Thursday, December 10, 2009

off the cuff

I probably need to calm down before I write this, but if I can't vent to the blog, who's left? 

We have been lucky to have good insurance (disclaimer: this is NOT  post about health reform....I'm purposely staying away from that until I HAVE calmed down).   We were very very fortunate that with Tiny Man and all of his issues, despite some heated phone calls with insurance, we did not have to pay for much of his care.  I know I am one of the lucky ones, and I can assure you that when I count my blessings, health insurance is near the top.  Considering all we've been through, we've had a remarkably easy time. 

That having been said, there are some things that have irritated me to no end.  A few months after Tiny man was born we recieved a bill from Children's Hospital for some of his care.  I knew it should be covered, but there were some issues since we had switched insurances from mine to Hubby's (when I decided to stay home my benefits were suspended, as I was "on leave" for two years).  It took SIX MONTHS and I don't know how many phone calls to insurance and to Detroit to sort it all out.  It wound up okay.

When we started therapy at a private clinic to help Tiny Man develop properly (Physical Therapy and Occupational therapy is common in children with Down syndrome), there were so many loopholes it made my head spin.  Do you know that most insurances will not pay for Physical Therapy for children with Down syndrome, because DS is incurable?  Therefor, they think they'll be paying for life (more $$ out of their pocket).  This even though therapy is PROVEN to help children with DS lead normal lives, and many will not need it after ages three or four.  Anyway, there was some careful tracking, careful wording on prescriptions, and careful careful evaluation speech to make it happen.  Could we have paid for it out of pocket?  Not as much as he needed, we couldn't. 

Since Tiny man passed, we've been receiving Explanation of Benefit statements from our insurance saying that things were paid or not paid.  We've received several saying that they did not pay hospice for the last two days of Tiny Man's life. 

Let me amend that.  It wasn't really two days.  It was EIGHTEEN HOURS.  Six pm on 2/13/08 to twelve oh six pm on 2/14/08.  Eighteen hours and six minutes. 

I guess hospice got sick of arguing with them, because today we got a bill. 

I don't blame hospice.  It isn't an astronomical amount of money.  It's less than we spent on Christmas gifts.  We can pay it, thankfully.  They do good work and they should be paid. 

But I"m angry. 

I'm just angry at a system that is charging me for what is very obviously the last eighteen hours of my child's life.  Any person could look through the billing history at the insurance company and figure out what's going on.  But they won't.  They haven't.  They just said no. 

I'm so angry, and part of me doesn't know who to be angry at. 

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