Wednesday, October 14, 2009

Insurance - how I love and loathe you...

So, I thought I'd provide an update of today's calls and plans... This morning I received a call from a nurse in the precertification department of our insurance company, here's the jist of our conversation:
IN (as in, insurance nurse): Good, morning, this is _________ from Anthem.
Me: Oh, hi, how are you?
IN: Good, you?
Me: Good thanks.
IN: So, we called Nationwide Children's Hospital and they said that they do the Ponseti treatment
Me: Yes, they say that, however they are not a Ponseti approved provider
IN: Oh, I didn't realize that they had to be a Ponseti approved provider
Me: Yes. We were going to a doctor with Nationwide for treatment, but they won't recast children that relapse - they go straight to surgery. There is no one in the state of Ohio who will recast relapsed children.
IN: Oh. Well, you know this Dr. M may not be able to correct your son's feet with castings and he still may need surgery.
Me: Thanks for the negativity (okay, so I just thought this)
IN: I'm going to have to forward this to an M.D. for approval - they should have an answer in 24-48 hours

I'm hoping that we hear back tomorrow, if not, by Thursday.

So, then Nurse Maria at Dr. M's office called me (she is much nicer than Insurance Nurse). I tell her about the situation with our Insurance company. She says that Anthem normally isn't a problem but that if they (Anthem) aren't able to approve us for treatment, they (U of Iowa) can work out a payment plan and give us discounted rates. She assures me that we will figure this whole situation out. What a Godsend. So, we have decided to schedule six appointments between next Monday and December 7. I've been praying all day long that insurance will help us with the costs, but I'm so happy that regardless of what happens there, we can still go and X-Man can have treatment by perhaps the best Ponseti doctor in the Nation, maybe even the World.

I put in a room request at the Ronald McDonald house each Sunday before our Monday appointments. We won't know until each Sunday if we have a room because they give first priority to critical care families and families that are already staying in the house (families get to use their room for as long as they need it). It's a nine hour drive from Columbus, so we will need to leave each Sunday morning and we'll return Monday evenings. We're looking into churches with Saturday evening services so that we can have some sort of worship schedule.

Today, we also went to half-price books (I LOVE that place!) and picked up some books. We're going to give X-Man a new book at each Doctor visit in hopes that he'll stay still during casting. X-Man knows that we are going far away to see a doctor so that he can get casts on; we've been looking at lots of pictures of kids in clubfoot casts. I've also explained that he won't be able to walk with his casts, I don't know that he really understands that part. It'll be tough, but we'd take this over another surgery any day!

So, I would never wish this on any one, but there are definitely some huge blessings coming out of this situation already:
1 - I am realizing how truly blessed I am to have two healthy kids.
2 - My relationship with God has gotten so much stronger over the past couple of weeks. I've been praying more, reading more, and fasting more. And in all this, I'm not worried. I know that everything will work out for our little guy. I'm frustrated that we have to travel 1000 miles each week and that insurance is being difficult, but I know it will be okay.
3 - Ben and I are doing really well. We aren't arguing about silly things and our relationship is much stronger.
4 - I am calming down. I'm not worried about the dishes in the sink - they'll get done. I'm concerned with my family and not the chores and everyday things.

One more thing. This morning when the kids were eating breakfast, I read them Proverbs 13 (since today is the 13th). X-Man asked me to read chapter 15, there was so much that jumped out at me today. Here's two verses that seemed especially appropriate:
Pro 15:13 - A happy heart makes the face cheerful, but heartache crushes the spirit.
Pro 15: 30 - A cheerful look brings joy to the heart, and good news gives health to the bones.

I can't control this situation with the insurance company, but I can control my attitude. And that's what I shall do.


  1. Your attitude is awesome! We'll be keeping you in our prayers.

    love, hugs, and smiles to you all!

  2. oh, and I love the new background but find it very ironic that it's acorns with your history with squirrels. ;-)