Fighting the Insurance Company!

Last Thursday, I decided to work on the insurance company to figure out if they would cover the therapy at Mary Free Bed. Jordan was evaluated on April 2nd and was told that it would be a 14 day process for approval. I contacted Mary Free Bed (MFB) every week after that to see if it had been approved, but it was still in the process. Hannah at MFB was wonderful and called the insurance company each time I called her to see what was going on. Everytime they just told her it was in process. Well, it had been 3 weeks and I wanted an answer so she again called our insurance company. This time when she called me back, they had told her that it was a 30 day process for them and they were on day 15. I was so frustrated!! I also asked how long it would bake to schedule an appointment once insurance approved therapy and she told me it would take about 2 weeks. That meant it would be more than 6 weeks after her evaluation before we might even be able to start therapy!! I wanted to find out what I could do to speed up the process. I needed Jordan to eat better and I couldn't just sit back and wait for everybody to do their paperwork!! Hannah recommended I contact my insurance company directly and see what I could accomplish.

I called and talked to Theresa for about a 1/2 hour. She was very helpful in helping me understand their process as well as my options. After explaining my situation to her, she pulled up my information and viewed the report from MFB. She explained that this was a case that did require them to run a full inquiry and that could take up to 30 days. She also understood that as a mom I was desperate to get the help I felt was necessary for my daughter as soon as possible. She explained that although a full inquiry and approval were necessary for them to cover the therapy, it was not necessary for me to receive the therapy. In other words, if I could work with MFB to move forward with therapy without approval from my insurance company, they would continue their inquiry and may approve at a later date. She also confirmed that it would be retroactive and that any therapy received, if later approved, would be covered. This was a huge relief!!!!

I called Hannah at MFB and asked about moving forward with therapy before my inurance approved it and she explained that I would have to sign a "Self Pay" form. I agreed and was able to schedule Jordan's first therapy appointment. She will start her therapy at Mary Free Bed on Tuesday, May 6th.

Through all of this I have learned how important it is to be an advocate for your children. If I had just waited to hear from them, Jordan might not have started therapy for several more weeks. It's also important to mention that I never got angry or upset with Hannah or Theresa while trying to figure all of this out. At one point while on the phone with Theresa, I did get emotional because of my concern for my baby, but I think it helped her to understand how important and urgent this was to me. It was then that she mentioned that I could move forward without their approval. I know now how important it is to gently push when you need help for your children.