Monday, July 26, 2010

experimental

Warning!!! I'm getting out my soap box.

On Friday I called insurance on my way home work and I of course I went through a dead zone and lost the call. Which means I had go back through the whole regamole and start back at square 1. After some looking the status was still pending. I asked how long it takes to say yes or no if something is marked URGENT and was told to call back Monday afternoon (today).

Once home with my favorite lil guy, we got the mail and wouldn't you know there was an envelope for Ian. I proceeded to open it (with his permission of course) and it was from the insurance company. And they denied coverage because it is experimental/investgational. Now, we knew all along the chances of them covering would be very slim but their reasoning is a bit of a stretch. Isn't everything in the medical field experimental/invesgational doctor's practice medicine for a reason. Nothing in the medical field is 100%. My sister broke her wrist they set it and put a cast on, only to then have to do surgery to re-break it and put pins in. She still has some issues with it...seems a bit experimental to me. Through all my research I've done with the cranal remolding they've all had success stories. So I guess I'm a bit confused as to how this is experimental/invesgational.

I'm going to call the orthotics company and see of there is anything else they can do to help get it covered or if it's just a loss cause. Marcus and I talked and had they just come back with the answer of no with the reasoning that Ian's case is not severe enough or they feel it's just comestic (which isn't true) then we wouldn't have an issue with it. But we feel their reasoning is a cop-out and a sad excuse.

The bottom line is that Ian is no matter what going to get what he needs.

The soap box has been put away, thanks for your time.

1 comment:

  1. That is so annoying and wrong! We've been fighting with insurance companies about my gall bladder removal. They had us pay and then paid some of it back, but not as much as they said and lalala. It goes on and on. I'm so sorry!

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