"Trust in the Lord with ALL your heart and lean not on your own understanding, but in all your ways acknowledge HIM and HE will direct your path." - Proverbs 3:5-6
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| Happy Mama & Happy baby!! |
**Rewind**
Yesterday, after we received the news that our request for coverage had been denied we were filled with all sorts of emotion. To say we were deflated and bummed would be an understatement. Last night I sent an email to all the contacts at Blue Shield that I had email addresses for (thanks to working for a small company we have easy access to local contacts at our insurance company). I wrote a long email and pleaded with them to read the email in it's entirety as I did not feel as though they really understood what we were requesting of them. I knew it was a long shot to get coverage from the beginning of this process, I'm not going to lie, at times trusting in God has been hard, but deep down we knew that whatever happened would be God's will and He would provide. Within 10 minutes of sending the email, one of the reps wrote me back and said that she would try to push for our case to get re-reviewed, instead of opening up an appeal since that would take 30-45 days, but couldn't guarantee anything.
Then today, I went to Stanford to try and get a letter stating that we've been through their feeding program, that it did not help and that they did not provide the same services as Clinic 4 Kidz. Well this was an extremely disappointing trip to Stanford, as the OT told us she could not (or would not?) write a letter but that we could request her notes from Medical Records. So off to Medical Records I went, at least it wasn't too hard to get the records, but then I open them up and read her "notes" on the days that Abby saw her. She had things in there like, there is nothing wrong, she drinks a bottle, mother is just concerned.... WHAT!??? Um wow - how I wish that were my child she was talking about, I mean come on, drinks a bottle!? I WISH!!! Yes I am a concerned mother, but there is 100% validity to my concern. And if this wasn't a concern, then why is her doctor giving us the option of feeding clinic or feeding tube - there HAS to be a problem. This just reaffirms that my feelings I had when we first saw this OT were right - we didn't feel like she paid attention or listened to us, she never even EVALUATED Abby, she just sat there and talked about how we should "just shovel food into her mouth, or maybe cheese whiz, or actually good luck I can't really help you."
Throughout the day I was back and forth on phone calls, emails and in my head, trying to figure out how we could just come up with the money to get Abby into the clinic as who knows how long it would take to hear from insurance, and at the end what if they still denied it. We were even ready to sell our cars, jewelry, furniture, whatever it took. I actually wrote an email to the Clinic asking them if they could let me know how much exactly we needed to be able to pay for the clinic ourselves as we were not willing to wait months to hear back from insurance, Abby needs this treatment NOW.
On the way home from Stanford I talked to a friend who is an insurance broker, and he was saying how this is going to be a really hard case to fight and it would probably be a long drawn out battle, and that in his time of working with insurance, he hasn't seen insurance agree to pay full amounts like we were requesting.
When I got home I checked my email before I even got out of the car and saw that the Clinic wrote me back. For the first year of treatment the cost was at least $76,000. Think I was stressed before, well now I was about to just sit in the car and cry! But then... I got the phone call - "You're never going to guess what just happened, we got the letter of agreement from Blue Shield for full coverage at the in network level for the entire billed amount." ARE YOU JOKING!?!??! A tear or two may have fallen, I think a bug flew in my eye or something.... He told me that this has never happens, for just 1 day after they deny it for them to turn around and give them the letter of agreement for exactly what we asked for. I told him it's because GOD provided and He is faithful!
So we are doing the happy dance over here and praising and thanking God! God says - "Why so downcast O my soul, put your hope in God!" Forgive us for doubting at times along the way Lord, you have proven time and time again that you LOVE us, that you will provide for us and to YOU be all the glory!
Feeding evaluation is tomorrow, can't wait to see how it goes!!!
Thank you thank you for ALL your prayers, we've needed them and will continue to need them as we begin treatment soon!
Blessings!
Happy Mama
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