Thursday, April 17, 2008

Field Trip to the Zoo

Today Drew's preschool class had a field trip to the Folsom Zoo. We met there in the morning and played on the playground for a while, then walked through the zoo. Afterwards we ate a picnic lunch and rode the train. Drew's favorite animal was the tiger, which we got to see eating raw eggs! Ava's favorite was the horsey. Although both kids really liked the chickens and peacocks that roam freely in and around the zoo. I took the morning off from worrying about insurance, figuring I'd have time for that once we got home.

Swinging before the zoo

Balancing with a friend

Drew and Miss Cathy

By the monkeys

Peacocks

Riding the train!

So, after a short rest to gear up for the phone calls I'd be making I started in on it. I looked up CCS and Medi-Cal online, but didn't see anything that applied to us. I called the cardiologist to get his opinion on what to do next. I mentioned the appeal and he said yes we should do that, but that he doesn't think it will work, even with an awesome letter from Dr. Hanley. He had a couple of ideas about changing insurance, or changing medical groups to one that does routinely send kids to Stanford, but I don't really like those options. For one I'm scared to change insurance for fear that they would deny us any coverage for Drew because of his "pre-existing condition." And Drew is seen by a lot of specialists, and that would mean leaving those doctors behind to find a new pediatrician, endocrinologist, immunologist, cardiologist, etc. The best option that Dr. Parrish brought to my attention was to inform Dr. Hanley of our situation and see if we could work out some kind of "deal" with our portion of the copay. He said Dr. Hanely could probably call the business office and waive our co-pay if he wanted to! Or work something else out, like a smaller percentage, or a more manageable flat rate. So I sent him an email this evening and I'm hoping we get a response soon. I feel a little embarrassed to ask him to do that for us, but I guess it can't hurt to ask.

I also spoke to my friend's husband who works for the Department of Managed Health Care and knows a lot about denials/appeals. He said if Stanford is a covered hospital on our insurance plan, which I believe that it is, they may choose not to cover the physician's fees but the hospital stay itself could be covered. Then we would only owe a 20% copay on that portion of the total bill. He is going to look into it and make sure. So I'm feeling a little more hopeful today. I guess we'll take it one day at time and see what tomorrow brings. Which reminds me of a verse I like from Matthew:

Don't worry about tomorrow, for tomorrow will bring it's own worries. Today's trouble is enough for today.
~Matthew 6:34

7 comments:

Kate said...

i like your perspective, andrea. and such jaunty neckerchiefs! and peacocks are my favorite birds! i'll have to sneak away from work and walk down to the zoo the next time you go. :-)

The Portas said...

Great zoo pics! :)

I sure hope you guys can get this figured out with insurance and Stanford. What a hassle. I feel for you. This is something you should not be having to worry about!

Everything will work out how it is supposed to. God has a grand plan for the whole situation!

Isabelle & Calista's Mommy said...

Andrea I am so sorry you have to be going through all of this! I am praying for you! If you need anything just call!

Molly said...

We'll be praying something works out with the insurance situation! Glad you had a morning off to not think about it!
Amy

Katie Scott said...

You are so amazing! I'm praying that Dr. Hanley has a great response to your email!!

Lindsay said...

How horrible that we can't choose the best for our children but that we have to be managed by our insurance companies. I truly hope that this all works itself out. After all that it took to finally figure out what would be best for Drew and your family this just doesn't seem right. Sorry for all that you are having to go through.

Kathy said...

OH Andrea...
I'm glad that you were able to escape to the zoo...looks like it was fun!! (I wish we had one here...crazy that with all the people that live here...we don't!)
We'll pray that Dr. Hanley does respond to your email and that your insurance friend can find out anymore useful information for you to use.

It's hard enough taking care of these special little ones...without having to worry about insurance and paperwork. You're doing all that you can...keep it up!!
Kathy