The Battle Continues!!

Well, the battle with the insurance company isn't over! Yesterday we received a letter stating that "the medical policy or plan limitations exclued coverage for Occupational Therapy when treatment is not for a specific sickness/injury." Basically, without a specific diagnosis on an illness, they won't cover the feeding therapy.

As soon as I read this, I started to cry. My baby is under the growth chart, won't eat or drink well, and yet there is not as of yet, a specific reason for this. And because of this, we are expected to either not do anything for her or try to figure out a way to pay for her therapy at approximately $175 per session.

My husband was frustrated because in January, he had surgery for a bone spur on his toe. It was somewhat uncomfortable and has been bothering him for years. He joked that basically it was to fix something that just went bad as he got older. He will be having the other toe done later this year. His comment to me last night was that he would have passed on his toe surgery to make sure we didn't have to worry about Jordan's therapy being covered.

I think one of the things that is frustrating for us is that we feel as though we are still in the process of determining what is actually going on with Jordan. Diagnosis or not, there are just some things that don't seem to be quite right with her. When I was pregnant for all 3 of my children, I prayed that they would be healthy when they were born. There were absolutely no complications with Mak at any time in his growth, development, or anything. He is now a healthy 13 year old boy. Conner was always long and lean (high percentiles for length and low for weight) but he was always on the chart and extremely healthy. We have struggled with determining if his speech was delayed, and now that he just turned three, we are having him evaluated next week. With Jordan, I feel like there have been lots of little things that when I put them all together, almost overwhelm me. I just want her to be healthy and I feel that this feeding therapy is a vital step to making that happen.

Today I will be contacting Mary Free Bed to see if I can get a copy of the evaluation that was sent to the insurance company. We want to see if the report included the diagnosis of "Failure to Thrive" given by her pediatritian. If not, we are going to see if a combination of reports from the pediatritian, Ken-O-Sha, and MFB might have a bigger impact on the insurance company. I feel like the battle is just beginning, but it's one we will fight with everything we have.

MFB does have a program to reduce the cost for patients that have financial needs. We may apply for that program in the meantime, in hopes of reducing the overall cost. Derrick's work also has an employee assistance program that we may seek assistance from. I know we will make it work, but it's just another stress in my life, I don't feel like I can handle.

I am overwhelmed by the big picture of everything, but when I look at my little girl, I would do anything to help her!! Please pray that we find strength during this time. I know we will get through it, but right now I feel very weak and small.