Thursday, June 25, 2009

DENIED

So I got a bill from the Orthotic and Prosthetic company the other day .. for TWO THOUSAND DOLLARS. Um, what? I thought for sure it was a mistake as they told me we were good to go as far as insurance coverage. I didn't check, but they did - or so I thought. Well, I guess they didn't. Because Highmark denied us. The cost for the helmet is 3000 dollars .. the discount for non-covered patients is 1000 dollars - hence the unexpected bill for 2000 bucks.

I'm fighting it. Will appeal to the insurance company. But it's yet ANOTHER battle to fight and if you've read this blog over time - you know I have fought and fought and FOUGHT. From infertility ... to a risky pregnancy ... to breastfeeding disaster ... and then fighting for the plagiocephaly diagnosis after pedi blew me off and now - this. Another fight. (And I've never even gone into detail here about the battles outside of my immediate family ... my sister's loss of her husband and the (ongoing) battle to keep her and her kids afloat ... my other sister's unspeakably tragic loss of her 15 year old son last fall. Yeah, we've had more than our share heaped on us in recent years.)

And even stupid stuff ... working to get our house refinanced (successfully! woot!) Laboring over whether or not to go part-time in the fall so I can spend at least one more day a week with my son (I think I'm doing it. We'll take a hit financially but working five days a week is eating my soul. I fought so hard for my little guy - it's too much time away from him. But that's a battle I fight with J - who is afraid of financial insecurity - and understandably so in this shaky, fucked up economy. So it's an internal battle I fight with myself too - my own fears and doubts - wanting to make the best decision for JACK.)

Mama's tired.

But I'm on it. I found some really well written successful appeal letters (insurers love to deny coverage for these helmets) so I am cutting and pasting the good stuff and customizing it to reflect Jack's situation. And making calls to the specialist he saw at Children's and asking them to gather up paperwork and help me out and having my mom sign an affidavit that as his childcare provider she participated in efforts to reposition him since before he was 3 months old and etc., etc., etc. I'm on it.

BUT THIS NEEDS TO BE MY LAST BATTLE! At least for a few months. I need a break. Really.

Urgh.

2 comments:

Melisha said...

Hang in there. I have never seen a battle you haven't won!

Rachel said...

OH man, i'm sorry sweety!! I hope it is too!