I’m super honored to have partnered with the Christopher Reeve Foundation as a guest blogger on my recent Health Insurance Appeals battle.
I am presently engaged in another battle with my health insurance company on getting a medically necessary specialized shower chair approved! Stay tuned for that one … Events unfolding as we speak!
Here’s the first installment of the article and the second one should be out later this month.
After a long and arduous 7-month road of winding adventure of denials, appeals, and out of the box advocacy techniques … I’m proud to announce I took receipt of my new power wheelchair yesterday with the seat elevator I was denied.
I outlined several detailed articles in Push Living Magazine (article 1, article 2, article 3) on the labyrinth I had to make my way through during this process.
I went to the local media and was able to land a written piece by News & Observer and a small TV segment by ABC 11’s Diane Wilson, investigative reporter, on the battle I underwent.
During this pandemic the most unlikely of things happened. I developed a laser focus and passionate advocacy mission all the topic of health insurance denials for medically necessary equipment.
Whether you have Medicare, Medicaid or private insurance, there is a process, albeit tedious more often than not, where you can navigate your way through the maze of red tape to overturn an insurance denial. You have Rights!
Read the rest on Push Living Magazine: https://pushliving.com/health-insurance-company-vs-the-individual-0-1-advocacy-101/
Over the last several months I’ve connected with friends from around the globe and have observed a wide array of different reactions on how they have been dealing with the pandemic during lock-down, and how their normal lives have changed to date.
This pandemic is not going anywhere anytime soon, and as such, many people have had to change their daily routines such as working from home, wearing a mask to places of business, limiting their movement in social gatherings, etc. Leaving aside the economic impact, I’ve been curious as to how people have been coping mentally. More specifically, I have so many friends who have also sustained a spinal cord injury (SCI) as well as many able-bodied friends.
I’ve noticed a stark contrast in how many of my SCI friends have been coping with the pandemic versus my friends with two working legs. Personally, I can relate more closely my SCI friends on this front. The pandemic has caused me to push the pause button on my life since taking that fateful shallow water dive 10 years ago this August.
Many of us with SCI live in social isolation on a regular basis. Continue reading
ABC11 news interview came out last night on my latest insurance battle for the seat elevator on my wheelchair.
Such a great advocacy tool for all of us us out there who are trying to get the right equipment in our home to survive!
And on we go … I’ll keep pushing with the help of so many wonderful folks guiding me 😎
As I was lying in bed last night the metaphorical wheels were turning in my head with respect to the next move I am planning on making towards my advocacy mission with getting durable medical equipment and services paid for by Goliath health insurance companies. My mind unexpectedly wandered off into the most unlikely of places. I needed to wind down my brain to try and overcome my insomnia when I started giggling out loud.
Somehow I started reflecting on some of the most embarrassing moments I’ve endured over the last 10 years living this life in a wheelchair. When living with a spinal cord injury there are a 1,001 things that can go wrong in your life on a daily basis, most of which are frustrating, dangerous, embarrassing, and suck the life out of you, but I find there can be humor in most situations.
Whenever I read other people’s blogs, websites, stories, etc. I find the ones most interesting who share their personal experiences in a raw form because so many of us can relate to those moments. If you do not have a disability, I’m sure what I’m about to share with you will hopefully make you laugh, perhaps shy away from reading a certain sentence or paragraph, but at the very least will make you appreciate some of what many of us with varying disabilities deal with on a daily basis. If you do have a disability I’m sure you can relate to at least one of my stories!
Without further ado, I’ve invited myself to a “Roasting” as they say in the celebrity business. Continue reading
Over the last several months I’ve engaged in a head-to-head battle with my insurance company, Blue Cross and Blue Shield of North Carolina (BCBS), for a critical function on my power wheelchair called the seat elevator. The seat elevator was deemed not medically necessary by my insurance company and after multiple appeals I was sent a final denial letter by BCBS.
Last week I wrote an article outlining the various steps I have taken over the previous several months in fighting with BCBS over approving my seat elevator for a power wheelchair in regards to the process I have been through, why the seat elevator is medically necessary in my situation, tips and tricks for others, and my overall strategy (https://pushliving.com/the-fight-for-survival-health-insurance-battle-tactics-for-medically-necessary-services-part-2/.) I was in the process of pursuing an external review with the North Carolina Department of Insurance to overturn BCBS’s final denial of my seat elevator. Every state has its own Department of Insurance who sends your external review to an independent review board.
I’ve been through the appeals process many times over the last ten years of being injured, but this time was different. I went a step above and beyond to reach out to local news stations, wrote letters to the CEO BCBS NC, and had several folks working on the internal side. I’m not sure which avenue yielded this welcome and frustrating result, but here’s what happened:
Read the rest on Push Living Magazine: https://pushliving.com/the-fight-for-survival-health-insurance-battle-for-medically-necessary-wheelchair-seat-elevator-final-decision/
We should be enraged, inspired to change, and determined to fight as Americans with the state of our healthcare system in this country. The fact that we spend 2 to 3 times more on health insurance in the United States for subpar services as compared to many other countries in the world is outrageous. It speaks to the issue of no regulatory authority in our healthcare system. The government does not regulate healthcare prices resulting in huge price variations in addition to, but certainly not limited to, consistent denials for countless medically necessary services and products for many hard-working Americans.
-I have a Story –
Tens of thousands of others share similar stories. I’ve had enough and it’s time to fight for my survival and for those who cannot do it for themselves. I’m hard-working, pay into our governmental system, and spend $8,000-$13,000 per year out-of-pocket for health insurance only to be denied medically necessary equipment at every turn. I have spent hundreds of hours over the last several years fighting quietly for medical services I need and now it’s time to take the fight public. This is an issue of basic human dignity so that I may live my life with independence and freedom despite being severely physically disabled.
Read the Rest on Push Living: https://pushliving.com/the-fight-for-survival-health-insurance-battle-tactics-for-medically-necessary-services-part-2/
I am honored to have another article in New Mobility Magazine. I had the privilege of also interviewing a friend, Jonathan Merchant, who has accomplished so much in his life and how he dives into the aquatic lifestyle! Hopefully this article encourages the thousands out there who are wheelchair-bound to start splashing around.
Take the small moments in life … it’s those ones that you will remember decades later!
Read the rest on New Mobility Magazine: https://www.newmobility.com/2020/06/taking-back-the-water/
Taking Back the Water
I’ve always been curious by nature whether that be understanding the physics of a white dwarf star in our universe or diving into the world of neural plasticity to study how the brain can change itself or simply figuring out why human history always seems to repeat itself. There is no topic to simple or complex that doesn’t intrigue me in some fashion.
Over this past weekend I took a few hours, as I often do on lazy Saturday mornings, to poke around the Internet to stimulate my intellectual curiosity on unknown topics. Much to my surprise, I stumbled upon a short video clip produced by Business Insider Today on the topic of the Digital Sex Industry. I must admit this is not a topic I have given much thought to, or ever for that matter, but it piqued my curiosity leading me down my proverbial inquisitiveness rabbit hole.
The wheels in my head started turning as I was thinking about sex, which many of you know I’m very open about and cannot understand why sex is such a taboo topic to discuss in public – much like money or religion. In any event, I wanted to explore the rise in the digital sex industry over the last several years, and in particular, how the industry has changed over the last two months in light of Covid-19. Continue reading
As I was strapped into my electrical stimulation bike while simultaneously lifting weights I had my Bluetooth snuggly positioned into my ear listening to my “Rock it Out” music to keep my motivation over that next hour. Pandora played a song by the black-eyed peas, which came out in 2010 called “I’ve got a feeling.” It’s an incredible dance song when you want to feel pumped up and I used to play it on repeat before my accident in 2010 when I was living at my home in the Bahamas…
… It was a time in life that reflected simplicity, clarity, and pure joy. Life was so simple back then. I was pumping myself up last week because I’m in another battle of a lifetime with Blue Cross and Blue Shield (BCBS) for a new power wheelchair…
… I started the uphill mission of working with my durable medical supplier, my physical therapist, and my general practitioner…
… Two weeks ago I did, finally, receive a letter from BCBS saying that they were denying me a very critical function of the wheelchair called the seat elevator. This allows my power wheelchair to go up and down. Most insurance companies do not think this function is medically necessary for folks in wheelchairs. I then called all the parties involved and there was a complete disconnect among my medical providers. So, in a very Ali fashion, I decided to take matters into my own hands. The age-old saying “when you want something done right, do-it-yourself,” holds true 100% of the time …
… Without further ado, this is the appeal letter I sent into the BCBS appeals committee last week. I will keep you posted on what their decision will be, but when you really want something, you’ve got a fight tooth and nail to get it. Sadly, this is the reality we live in and the fact that we have to justify why we need certain items to insurance companies to, not only survive with the spinal cord injury, but to thrive with it is slightly disheartening. However, this is the healthcare system we presently have to navigate within!
Read the rest on Push Living Magazine: https://pushliving.com/the-art-of-health-insurance-appeals-my-battle-for-a-power-wheelchair-seat-lift/