In With Evaluation, Out With Insurance

Today I called the clinic where we are supposed to be going, to check on the status of our insurance authorization. I am so glad that I did! I was told that our insurance company currently refuses to review the cases. They will send the case back to the clinic saying that outpatient therapies do not need preauthorization. The therapies the kids receive while there are not outpatient, and are highly specialized and intense. Some kids are inpatient, and some are day patient, so they do not show up once a week for an hour session, but instead receive many sessions every day. I knew this would be a big fight, but I had no idea how big. I was told that there are a lot of kids with our insurance who could've been seen and treated by now, but they are still waiting for this company to review their case. This has been going on for 2-3 years, and there is no agreement in the works at all. I cannot wait to get treatment for Ben, we need it now. So, I have begun to brainstorm.

One option I came up with is to change insurance companies, and fortunately, it is open season. We have been with our current company for 6 years, so changing that is a bit unnerving to me. One other problem is that the new company that may cover this stay is an HMO. I don't like HMOs. Having grown up in medicine, I can manage our care very well on my own, and I like to have control in my choices of specialists. I feel like I am losing some of that control, and that using an HMO is a serious step down from what I'm used to. My consolation is that I can go back to our current company in another year. I just have to get Ben's stay covered and completed, then hope we all stay healthy.

I have been deeply concerned about this battle with the insurance company, enough to ask for the faith of our family, church family, and friends. On Sunday we held a fast for Benjamin and this whole process. I am very grateful for the help of those who prayed and fasted for us. I truly felt their love, and received comfort because of their efforts. I know that somehow the Lord will work this out if I do my part.