Just wanted to note that this is really good advice. I have experience dealing with thousands of (often angry, and rightfully) customers myself in a different arena, so I totally get it
Current status is appeal initiated and waiting for contact from whoever gets assigned to my case
The bill itself has been extended 60 days which I hope gives the appeal time to at least have a chance to resolve the issue
If appeal is to no avail toward the end of 60 days, I’ll decide whether to let go to collections or just pay the damn thing. I couldn’t get it in writing, but the last person I talked to said they could effectively cut the bill in half if I choose to pay
So, again, much appreciated on the advice. Doubt I’d have been as effective yelling loudly and venting frustration to entry level reps I assume are on the other side of the planet…
I’ve been going thru some of this shit lately. Same company Anthem Blue Cross but different plan and then therefore everything on the old plan no longer applies. All prescriptions need to be pre authorized again. No way this giant company can reconcile one plan to another apparently. Chat or in person I have to give the same info over and over again. I understand getting angry with the prole on the phone isn’t going to do anything but I also don’t really think its gonna make a difference either. There job, whether they know it or not (and I truly believe most don’t), is to obstruct and prevaricate because ultimately that is a more profitable way to go.
Not holding my breath, but it does appear that my balance was zeroed out on my portal. I called insurance today and the rep (finally, after a week lol) knew the name of the person who called me (mentioned in prior post). Cautiously optimistic this may have finally been resolved…
What’s weird is I was told I still haven’t been assigned someone to my appeal and this person that called/left voicemail with no call back number is not a part of that. She’s just some rep from the consumer billing department, or so I was told…
So the balance shows 0, but I’m apparently waiting for a phone call from whoever is assigned to the appeal and another phone call from this mysterious rep who I think is actually the reason balance is now 0
But if you are nice to everyone you’ll eventually connect with the person(s) best equipped to help you and/or the few competent and/or kind souls who actually give a shit about helping you solve the problem(s). It’s like a game, unfortunately, where you’re on a giant fact finding mission and lines of questioning and how you present your situation impacts how well you navigate through the game and waste as little time as possible on the NPCs
None of this is complicated. They can’t employ people to work out the simplest of shit? Why is this like a game? The department that takes the money seems to hum along quite nicely.
It’s a game and it’s complicated because that’s the reality of it. This isn’t the first time I’ve had issues with my insurance company…They’ve actually cost me years of my life at this point. That is not an exaggeration…
The worst part about it is it’s a gigantic, convoluted system where you can’t actually pinpoint one person to get angry with. A lot of them are just cogs in the machine and that’s what I mean by “labyrinth” and “game”
I can only say from my experience that going on emotional tilt, no matter how justified it is, won’t serve any meaningful purpose. You will run into actual kind and actual competent souls along the way and they may be the keys to resolving any issue or completing any objective. It’s complete bullshit, unjustified, immoral, evil, etc, but tilt may cause you to delay the time it takes to get what you need to get done done. It might even make it impossible
Ironically, I’ve been binge watching Designated Survivor and just saw the episode where a kid needed an operation that cost millions of dollars and post-op meds that cost 5 figures a year for the rest of kid’s life
I wonder how much it actually costs to make these absurdly expensive drugs and perform these operations?
Would also be nice if we could see the price of everything sans insurance like a menu. I ask what the full price of things are and half the time nobody even knows the answer
I assume the high cost comes from research and development being recouped. I don’t most drugs are very expensive to produce unless they need some rare snake venom or something.
And I don’t begrudge companies getting their r&d back. But you made a drug for only a few people. More people will have gotten it in trials than will ever be serviced by it. What happens to the people who took the meds in the trials? Are they cut off or do they at least get a lifetime supply.
I mean there’s like 40 kids per year with this disease. While the profiteering comment obviously isn’t wrong this isn’t some blockbuster drug or whatever.
That’s my issue. They pursued it knowing it had only a small use case. So either they were trying to do something good, or just misjudged what the healthcare infrastructure would pay. It’s also possible they accidentally found this while working on something else.
It’s the proof of concept of this approach that’s valuable as well.
Also looked into this drug a bit, I think the wiki page sums it up well:
All children with pre-symptomatic late infantile metachromatic leukodystrophy who were treated with atidarsagene autotemcel were alive at six years of age, compared to only 58% of children in the natural history group.[7] At five years of age, 71% of treated children were able to walk without assistance.[7]85% of the children treated had normal language and performance IQ scores, which has not been reported in untreated children
Bolded for emphasis. That’s a god damn miracle. Going from 42% dead, the rest with severe cognitive impairment and not being able to walk, to everyone walking with 85% normal range IQ is amazing.
I tried finding the history of how they got here, and there’s nothing obvious as to what their motivation is. They seem to be working on multiple other drugs though. I’m guessing that they chose this one because their platform could work for it and the mechanism of disease is such that they could make a difference.
That is kind of irrelevant though, as they recently got bought out. So it’s likely pure profit motive right now.
This is also different in that it seems, at least so far, to be a one time dose. So it’s more like a procedure than a medication. If you want to be real shitty about it, it’s probably roughly the cost of caring for a child with huge special needs for a decade or so.
I think for a lot of people in the company actually doing the science it’s both. But for the CEO specifically, I’m certain #2 is way ahead of #1 on their list of personal priorities.
Pharma industry doesn’t see a contradiction. You need to make money so you can help people. The patent expires but the innovation is there forever. The profitability attracts capital which enables discovery of new drugs.
Specifically shareholders, why should they buy stock of a Pharma company instead of say a tech company? Buying those shares doesn’t inject capital into the company, it doesn’t directly help anyone (though there are some indirect benefits). What should be the motives for any of us when buying stocks? Should people on this forum only invest their retirement in companies that are less profit motivated and most helpful?
Look I haven’t read the actual study yet, but a study of 17 purposely selected patients out of a hundred plus screened absolutely does not definitively prove anything, and you should assume that anyone else telling you otherwise is selling you something
Anyone here ever been on a statin? My new cardiologist is pretty much insisting, but ive heard they can have pretty gnarly side effects. Would love to hear some success stories