To whom it concerns :
My Husband and I recently had our second child, Andrew, who was born with End Stage Renal Disease. In order to sustain life he must have daily therapy … Peritoneal Dialysis to be exact.
We recently received a bill for $2669.00 specifically for the MANDATORY STATE REQUIRED 2 weeks of Peritoneal Dialysis training we had NO CHOICE but to have so that we could learn how to take care of our son and perform dialysis at home. After speaking to a tricare representative it’s been brought to my attention that it’s our responsibility to pay because the “MANDATORY STATE REQUIRED DIALYSIS TRAINING” is on the GOVERMENT NO PAY LIST. WTF ?
Let’s be clear. You approved for and paid for him to have his Peritoneal Dialysis tube surgically placed. You covered dialysis while he was an “in-house” patient at Children’s Hospital Los Angeles. You’ve approved and are paying for us to do dialysis at home, as well as covering all of the necessary supplies and medications to be delivered directly to our home. BUT, you won’t cover the “MANDATORY STATE REQUIRED DIALYSIS TRAINING” ?!?!?
This Makes NO sense. Believe me, you’ll be receiving a personal letter appealing said bill, as will our state congressmen and women. I’m going to make it my personal mission to have this changed, if not for my family then for the next family whose unfortunate enough to experience any of this.
Oh, and if you haven’t noticed my self tittled blog “Type A Momma” … I’ll find the time to be a pain your ass.
Howdy! My name is Hannah and this is my blog! While pregnant with my second child and on house arrest, I mean bed rest, due to some serious complications... I figured it'd be cheaper if I started blogging rather than shop online, so here I am ~ blogging about my MIRACLE baby, and at times my crazy ass pre-schooler! BTW, I've learned that just because I'm a REALLY GOOD online shopper, does not make me "computer savvy!"
7 Comments so far
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I’m sorry you have to deal with shit like this. As if you don’t have enough other stuff going on in your life.
BUT, I have NO DOUBT that you will prevail. :0)
By Meghan on 02.05.09 3:14 pm | Permalink
I agree with Meghan. There is no doubt in my mind that this will be seen about with you as their fearless leader. G’em Hell, Chica!
By Jess on 02.06.09 4:11 am | Permalink
Hannah I’m so sorry you have to go through all this insurance BS. I worked for Anthem and probably the best way to be a pain in their collective asses is to do a few things.
1.Write a letter appealing their denial decision. They have 30 days to get back to you with an answer.
2. Write the Bureau of Insurance. They are the Federal entity that over sees the insurance companies.
3. Get your Doctor involved in helping get it covered. They’ll throw words at you like Medical necessity and other crap but don’t let the insurance company push you around.
By Jessi on 02.10.09 10:57 pm | Permalink
Hi. I am a former student of Nat’s. I have been living with End Stage Renal Disease since I was young. Over the years,I have had two successful transplants but I am currently on dialysis. My son, who is now 31, has also had a transplant. And even though my daughter consulted doctors before becoming pregnant, we have recently learned that my 5 year grandson also has the disease. Marti hooked me up with your blog and I have been following along for some time. I hope you don’t mind.
I am so sorry you are having insurance problems already. Believe me, I could write a book. (Not that anybody would want to read it!). When I had my first transplant, it was before HMOs and PPOs. Most things were paid up front by the patient and then reimbursed by the insurance companies. Ouch!!
But enough about that. I just wanted you to know that I am thinking about you and your family and hoping the best for you. I am confident that your little boy is going to be just fine. He does have a lot of challenges ahead of him but I am sure he will also have a deeper understanding of life that will come with those challenges.
If I can answer any questions, just let me know.
By Denise on 02.16.09 5:59 am | Permalink
Thanks Jessi ! What a help ! My doctors are writing letters to our insurance as I type !!
By typeamomma on 02.17.09 10:51 pm | Permalink
Hanna,
YOU GO GIRL!!!!!
Love ya,
Terri
By Terri on 02.20.09 6:06 pm | Permalink
[...] I called our insurance again, trying to get some answers, but of course I ran into another dead end. I have gotten a [...]
By Type A Momma » Blog Archive » My insurance woes … on 02.24.09 5:11 pm | Permalink
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