Real Life

[lls_mutant]

So, a calmer post.

I got the call on Monday that the insurance paperwork had not been filed for Toby's day hospital, and we couldn't start on Tuesday. But we'd probably be able to start on Wednesday or Thursday. Okay.

I got the call yesterday that our insurance plan does not have a day hospital benefit, and we were denied. Not okay.

I am devastated. I am also appealing our case. We're faxing the letter out today- I hope we made a good argument for it. Basically, we focused on the fact that this treatment IS medically necessary, and that the next step if he doesn't go to day hospital would be in-hospital treatment, which would take 6-8 weeks (and be much more expensive). Hopefully, they will concede that day hospital is much cheaper, this needs to be done, and okay, they'll make an exception for us.

Right.

After all my angsting about day hospital, I'm now terrified my baby won't get any treatment at all. I hate this.

Comments

[trovia.livejournal.com]

It sounds like a good argument to me.

Wishing you best of luck. Go tell your husband that I said he should hug you thoroughly. :)

[inksheddings.livejournal.com]

Good luck. I hope it all works out. *hugs*

[tin-o-biscuits.livejournal.com]

Much prayers and hugs~

[musesfool.livejournal.com]

Good luck!

[daybreak777.livejournal.com]

I am really crossing my fingers and hoping hard this will all work out. Our country is crazy about insurance. So crazy I can't even get into it here.

But hugs. Get hugs, hug your son, hugs from us.

{{hugs}}

It's all so not right, but I really hope there is an answer for you soon.

[pinkfinity.livejournal.com]

Honey, I think I missed your post about this at the end of last year, and just caught up. Hugs to you - and good luck with the appeals process. Talk to the doctors, too - see if there is anyone in their practice or in the hospital who can help with the appeals process.

[lls-mutant.livejournal.com]

Thanks :) And he did. He's good like that :)

[lls-mutant.livejournal.com]

Thanks! We'll need it!

[lls-mutant.livejournal.com]

Thanks! We'll need them :P

[lls-mutant.livejournal.com]

Thanks! We'll be needing it!

[lls-mutant.livejournal.com]

Thanks. I'm hoping we'll get an answer (a good one) soon, too. I'm really hoping the "well, you don't pay for day hospital and he has to go to in-hospital, which you DO cover" argument works. ::crosses fingers::

[lls-mutant.livejournal.com]

Thanks so much!

The doctors have been helping us, and I've been badgering the case worker. Hopefully, if nothing else, the insurance company will pay me to just go away. (Although the day hospital vs. in-hospital argument sounds pretty compelling to me!)

[sasha-davidovna.livejournal.com]

~hugs~

I'm so sorry to hear about this. Insurance companies are such heartless bastards. :( Good luck to you!

[sambethe.livejournal.com]

Oh, that sucks, L. I'm so sorry to hear that all this is occurring this way.

You all are in my thoughts.