for wisdom teeth. Some dental insurance plans specifically exclude benefits for wisdom teeth. It is safe to assume to never assume that while you may know what insurance benefits you have and don’t have, that those benefits apply to those suckers. I don’t recommend calling just once, but twice, and to talk to two different representatives.

As I wrap things up, I would advise you to familiarize yourself with how your medical AND dental insurance may coordinate on benefits for 0ral surgery. I recently had this example: medical insurance only covered impacted wisdom teeth and the dental considered the procedure strictly a medical and had no benefits at all for the specific procedure. What happened was that the patient’s wisdom teeth were all erupted, so no benefits under the medical and none under the dental. All that insurance and no payment whatsoever…just sad. And then there’s the “no duplicate clause”: medical had benefits but the deductible was crazy high ($10,000) and not even close to being met. The claim was then sent to dental, but they had the “no dupe clause” and since medical already processed it, they denied. Again, all that insurance and not a dime was paid out.

Lastly, BIG TIP #4: look at your Explanation of Benefits (EOB) when you get it. Don’t wait until the doctor’s office sends you a statement for balance due and then get your panties in a bunch wondering what the balance is for and call the office and start chewing out the office staff claiming you don’t know what you’re being billed for. I repeat: YOUR insurance is YOUR insurance. I don’t pay the premiums, YOU do. If you want to know what your insurance paid and didn’t pay, call the phone number that came on your EOB and ask someone. And if you get a check with your EOB because your insurance company pays you directly and not the doctor, don’t be a tool and cash the check and spend it on outstanding bills and then not pay your doctor. You will get absolutely no sympathy when you call and say, “I got a check three weeks ago for $500 but I spent it on my cell-phone bill, cable and cigarettes and would like to make payments of $50 a month with you.” That just makes you douchey and a flake.

I’m sure I missed something equally important and as boring, but I have wanted to share this information for a while with you, the ‘net. After a decade of experience at the hospital and now this, I can safely say that only about 90% of policy holders understand the basics of their health insurance. It is complicated, but making the attempt to gather information makes everyone happier, and trust me, I don’t like looking at anyone’s face as they gape at me in open-mouth horror and shock when I deliver a quote of benefits. I don’t want to see your buccal cavity. My boss does.

Ambivalence is My Middle Name

It’s funny how I don’t feel like updating here anymore. Every day several times a day I think, “Hey! That would make for a great blog post!” and then? Seriously. I haven’t written a great blog post since never. Speaking of which, I started blogging August 2005.

I have no idea why I brought that up since it’s October somethingorother. Which also reminds me, I won’t be participating in NaBloMo or whatever it’s called.

Did I just hear a collective sigh of relief?

My daughter still hasn’t pooped in the potty but she’s not holding it for five days at a stretch, either. She keeps telling me “next time”. In an uncharactheristic move, she also pissed her pants while sitting on my glider-rocker. As I was stripping her down for a quick belly-button-on-down bath, I asked why she did it.

“It was an accident, Mommy! I’m sorry.” …. dramatic pause … I love you.”

I bought a couple tuttu skirts from Target thinking they’d be a novelty. However, Aitch has become so enamoured with them, I went and bought a couple more. She has worn one at least every day now. When it’s cooler, she’ll succumb to the addition of leggings, but it’s like trying to wrestle a cat into a pillowcase.

I went back for a three-month follow-up appointment with my PA. I need a refill of the paxil and ambien. The thing is is that I didn’t really want a refill of the ambien because I was anticipating my evenings just so I could TAKE the ambien. He said as long as I’m able to get up in the morning and feel rested that I’m taking it as I should. And then we talked more about my depression. Actually he asked why I thought I was depressed. I told him I wasn’t really sure, but that maybe it was the miscarriages and infertility or the pregnancy with Aitch that I was sure was going to end with a dead baby and then the loss of my job after ten years and then the cancer. Oh, and let’s not forget my son’s ADHD which makes him do things that make me so angry at everyone and everything that I’m sure my fury will result in one of those rare cases of spontaneous combustion and the only thing that will be left will be a pair of hopefully fabulous shoes and a singe mark on the ceiling.

I’m sorry. What was the question again?

He suggested, as many of you did, I seek counseling. I told him I would think about it, because you see I am still in denial. Enough so I didn’t pick up my refill of paxil and ambien. At least not yet.

Profound:

1 a. having intellectual depth and insight; b. difficult to fathom or understand

Let’s just get this out of the way right now: I am not referring to this post. Instead it was several events today that I consider profound in their individual ways.

First off, my boss gave me the task to do some research on an issue of compliance. He told me yesterday that whatever my final determination would be just that, final. The office would have to respect my decision and my “word would be law.” He was actually saying, “I’m avoiding conflict.” I slept on the issue and this morning I requested input from the corporate level via an email.

I’m not very good with emails. I tend to be brusque. Even – what was the word one of my blogging friends described me as? Oh, yes: CAUSTIC in my correspondences. I don’t bullshit. This morning I typed out my email knowing that I had to be succinct but detailed enough for him to understand the concern without a lot of back and forth. I started to include more details of the issue including names of employees and I realized the email would be recognized as getting personal, so I eliminated much of it. Coco Chanel supposedly said that before you leave the house, look in the mirror and remove one accessory. I applied that concept to my email. Before I hit Send, I removed one (or two) sentences.

A couple of hours later I had my response. Happily the one I was hoping for. I wasn’t expecting for the email to be copied to the office, but it had been and I was figuratively wiping my brow in relief that I had remained professional and unbiased in my original email so the office wouldn’t say I was deliberately swaying the response my way. It was a profound moment.

Unfortunately, all was undone later when I heard that a staff member had been talking smack behind my back. The details are boring, but I did confront the coworker and we had words. Lots of words. Looking back on it the exchange on both our parts was sophomoric. We eventually came to blows an agreement and since we both are straight-shooting personalities, we’ll go directly to each other in the future. And in a strange turn, we realized not only are we both strong-willed but our family-building paths were tragically familiar. She went through four years of infertility treatments, two twin pregnancies (losing both sets as well as a tube when one of the twins was a hidden tubal), a term pregnancy (healthy baby girl who is studying to be a doctor), cancer, and a hysterectomy.

Yes, that all came out in a single conversation. It was, say it with me, PROFOUND.

And finally on a much lighter note that involves the adventures of potty training, Aitch announced as we turned down our lane that she had gone potty in the carseat. *groan!* When we got home, she had a couple more accidents including a piddle on the living room carpet, which I have emblazoned into my memory for total recall when I start thinking how great it’d be to have a PUPPY! (nevernevernevernevernever….) She had been doing so well these past couple weeks except for the whole BM thing. She’d request a diaper for that, which I didn’t have a problem with. I’d rather that than her get constipated.

After supper, and the two prior accidents, she announced she has to go potty and ran to the bathroom. Sparring Partner was on duty, but within moments I heard, “Uh, mommy? Mommy?!” In his way, SP was beckoning me to join him in the bathroom (now there’s a sentence I thought I’d never have to write). I found Aitch sitting on the potty with tears in her eyes. “I’m scared of the poop! I don’t want to poop in a diaper! I’m scared! Noooo!!” and big, fat tears plopped off her red cheeks and onto her lap.

I rubbed her back and stroked her arms letting her know it was OK, and she eventually stood up and turned to look at what was her first BM at home. Gross, I know, but we made a big deal of her accomplishment and she quickly calmed down. She expelled a big breath and said, “I feel better now!”

I am so proud of her. She was proud of herself. Oddly enough, her fear/excitement and our need to assure her of her bodily functions were...profound.

How’d It Go?

It was a good first day. The person I am replacing is training me. She is moving to another office within the corporation so whatever questions or problems arise means I can and should call her. That means it is in her best interest to get me trained efficiently and accurately. Plus, there is no “deadline” on the horizons for her to be at the other office, so we can be quite thorough.

I think I’ll like it. I got a sniff of the office politics already. Apparently the clinic staff can get a little territorial and think she (and later, I) should go to them with questions about the procedures; however, the person training me told me quite simply that if I have questions about what happened in the chair, I talk to my boss: the doctor.

The highlight of my first day was having flowers delivered to my new office. Flowers from Sparring Partner? The last time he sent me flowers was….

…uh….

Yeah. I have no idea when. It’s been years.

The day would’ve ended perfectly if I hadn’t had to come home to bickering and whining. Unfortunately, the largest contributor to this was the person who had sent me the flowers.

It’s like I had never stopped working.