Tuesday, March 24, 2009

Insurance News...

I received great news yesterday from Blue Cross/Blue Shield about the coverage for Connor's feeding supplies.

Here's how it went down.....I had been calling daily to find out what the predetermination review results were and there hadn't been any news in days, until Friday when they told me that they had sent me out a denial letter for coverage of Connor's supplies and formula. When the woman told me this she was aghast at the fact that her company actually sent me a letter telling me I couldn't feed my little boy. As we talked she told me that she was the mother of a 3 year old as well and she just couldn't fathom being in our position. She knew there must be a way to find a positive result to the situation so we began putting our heads together and we came up with a plan. Throughout our conversation I told her that I had prayed before I even called that day and asked the Lord to give me favor with the company and to get a helpful and kind person on the other end of the line. I told her she was an answer to my prayers and she said, "Great...I'm a Christian too!!!" We worked on putting another letter together with procedure codes and diagnosis codes and prayed for the best. She said she would personally walk the letter over to the proper department and let me know the results. Yesterday she called me to let me know that the results were in and we had received full coverage for Connor's supplies. I feel so blessed that she was willing to help us in the process and the battle for our insurance compay to see the need for this.

So, the weight has been lifted for coverage and we can place our order without having to worry. We still have to meet the yearly deductible and if our out of pocket expense of $1500 is not met, then they will cover at 85%. Once our out of pocket expense is met (which it is for this year already....) they will cover at 100%. It is always up to a yearly review, but we are confident that with the help of the nice lady at BCBS we won't have any trouble .

So, there you have it....answered prayer. Thanks for all you advice and prayers on this issue. I am beginning to understand the insurance battle that so many of us face on a daily basis and I realize that not everyone gets good news all the time. My encouragement for those of you who might have similar battles is to never take no for an answer and keep trying. As frustrating as it is, keep calling and keep pushing. With the economy the way that it is, we can't be too frugal with our finances and with our precious treasures...our children. Find someone on the inside of your insurance company who can be your advocate on the inside and hopefully you will make progress and you will get good news as well.

Although we continue to have challenges, this is one I can cross off the list for the moment.

Lovebug Hugs,