I loathe our insurance company, but I love God!

So, this morning starts off by a call from University of Iowa's financial office. The guy on the phone tells me that our insurance company has denied coverage for X-Man's castings (wow, I am so glad not to have his job!). He tells us we can become self-pay and gives me an estimate of how much all of his visits would cost us. Let me tell you, they were so generous with the amount that they will charge us - I was expecting charges much higher than what he told me. As a self-pay patient, we will have to pay $700 on Monday and then pay the rest as we go on with treatment.

After I put the kids down for naps, I called Anthem and asked if they could provide a reason that our coverage was denied. They tell me it's because people in Ohio do the Ponseti method (once again I explain that they do the method for babies, not for relapsed children). I ask what option I have, can I talk to someone else to get this taken care of? They tell me to call Dr. M and ask for three times that they can call him for a Doctor to Doctor consultation.
I call Dr. M's office and leave a message for his nurse, Maria (she, BTW is maybe the kindest person I've talked to in a while). She calls me back and says (paraphrased)
"I'm sorry that your insurance company is giving you so much trouble. I talked to Dr. Morcuende, and he said don't even worry about the insurance company. Come to your appointment on Monday, we will cover the costs..."
I can't breathe. I can't talk
"We have a fund set up for people in your situation. Of course we like to make money, but we want your son to be able to have treatment."
I tell her "You're going to make me cry... " I think I muttered some non-sense and then thanked her again, and again, and again.

How amazing is that?

I called Ben, I feel bad. There are so many people who are in much worse situations than us. He tells me "Michelle, this is God's hand at work". Wow, that Ben is so intuitive. We agree that we will pay back every cent so that someone else can have this amazing opportunity - it may take a year or so, but we'll do it.

I woke up this morning praying that God would have insurance cover our costs... God responded by giving us an amazing opportunity. Our X-Man gets to see the top Ponseti team in the world for treatment, and we only have to pay for our travel costs. Talk about answered prayers.

Thank you God... How could I ask for more?

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.

I'm a blogger!

Well, it's been a crazy few weeks. We've had some pretty low lows and some pretty high highs too. I should probably add that none of this was drug induced.

We found out two weeks ago that my darling X-Man's feet have relapsed and that he needs surgery on both feet. After tons of research (we're talking up til 3 am every morning), joining groups for other parents with children who have clubfoot, tons of correspondence with doctors, and of course, nightly meetings with God, we found out that we may be able to avoid this surgery.

I've been in contact with Dr. Morcuende in Iowa City, Iowa. He worked with Dr. Ponseti (who is a god in the clubfoot world) for the past 15+ years, so he knows his stuff. After sending some photos of X-Man's feet, Dr. M said that he is pretty confident that his feet can be corrected by applying 5-7 casts. Unfortunately, there are no doctors that use the Ponseti method (on relapsed feet) in all of Ohio. So we will be traveling to Iowa every week through the middle of December.

Now comes the politics of all this... We have amazing health insurance; X-Man has had castings, surgeries, and braces, and we've only had to spend maybe $300 out-of-pocket. I've had two babies and haven't had to pay a dime for either birth (AMAZING). Granted, we pay a ton for insurance, but it's totally worth it. Unfortunately, we just found out that we have no out-of-state benefits. There are no doctors in Ohio that do this treatment, and because of that, we may end up paying out-of-pocket - how insane is that?! Luckily, Dr. M's office called and said that if our insurance gives us trouble, they will give us a deeply-discounted rate and give us a payment-plan.

At any rate, we've been updating family and friends about treatment and my BFF (yea, I said BFF) Jaimie suggested that I start a blog to update family and friends. So that's what I did.