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View Full Version : Pharmacist Steve....my hero!


satchelle
04-04-2007, 08:36 PM
Hi Remember me?

Well I wanted to let you be the first to know my great news I just got about 5 minutes ago. My insurance company Cigna has authorized the Actiq 800mcg 4x a day which is the full amount of that dose that I was requiring. The Actig 600mcg 4x a day they only authorized 100 per month instead of the regular 120 a month, there reason being that they couldn't auth more since it was not used for cancer pain. But I don't understand that because they auth a higher strenghth. Sometimes I think they have trained monkeys just pushing the buttons deciding who gets what. Well since you have built up my self esteem this far to be able to get what I need I think I will go ahead and make a go at the extra 20 Actiq a month.

Steve, from the bottom of my heart....thank you for giving me the encouragement to fight these people and to go after what I needed. I tend to be one of those type of people who say" Oh well thats their decision, I'll have to figure out another option for pain relief. Steve you made me believe that I have the fight and the courage to go head to head with these big corporations. I never thought the little pion like mysef would actually get a favorable outcome....I was ready to give up until your words of encouragement brought out the angry and frustration and "how dare they do this to me attitiude".. My words can't express enough how much your help has meant to me. I mean this is such great news that now losing my job over all of this job seems like a menial task that I can handle with very little problems.

I just can't seem to say it enough but thank you Steve, you have made a big difference in my life.

Your friend,

Satch

Bobbi
04-04-2007, 08:47 PM
That's sweet of you, Satch.

And, Steve... he's a keeper! (He's helped more times than I've counted so that I could understand insurance ins-and-outs and its rationale - whacky as that is at times - a whole lot better.)

satchelle
04-04-2007, 08:51 PM
bump up for Steve...very important

Pharmacist.steve
04-04-2007, 10:37 PM
Satchelle

The insurance companies want people to believe that all their decisions are "knowledgeable decisions" and in black and white and it couldn't be farther from the truth. The insurance company figures that the people they are denying are sick and not up mentally/physically to put up a fight. Those that challenge the decision more often than not get the decision reversed. But it is so easy for the insurance company to generate a "not covered" decision.. in your particular case a few dollars generating a "not covered" decision would have saved them THOUSANDS PER MONTH .. if you had just "went away" .. of course .. your quality of life would have been thrown into the crapper... BUT the insurance company would have SAVED MONEY!.. and that is what it is all about -- for them!

I am glad that you are getting what you need to help you manage your pain... but you did all the work to make it happen...

BrokenBladder
04-04-2007, 10:50 PM
Steve~~~~you're a wonderful asset to this board. You have given me lots of information that has been helpful to me understanding certain things. So here's a BIG thank you from me as well, you deserve it!!!!!

FLGIRLINPAIN
04-05-2007, 06:01 PM
Hi Satchelle!!

This is wonderful news!! I have Cigna as well and they wouldn't approve Actiq for me either. However, I called them today and they said they would approve it for me as long as my doctor calls them!!! Yey!! I am so excited.

Hugs,
Caroline

Lea
04-05-2007, 10:36 PM
That is such awesome news!!

Thank you Steve for helping Satchelle!

RJW
04-06-2007, 07:55 PM
Steve-Any idea why the Actiq is soooo expensive?

Pharmacist.steve
04-06-2007, 08:05 PM
Steve-Any idea why the Actiq is soooo expensive?

GREED
by the manufacturer.. now that it is off patent... you will most likely see the generic's price to drop off over the next couple of years. There is also a lot more rules/regulations/paperwork with dealing with a C-II