Monday, November 8, 2010

Coventry Health Care Inc Accreditation Questionable

Tuesday’s Tirade


" Be sure you put your feet in the right place, then stand firm." ~Abraham Lincoln

There is an epic story in Scripture that depicts a very weak, frightened shepherd, named David, slaying the giant Goliath with one of five stones he brought to the battle. An inexplicable event if one does not see through the eyes of faith.

Today’s blog continues a series of blogs where I introduce the people who closely walk with me as I continue to fight against the Fortune 500 Heath Insurance giant Coventry Health Care Inc of Bethesda MD.

Bernard W. Schmitt is the Bishop Emeritus of the Diocese of Wheeling Charleston WV. He has been a loyal shepherd and friend for decades. I have learned much by sitting at his side and listening to his wisdom. It was natural to seek the bishop's guidance as I dealt with ruthless treatment by my former HMO, Coventry Health Care Inc of Bethesda MD, ruthless treatment that continues to this day.

Bishop Schmitt became my spiritual director in June 2007 and that relationship continued until the spring of 2009. Bishop’s advice ranged from how to write effectively to stir others to action to how to approach others to unite in community.

Most importantly, our visits were peppered with spiritual advice and encouragement. God has great love, for me, as He uses me to fight evil, Bishop Schmitt reminded me often. God’s goodness will, Bishop stated emphatically, ultimately win against Coventry.

I always left the Bishop’s home singing, considering the many amazing thoughts that elevated my soul and spirit:

• Writing my blog must be a top priority, as it can provide talking points for discussion groups studying the quality of healthcare in West Virginia.

• Seek out priests like Rev Msgr. P Edward Sadie, VF, of the Co-cathedral in Charleston WV.

• Use my journals as a way to guide me and see God’s direction for my life.

• Develop the seven gifts of the Holy Spirit as I must now learn a new way to communicate well my story.

• Make sure all details about Coventry are factual.

• God uses problems as a way to direct us. As we surrender to these problems and give up our timetable, miracles will happen.

• Recognize your limitations. Balance work with rest.

• Ride on the coattails of people like Michael Moore.

• Many people today do not feel it is necessary to tell the whole truth, especially when it affects them personally.

• I told Bishop Schmitt that an accreditation agency awarded Carelink an “Excellent” seal of approval despite the existence of the “egregious” treatment of me. He reminded me that deceit is how the devil uses others to ensnare man. The saints persevered through persecution and suffering; I, too, must suffer and persevere.

The devil has a firm grasp on society universally. God has given free will to man but today man has chosen self-interests which destroys the quality life for others. People are too caught up in “What’s best for me?” and search for more possessions as a way to create joy for awhile. It will not work.

Today, as always, I believe Bishop Schmitt speaks truth. He encouraged me to write daily. I do. It’s my way of contributing that 10% of my talent for which Bishop Schmitt called me to do over three decades ago.

Tuesday’s Tale

Another Victim. Another very sad story.

Why is it that victims are oftentimes demonized for seeking justice in a court of law?

It’s all there in my daily notes and correspondence. Coventry is targeting me, suggesting it is I who have done wrong, not they. My wild imagination, my lies, and the danger and violence that they describe as part of my life have intimidated them. So they say. They never intimidated me or caused me emotional harm. So they say.

Among the many notes I have collected, there are accounts of others, I personally know, who have been denied their rightful benefits by Coventry. Meet Nancy Tsien.

Nancy Tsien, age 87, has been my friend for over twenty-five years. We worked together in a bible study program in our local parish twenty-two years ago. I learned Nancy’s story and my admiration for her grew. Today Nancy has very little support from her family or friends. She is eccentric and she lives with dementia. I am her contact with the real world.

In 2009, Nancy authorized me to act in all matters related to her life. Not surprising, in a cruel twist of fate, I learned that Carelink Health Plans, Inc of West Virginia denied Nancy of medically-necessary therapy. I received Carelink’s letter directed to Nancy re her denial. I receive all her mail.

Nancy Tsien, age 86, confused and suffering from dementia, back hurting from three recent falls was denied essential physical therapy. The Carelink CSO did not ask for an explanation, just advised Nancy of her rights to appeal Carelink’s decision by letter. For those who are not familiar with my story, it took me four appeals followed by 19 months to receive authorization for my medically necessary surgery. Nancy remained in pain.

Nancy Tsien, an elderly, sick woman, has paid her dues to society and contributed much to our small corner of the world. Does Carelink expect Nancy to fight by herself with no skills and a foggy mind? Nancy did not. Nancy could not.

That last fall, according to a former neighbor, was a nasty one, down concrete steps, with Nancy’s striking her back and head. Did Carelink ask any questions? No. The real outrage is that this brutally cruel way of Coventry’s doing business occurs again and again.

This is not the rest of the story. So sad to report.

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