birds in a barrel's mission is to release creative nonfiction into the wild.

40 Days & 40 Writes is its first project.

Office of Medicare Hearings and Appeals

I know I’ve mentioned a few times that I used to work with my parents at their medical supply store. I worked there for about 10 years before my parents retired and sold the store. I feel I truly toiled during those years. Not just me, but my parents did too. Even now, I shudder at the thought of all those hours cramped in that back office, all the stress and anxiety. I fight through the physical reaction against memories of Hometown Medical Supplies to write about it because on the table next to my laptop in this very moment is a letter from the Office of Medicare Hearings and Appeals, of the Department of Health and Human Resources, dated September 11, 2017. My dad tried to read the letter to me over the phone last night and I couldn’t quite understand what it was about. He brought the letter over to my place this morning. I felt nauseous and I ignored it for the rest of the day. My dad’s going to ask me about it tomorrow so I reluctantly opened the letter a few minutes ago, at 10:30pm.

Now, to get a letter from the Office of Medicare Hearings and Appeals in 2017, it means that a Medicare card-holding customer came to our store one day in 2012 with a prescription for a motorized wheelchair. It means that we then called the customer’s doctor for documentation proving that the prescribed item was medically necessary. We decided that it was, and that we were sure Medicare would reimburse us for 80% of the Medicare-determined cost of the power wheelchair. It means that in 2012 the customer zipped out of our store on his brand new power wheelchair. It means that we—I—submitted a claim to Medicare shortly thereafter and a few weeks after that Medicare denied our request for payment. It means that we—I—then submitted all the medical documents and requested a redetermination and the claim was denied again. It means that I then submitted additional medical documentation in 2013 and requested a reconsideration and that was denied. It means that I then got so worked up that, rather than give up, I, by now at the end of 2013, requested an appeal to the Office of Medicare Hearings and Appeals—more or less the last stop before there are no more requests. It means that then in September of 2017, after my parents have retired and I have blissfully forgotten all those long days agonizing over illegible doctors’ scribbles on medical records and figuring out the ins and outs of LCDs and ICD-10s and all the other mumbo-jumbo, the new owners of the store got a letter discussing a case from the past and it sat in a pile of mail addressed to the previous owners until my dad finally swung by the store this week to pick up old mail. That’s what that means.

So I opened the letter. The letter said that, after receiving our request on January 6, 2014, for an appeal request on the denial for reimbursement for a power wheelchair provided to the customer on December 28, 2012, the determination was made on September 11, 2017, that the equipment was indeed medically necessary and that Hometown Medical Supplies should be reimbursed for the item. I don’t know what to say, except: case fucking closed.

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