Our little guy is staying in upstate NY with his Granny so Jeff and I have had some rare alone time this last week (thank you Mum!!!). Jeff is very tired and needs to sleep a lot but we have made it out to the MOVIES and even went to a grownup party at NIGHTTIME. Those of you who are also parents of young children know exactly what I’m talking about. We also spent a couple of nights in a perfect, bay front cabin on stilts at Nick’s Cove on Tomales Bay. It’s only 30 minutes from us but it was like visiting a far away land (maybe because there are no giant trees blocking the view?)
We’re a week into Jeff’s 3rd round of chemo. It’s going well. The Thing has already shrunk, a lot. The current plan is to do 6 rounds followed by radiation and gamma knife on various bits of him. He has surgery soon to put a pin in his hip (he has a complete fracture of his femur). As you can imagine, he hates having to use a walker and a wheelchair and we’re hoping the surgery will give him back his mobility.
We are realizing that this is a long road. Speaking for myself I’m gradually adjusting from emergency mode to some kind of acceptance of our new life. Not always though. Occasionally I have to get in the car, drive down the hill and have a good scream.
We’ve been floored by the generosity of friends and neighbors who have helped so much: picking up Alex from preschool, having him for playdates and sleepovers, bringing us meals, etc, etc. Thank you.
And then (this is the part that is hard for me to write and where I keep getting stalled)….. and then there is you and your generosity. Our portion of the bills* have finally started to roll in from the hospital and the labs and the imaging center and the oncologist and the second opinions at UC Davis and UCSF….and ….YOUR DONATIONS ARE COVERING IT!!!!
(*What we will be totally responsible for is always shifting and hard to get a handle on. I seem to spend hours on the phone with medical billing departments and Anthem BlueCross, mostly correcting “coding” mistakes. I don’t understand how patients can deal with this unless they have a family member who can quit their jobs to stay on top of it.)
I can’t tell you what a weight off my mind it is not to have to worry about that on top of everything else. I don’t know what to say other than…..thank you. Really. Thank you. I can’t do it right now, but as soon as time stops being so compressed, I will be sending each and every one of you at least a thank you card. I can’t believe that you all care about what happens to us. Ok I believe it now but you’ve kind of blown my mind. Can’t. Write. How. I. Feel. In. Words. Ack.
Ok. Onwards. One day at time.
My friends at ODC Dance are throwing us a benefit concert on July 31. They will be dancing and the Magik Magik orchestra and the Pacific Boys Choir will be performing the music (if it’s not weird to play at your own benefit concert and if I can get down to SF that night and do so without dissolving into a puddle I will be there to play “Optimist”, but I can’t promise).
Huge thanks and love, Z
Yup, a lot of horrible stuff has happened the last three weeks but I am still having a concert at SF Jazz on June 20.
My husband is going to be there. Did you know I wrote my first layered cello-piece for him in 1999? It was a proto-version of Exurgency called “Because I Miss You”. His encouragement spurred me to keep developing it. June 20th is going to be my best goddamn concert ever…for him.
Friday, June 20
SF JAZZ Center, Miner Auditorium
Get your tickets here
On May 13 an MRI found 20 tumors in my husbands brain. On May 15 he could barely breathe and was in a lot of pain. A CT scan that day revealed he had a softball-sized tumor in his lung, tumors in his other lung, his liver and possibly his bones. On our way home from the imaging center our primary care doc called and told us to turn around and get to the hospital right away. My husband was admitted and they promptly removed more than a pint of fluid from his lungs, which helped him breathe better. We were there for 6 days while they performed a bronchoscopy, did more scans, gave him drugs to stop his brain from swelling and administered emergency chemo.
Today I got a letter from Anthem Blue Cross regarding his hospital stay:
"Coverage for the requested service is denied because the service does not meet the criteria for “medical necessity” under your description of benefits. To assist our Medical Director in making this decision, we have put a process in place to send all information about the service to a clinical reviewer with appropriate credentials. Based on their opinion, we have determined that coverage for the requested service is denied. Our Medical Reviewer Layma Jarjour MD has determined we cannot approve your hospital stay for cancer. We do not have enough facts to show that it was medically necessary. "
Anthem is owned by WellPoint. Did you know Wellpoint CEO Joseph Swedish earned almost $17 million during his first year on the job? Now you know how they can afford to pay him.
Update, Thursday May 29:
Yesterday the local CBS station KPIX came out to report on our story.
I also got a call from a women named Patricia at Anthem, who told me not to worry, my husbands hospital stay would be covered. I spoke to Patricia at length today. It’s a little hard for me to explain the reason they denied my husband’s hospital stay, because frankly, I still don’t understand it. But luckily I have an excellent memory and can type fast, so you can just read my transcription below.
Hopefully our situation is resolved and I can go back to focusing on my husband and son. I post this in the hope that it will help other people (people who do not have 1 million twitter followers or who’s stories don’t get covered in the the press) get their denied health insurance claims reversed. What should you do? Keep meticulous notes. Be persistent. Make noise. Do not take no for an answer. Tell everyone. Why this all has to be so convoluted, I do not understand. It makes me livid to think of how many families suffer needlessly because of corporate bureaucracy and greed.
Thank you so much for your help and words of encouragement.
much love, Zoe
Patricia: let me tell you what my research has found out so far. one of the things that happens is that when someone goes to the hospital, the hospital sends an electronic notification to the insurance company and then the insurance company calls the hospital and says ok, give us the information like we understand you’ve got a patient going in, what’s the information, give us the medical records. and apparently in this case there were 3 calls made and we didn’t get any answers back. and so what we were trying to say is that we need this information from the hospital and when we get it we can further handle this case but in the meantime they have a timeframe requirement to make a determination that is under the regulatory requirements that you have to have made a determination by a certain time and if they don’t have the information at the time they have it them um, that’s, that’s, ah, all they can go on and then when more information comes in then we can um of course overturn that. so what we’re gonna do is pull the information to us and get that handled quickly because it’s clearly a covered service and we’re going to work on how we can better word the letter when it goes out to say and let you know we’ve contacted the facility, we’ve asked for these records, once they come in we can consider this, but at this time and at this particular moment we don’t have a claim and we don’t have the information.
Patricia: so it’s one of those things where they notify us and they’re supposed to send that corresponding data and for some reason that didn’t come in and we have made three attempts to get it. so um this is something that we’re going to work on, making us do better
Patricia: and uh, in the meantime i wanted to let you know that we got you a good care manager, i don’t know if she’s reached out to you
Me: yes, yes, she has, thank you. ok, i hear what you’re saying . i think probably from the patient’s perspective of somebody who’s not a health care expert, i just see a letter that says “denied”. so yes, i think you’re correct that if you can do a little bit better to explain the process to your customers, to let them know how this is supposed to work and what they’re supposed to do and this is not a bankruptcy sentence, in addition to a death sentence that would be, um, kind of important. (start laughing). sorry i’m laughing, i’m going through a lot and i don’t know what else to do except laugh because every time i read this letter it seems more and more alarming. so i think that of course, if you don’t have the information that you need in order to approve a claim then yes, that makes sense, but i would think that the letter would say….
Patricia: the letter does say that you can file an appeal
Me: yes, that is at the end. there is a separate page here that talks about how I start a grievance procedure. but the letter says very clearly from the beginning, “we cannot approve your hospital stay for cancer”. so it’s not obvious from this that you just don’t have enough information to make the claim, it just says “we can’t approve it”. so that’s very misleading because the letter, it says, it’s not being approved and that i have to file a grievance when actually the situation is that you just don’t have enough information. so that’s a clear difference in understanding between what you guys think you’re telling me and what i think the letter says and I think you could do a lot better with that because that’s a really alarming letter to get when your husband has a serious illness that you just learned about in the previous week.
Me: i appreciate your calling me with this and talking about it and I’m going to sleep a lot better tonight knowing that we’re not about to go bankrupt.
Patricia: what is is, uh. it’s a very important. um. i mean, we’re very highly regulated in order to do the right things for everyone. i mean especially in california you know, they want to make sure we acknowledge the receipt of your issue when you file an appeal so you get something within five days and it says we’re working on this. and there are things that we can do expeditedly for you when it needs to happen quickly, you can say I need this to be rushed through in an expedited case, we can do that in 72 hours and there’s a lot of good people here that want to make sure the right things happen for your family.
Me: ok, thank you. so going forward. say something happens to my son and I have to go to the hospital with my son. how can i stop this from happening the next time? because you can imagine when you have a catastrophic illness happen to your family, it’s not like you have a heck of a lot of time to be on the phone with the insurance company all day and to be filing more paperwork and all this stuff and, i actually don’t feel like i should have to be doing that. so is this going to happen again the next time we go to the hospital?
Patricia: well, we would hope not. uh. but I’m hoping that i can provide a little more insight for you to understand how everything works and give you resources to contact so that we can work with you if anything doesn’t go the way it should. what usually happens is that the hospital notifies us that someone’s gone inpatient and we reach out to them and then there’s a response right away and they can go and say, oh, we see what’s going on and everything goes through. for some reason, in this case, the response didn’t come even after three attempts and we’re looking into why, into what was the obstacle in getting the information to us in the time period of those calls we made to them. so we’re dealing with the facility to see how can we do that better because we don’t want you to go through that.
Patricia: and so in normal circumstances we ask for the information and they send it and for some reason it didn’t get sent and we’re going to try and find out why and do better on that. and then we can also say in the letter a little more clearly, um, there wasn’t enough information at the time and then maybe give some explanation as to what, uh, would, you know, something along the sense that says when this information comes in, we can reconsider this. and that would put you at ease.
Me: uh, oh, ok. thanks. so, um, what do I need to do today?
Patricia: you don’t need to do anything today because what I will do is, um, we’re gonna pull that information from the hospital and say, let us have those medical records and we’ll get the claim, because we don’t even have the claim yet, they’re preparing that for us. and when it comes in, it will go through processing and then if you have any questions once you see how that was all paid, um, you can always call me. you also have an appeal process and we can put this through the appeal process and we can do what we need to do to make sure everything gets handled the way be within the plan structure.
Me: ok. that makes sense
Patricia: and I think you can get a lot of questions answered through your nurse care manager. I’ve told her to keep you copied so i can make sure you’re getting your questions answered quickly and you’re getting to the care that you need on time and all of that.
Me: ok, I think I understand it now. Thank you for calling to help.
"The @zoecello order processing center. We’ve done over 200 orders in 2 days. GG packs the orders, I print and attach the labels. We’re a good team. If you like good music and are at all interested in helping my sister fund her husband’s cancer treatment, you should go to http://music.zoekeating.com and buy some stuff. Your order will be packaged with love by us.”
My husband Jeff has been sick with a mysterious illness for several months. It’s not so mysterious any more. My man, my best friend, my soul mate, my partner-in-crime for 16 years has cancer. All. Fucking. Over. Lungs, brain, liver, bones.
We’re at the hospital. He is a warrior. We are fighting it.
I have to be strong and present for Jeff and for our son and I might be away from music and social media for a while.
Please, don’t send any condolences. Send strength and love and positive energy, healing vibes, prayers, chants, interpretive dances…all of it.
And since my new album will remain unfinished for a while longer, if you want to help us in ways other than good vibes, you could buy some of my music. Listen to it, give it to a friend and think of us.
I wish good health for you and your loved ones.
Dear World, I’m hiring.
I suppose you could say I’m looking for a “manager” but the patronizing implication of the term annoys me. What I’m looking for is someone to help me grow my business. You might be an artist manager in the traditional sense but I’d prefer to think of you as a vice president of business development, of marketing, of sales, of operations, etc.
In the music business they say you don’t find a manager, that one comes to you when you’re ready. I think I’ve been ready for a long time but for whatever reason, the right person has not presented themselves and I’m such an outsider that I don’t know where to look.
Part of it might be that I’m known as a DIY poster child and often “DIY” tends to equal “amateur” and “struggling”. It’s true that I don’t have the metrics of most “normal” artists: I’m not young, I don’t sing, I don’t have any videos with millions of views. I’ve never even made a video. But there are 8,000+ user generated videos with my music on Youtube that get watched about 225,000 times every month. I’ve sold, last time I checked, more than 70,000 albums without publicity or marketing. My commercial licensing is regular and solid (car commercials, network TV, major films, ballets) and I can fill a concert hall in pretty much every city in North America, in Australia, and in a few European cities. All that to say, I might be DIY but this is not an amateur operation. There is enough money here to make it worth your while.
After a decade of running my music business alone, I think I have acquired some useful knowledge on how to do things. But as they say, you don’t know what you don’t know and I certainly don’t know everything. I have blind spots and increasingly less time (I’m a mom, ‘nuff said). I’ve let more than a few opportunities slide.
I have decisions to make: I have a new album, how should I release it? I have multiple commissions in the pipeline, which should I choose? I hate sports metaphors but I want you on my team. Let’s combine our knowledge to grow this thing.
In addition to relevant experience, there are some other basic requirements for the job. My previous career in information technology left me with certain standards about business communication and organization. You should have those standards too. You are fluid with technology and don’t see it as a separate “thing”, it’s an evolving part of life. You are curious about culture, about trends, about the world. You have moral and ethical standards and being a good person matters to you. You practice random acts of kindness.
If this sounds appealing to you, please write to me at info (at) zoekeating.com with an outline of your vision and tell me about your experience.
Thank you very, very much,
A couple of weeks ago I published my annual sales & streaming revenue.
The Guardian wrote about it, as did Digital Music News and Hypebot.
Then I wrote an email clarifying a few things, and Hypebot published that. A lot of the email is about streaming blah blah blah…
…the big money is to be made at the top of the tail…and therein lies the promise of commercial music streaming services. It will be financially valuable to those who make hits and those who aggregate legions of artists. For a single artist like me commercial streaming will never be more than promo. I accept that. But I will keep talking about it until streaming companies do more to make that promo more useful…
All my music will always be available for free in the places where I decide it works best. Right now that is Pandora, Soundcloud, and Bandcamp. If I determine the promo from a certain service isn’t useful, and/or if I don’t like how they do business or how commercial and ad-plastered the experience is, I won’t give it to them. I would prefer casual listeners to stream from the service of my choice or just torrent it.
Don’t have much else to say on that topic except this…I have a lot of confidence about what I do (translation: bloody ego maniac!!) and I’ve never seen myself as competing with other artists. I believe there is a small class of people who will like my music and my music will eventually find them.
Aren’t I just an example of “The Long Tail” at work? I will not ever sell one million copies of my albums, but I do sell 10k a year…..year after year with no marketing…. because people keep discovering my music on the Internet.
…another of my motives for releasing data: with all the commentary that seems to say “get big or get out”, I want to say that small can be good and to encourage all those weirdos who make good art to keep at it.
Keep at it fellow weirdos.
I think a lot about the ripples that radiate out from everyone’s actions.
I write this because I feel a need to explain why I’ve been talking about the music ecosystem. Here it is.
By some combination of luck, charm and doggedness, I’m moderately successful. (I say “moderately” because I’m certainly not one of those millionaire musicians but I sit somewhere in the possibly-shrinking middle class.)
So things are ok for me but I have this conviction that every successful person has an obligation to help others get to the same place. Whatever ‘helping’ means to you, you should do. For some, it’s charitable donations, for some it’s volunteering, for some it’s mentoring. I do a fair amount of donating to charities and other artists’ projects, but I discovered that maybe, right now, I could make more of an impact by speaking or writing about things.
That is one of the reasons why I started talking about my streaming earnings. I thought I could use use my story to draw attention to how a niche artist operates and to demonstrate that being a successful niche artist might be a desirable career goal rather than just a fool’s errand.
There are more choices than “Struggling” or “Superstar”.
I wanted to inject a healthy does of skepticism into what I saw as a new and well-funded marketing strategy, accompanied by a parroting press, that proclaimed “never pay for music again” and “artists don’t need to sell music any more”. Streaming is not new (I’ve had my music available for streaming since, um, 2005?) but this story about it was. I’m not a saint by any means, but I thought I could make a difference here.
Spotify (the company who did all that marketing to coincide with their US launch) very cleverly packaged their business model as a quest to save the music industry. It’s genius. “Labels, we can get you money you are losing to piracy! New artists, selling is over but we can save you! Just focus your efforts on building critical mass on our new platform!”
Obviously that message is resonating with major labels. New artists go along because they are desperate and have to put there music wherever it can be stumbled upon. But I’m an established niche artist not suffering from ‘piracy’. I make what is, apparently, a shockingly large portion of my income selling music directly to a comparatively small set of listeners. I’m not the only one.
Spotify graciously reached out to me after my first chirpings on the topic and arranged for me to meet with DA Wallach. Over burritos, he patiently listened to my diatribe and pretty much admitted that my model might be outside Spotify’s scope and maybe artists like me shouldn’t put all our music on the service. (That’s what i do, by the way, have some of my music up there)
I’ve never met Daniel Ek, but I don’t blame him for his blind spot when it comes to the economics of niche artists, not because I don’t think he gets us - although maybe he doesn’t, I don’t know. Most mainstream music industry folks have always been totally mystified by me. It’s why I’m DIY - but because it’s business. It’s his job as the CEO of a corporation to pursue exponential growth. By definition niche artists are not going to generate exponential growth…unless there are a lot of us ;-)
I’m pretty sure Spotify has been miffed at bearing the brunt of artist criticism but honestly, they asked for it. They were not the first streaming company by far but they were the first to audaciously declare that their business model would save everyone.
Did I need saving? Do other niche artists need saving?
Now, that doesn’t mean I think things are hunky dory for all the musicians I know. Why? New recording artists are not being hurt by file-sharing/piracy/insert-preferred-term-here. They are are being snowed under by the avalanche of artistic expression created by the largest group of young people in history. There is so much artistic expression that the internet has facilitated the distribution of, that most artists’ future fans haven’t found them yet.
Meanwhile, companies have stepped in to profit off the free and semi-free work of the striving masses. A little critical thinking and you quickly realize that it’s in the interests of many to call the art that is the product of your angst-filled soul-searching, “content”, and to keep it semi-free. Those companies might not have any incentive to send their audience elsewhere in order to help an artist sell albums or concert tickets or tshirts.
That’s not a conspiracy theory, it’s just capitalism at work.
So now what? Casual listeners should not have to pay for music. Those days are over. Let them listen for free or pay for a subscription to the streaming service of their choice. Assuming services pay all rights holders the same rates, we’re good there.
Next, it should be easy for avid listeners to connect to the artists they love and they should be encouraged to do so - to purchase experiences like concert tickets, albums, vinyl packages, whatever. Streaming companies need to facilitate that, rather than doing everything they can to keep listeners inside their walled gardens.
And that’s what happened yesterday. I haven’t explored it in depth yet but I’m guardedly happy about it.
In an uncoordinated and grassroots fashion, other artists have expressed their opinions on the subject. Like me, many have been criticized for being vocal. But you know what? I think it’s made a difference. I doubt Spotify would have thrown this bone if artists hadn’t made some noise.
Youtube, you’re next.