in this world

I’ve been remiss over the last seven weeks in not getting L. in to see an orthodontist. I actually did some legwork on this a few months ago at my semi-annual cleaning; I gave them a quick background and I asked them if they had an othro they’d recommend. Conveniently enough, they have one that comes to their office every Thursday to see patients and that seemed like perfect idea for L. She’s about 14-18 months into a two-year program so all we’re looking for are monthly adjustment visits until she returns to Omaha – or wherever – and has them removed.

I finally gave them a call this morning and rehashed the idea with the office manager and queried about getting her in Thursday afternoon. As if. What I unwittingly stumbled into was the maw of the “no people”; you know the tribe – can’t do, won’t get done, that’s impossible, are you fucking crazy? Yes, them. She tells me that he can’t do that kind of work because how could he possibly know (or learn) the inner workings of another ortho? How would he know what her plan was? What if this ortho would have done something different? It CAN’T be done. I pause momentarily before asking her a simple question: Are you telling me that no family has ever moved while having a child in braces? There was a long pause on the line. I followed up with: Do you think people decide not to sell a house and move because Jimmy has three more months in braces and they don’t know about the alchemy of braces in Nebraska yet? I told her that I had the contact information for her man in Omaha and all that needs to be done is to make contact, ask a few questions on the phone (I’m sure the two orthos understand the language), and then set-up an appointment. She takes my number and tells me that she’ll contact their ortho and call me back. Sounds good, I say, so I’ll hear back from you this afternoon? What? No? She tells me that she’ll talk to him on Thursday when he comes in; she is kidding, right? Does this guy live where there’s no phone? Maybe somewhere that requires him to teleport in from another galaxy? They are killing me.

(p.s. I just called back to get the number of the guy and do the work myself but the afternoon woman just said she’d give him a call and call me right back. Go figure?)

I had class on Friday night so I sent The Forty to see Orestes at the Folger Shakespeare Theater (I’d bought the seats about six months ago prior to getting my class schedule and child moving here.) They had a quick dinner in Rosslyn and then Metro’d in to see the show. When they picked me up after class there were great reviews (WaPo review here) from both girls so it appears their night out was a success. I’d taken L. to the Caps’ game the previous night and told her during intermission that she’d be hard-pressed to attend two more different events on back-to-back nights: crazy sports fans in red and a Euripides play.

t

...makes the world go 'round

Sometimes the learning bit is the hardest part. Well, that and asking the questions you know will confuse the worker bees. As reported yesterday, I had an appointment this morning to have a couple of fillings replaced after my dentist told me during my last cleaning that they were getting a bit tired and should probably be redone; it’s probably been 15-20 years since I’ve had a filling. “Sounds like a top-drawer idea,” I said to him and I made the appointment to come back after vacation and get all gussied up, dentally speaking. A few things popped into my head last night that gave me pause as I headed to bed last night: the first was the dental guard situation (see my previous work here and here), and the second was X’s incident with the boys’ fillings. A quick review of the fillings is pretty simple – the boys ended up getting a number of fillings amongst them and the bill came to an uncovered number around $1,000. The problem is two fold and has been created by both the insurance companies (Delta Dental for the boys and the Tricare Retiree Plan for me, both of which are similar) and the dentists. Fillings can be dicey since the insurance basically covers amalgam fillings but not the resin composite option that most dentists seem to prefer. In X’s situation there wasn’t any pre-work talk from the dentist about the type of filling and/or whether or not it was covered. I don’t necessarily expect the office to know the ins-and-outs of every plan but if there are filling types that often enough aren’t covered then they should point that out, pre-drill. I decided to ask the office manager about cost and coverage when I signed in this morning; I might as well have walked in with a pig on a leash based upon the confusion I caused. My position was this: I’m cool with amalgam since I’m not a supermodel and I don’t really want to come out of my appointment, walk to the counter to pay my share, and hear the number $500. I have 80% coverage on amalgam (my 20% would run about $80-$100) so I wanted her to give me confirmation of the type of filling and the billable amount to me. Twenty minutes passed before she said they don’t do amalgam but there is some talk in my coverage (which I’d already read) that allowed for an adjustable rate for the composite resin. In either case, she couldn’t actually tell me how much two fillings would cost me before getting the work done. I’ve also found out that filling replacements, in general, aren’t covered in any circumstance unless it involves the structure of the tooth. The end result was that I wasn’t interested in a procedure with no cost associated, especially something as simple as a filling or two. What she finally put forth was a novel idea that they send a pre-authorization request to my insurance who will then respond to both of us with covered costs which allows both of us to understand my payment before the work is done. Her final attempt at “mysterious procedures and billing” involved letting me know that it can take up to three weeks for a pre-auth to come back from the company. I told her that was fine with me since I figured the difference between the $100 I think I should pay and the $500 sticker shock was worth the wait. I have my own ideas of how an office manager should run the place but apparently it’s too hard for anyone else to understand….sort of like turning from your lane to you lane when you’re driving.

I’ll keep you updated.

kick in the teeth

Do you know what I love? Meetings. Meetings that are allegedly scheduled for a given time that start late and then devolve into an unmoderated, heaping pile of junk. It happens all the time: 90% of the meetings held in the business casual environment are completely unnecessary. And, if you’re going to ‘hold’ a ‘meeting’ you need to have an ‘agenda’ published ahead of time. “Hey guys, let’s get together and blindly say words and communicate via incomplete sentences concerning fragmented thoughts while staring at poorly constructed PowerPoint slides. It’ll be great!” Today I’ll be hostage to a telephone conference / meeting. Nice.

I’m back from my week out West and have settled into some cooking, a comfortable bed, and the cool weather of the greater Metro area.

The Eleven is off to the Opera tonight to see Carmen. The mezzo-soprano, Denyce Graves, is apparently the “greatest Carmen of our time” but we won’t see her – the understudy is doing two shows and one of them is tonight. We have horrible luck with these opera gals – Angela Gheorgiou (La Boheme) ditched us on closing night at the Met in NYC last Spring, and now this. We’ll be riding the Metro and then the Kennedy Center shuttle after learning last outing that parking is $17. At those kinds of prices they could charge $700 for occlusal guards.

Speaking of occlusal guards, my dentist came up with a cost of $719 for a pair. I went in yesterday for the taking of molds – imagining that plastic teeth guards that prevent grinding – and thinking it would run me something like $200. As they are in the middle of doing my uppers the office manager comes in to “let me know” how much it’ll cost and whether or not I want to have the guards fabricated. Apparently, the cost to them is about 15 minutes of time because they send the molds off to be made for $570. There’s also a mysterious $150 lab fee that isn’t covered at all by my insurance. She tells me the lab fee is for some type of special molding-canoodling that makes the guards more comfortable to wear at night. What? They are made for nighttime wear…shouldn’t that be standard. “Anyway, we can give you these night guards but they’re made of wood splinters. If you want them to actually be comfortable we’ll be needing some extra money.” I called back this morning and cancelled the whole thing. I’ll put a bullet between my teeth at night and call it good. Of course, I fell for the same old dentist junk: always ask and agree on cost before Dr. Doolittle gets you in the chair. Unfortunately, most that I’ve come across in the last two years are some shady financial characters.

I’m thinking of putting in for some government bailout money. Has anyone found the application forms online?

T

eff the customer, or...'done in by The Man'

I shouldn’t be so abrasive. The Eleven had some excellent encounters with the real world yesterday: she at the dentist, I at the IRS. I know my story better so I’ll give it the first whirl.

I left work early so I could get to the local IRS office by 3:30pm (they close at 4:30pm). I know that doesn’t leave DMV-quantity time, but it’s not like we’re in the midst of tax season. I had called the office beforehand and the message told me that there were only two types of inquiry that required appointments: tax preparation and handicap/special needs customers. All I needed was five minutes for some tax hack to pull up my account, tell me what they added, where they got the information, and tell me what form I need to fill out to begin the process of countering their excellent work. What I got was a desk lady telling me at 3:30pm that they aren’t seeing anyone else because there are still four people waiting for help. So? Do I care? Nope. I’m perfectly happy to sit in your waiting room to see if I can slip in before 4:30pm. She claims they don’t normally do that, make people wait without a number and all, but she’s clearly befuddled by my showing up at her desk during business hours…the nerve! The only option she had now was to go behind the cubicle dividers (with cipher locks?) and find someone to get me away from her. Out comes another IRS cartoon character and she relays the same story and recommends showing up at 8:30am to get a number and sit in the waiting room for up to five hours. Or, she can give me an appointment for sometime in June of 2035 (or next month). I say to her that they don’t recommend jack on the phone, in fact, they tell me that only the above two areas are valid for appointments. So I took my 2004 tax form from her, my letter from the IRS confirming how they’ve helped me, kicked her in the shins, and walked out the door...pissed. If I have it all lined up correctly in my head, here’s how it works: IRS adds some mystery tax bill to my account, charges me monthly interest, tells me to call the 800 number that can’t help me, tells me to remedy the issue by June 4th, can’t help me in the office unless I have eight hours to sit around steaming at their ineptitude, can make me an appointment three weeks away, and generally just expects me to be happy. Love it.

X ended up at the dentist office yesterday to speak with them about a bill for the boys. Her tale gets me more worked up than the IRS because I recognize the IRS as a ship manned by fools. I know they’re dysfunctional. A local dentist office is different; you’re standing right there while it’s happening, yet you get screwed in the end anyway. The short story is that they made some routine dental work choices (filling types and associated costs) that they knew weren’t covered by insurance. They didn’t tell her they were making these choices, knowing they weren’t covered, but still manage to standby the “you should know your insurance” line. That line is true but wasn’t the actual debate. If you don’t say you’re going to do A and/or B then my intimacy with my policy is irrelevant. In the end, X got a big bill for services that weren’t needed: nitrous and white fillings. The dentist knew the insurance issue with the nitrous (most don't cover it) but appears to have a soft spot for the comfort of children (a good thing), and felt that nitrous would make them happier (more comfortable?), so she did it without asking the parent if it was all right. That decision alone ends up being a chunk of money for two kids and multiple appointments. The white composites fillings for back teeth are just silly. Anyhow, X stood her ground and went to speak with them face-to-face after getting nowhere with the office manager. She had a short chat with the dentist/owner, who then went to fetch the dentist who did the work, and told her to explain her thought process during the treatment. After this recreation, and when both X and the dentist came to an agreement on some middle ground, the office offered to cut the bill by 50% and X accepted. It’s probably the best anyone could hope for in the instance, but I still have reservations about unexplained activities that involve other people’s money, particularly when we’re talking routine medical services. You certainly can’t walk into a dentist office and tell them to do some work and afterwards you’ll decide what you think is ‘best’ for payment. If there are choices for medical care than those choices should be provided. If we make the wrong decision because we didn’t understand our insurance, bad on us; but to intimate that we should be in the exam room during the procedures, and watching everything the dentist is doing, is just wrong.

Cake or death?

We’ve got a concert to attend at the Birchmere tonight…I’ll be nicer tomorrow.

T.