DENIED!

Yep, that's right. The big, old, nasty insurance company has denied covering the vital stimulation therapy that my speech therapist, G.I. doctor and Pediatrician all recommend. They say there is a line in the policy that says they don't cover electro-stimulation to treat dysphagia, however, they were the ones who said that Children's Hospital was the only in-network provider we could use! It's only now, that we are requesting an out-of-network referral that they say this. Oh, and that it's too experimental. I guess they would rather cover the cost of an anesthesiologist and a surgeon to insert a stomach tube, continue to pay for my food and ultimately offer no real chance for a cure.

So, mommy and daddy are looking into a private pay option and following the appeal and grievance process as a retro-active activity. The provider they are wanting me to see is being super nice and offering her reimbursable rate to mommy and daddy - not her full rate. Plus, the provider got mommy and daddy in touch with an agency here that coordinates and often covers this kind of care for kids like me. So there's a chance it will be covered partially by them. Miraculously, there's a government program out there that is not financially need-based, rather they focus on the needs of the child. Imagine that! Can you believe I sound so cynical at such a young age? Forgive me. I have been exposed to the big bad world of HMOs!

And now for a good health care news story!

Today, I had a consultation on my ears to see if I am a candidate for ear tubes. Mommy and daddy took me down to the place. My appointment was with Dr. S. When we got there, a nice lady performed a hearing test. I didn't cry at all. Then we went into Dr. S's examining room and waited. Mommy said we were in a good place when she noticed that Dr. S got his Medical Degree from the University of Oklahoma. Goooooooooo Sooners!

Well, anyway, Dr. S and his assistant Pam checked my ears. I won't lie; I screamed the whole time. Dr. S said my ears were full of fluid and red. No infection, but well on their way. He recommended ear tubes and prescribed a new antibiotic for me to take while we await a surgery time. Pam is going to work with the scheduler to see if there is something sooner than the usual 3 weeks out since my ears are so bad. It probably doesn't hurt that mommy mentioned her Okie connection either! ;)

Milestone Update

Well, I am walking really good now and am even trying to run, sometimes. But when I try to run, I go too fast and end up falling down. Oh, I even started waving! I will see if mommy or daddy can get a picture of me doing it and post it up here. It's pretty cute if I can say so!

I know it's been a while since my blog has been updated. Mommy has been really busy and now with this next round of health care junk, it's probably going to get even busier.

I promise to make her do her next update sooner than last time. If only I could do this myself!

Bye-bye!