Thursday, July 29, 2010

Ranting of a Mama Bear

We're trying to get a small procedure scheduled to reduce the size of Dayna's scar before she starts school in a few weeks. We've been working for almost 2 months to get it on the books. The problem is that our insurance company is requiring a preauthorization to do a "cosmetic" procedure. Apparently, they are the only insurance company that requires this (at least, the only company our doctor works with.) They have lost requests, shuffled our paperwork around, etc. for five weeks now. In the past week, 3 urgent faxes have been sent. Each time I call, our estimated timeline for approval gets longer.

Today, I was finally told that the insurance company will not approve the procedure. They told me to schedule it, submit it, and appeal it (because it WILL be denied....straight from the insurance company's mouth.)

Well, meanwhile, we found out that Dayna's ear tube has dislodged itself and needs to be removed. This is causing some minimal hearing loss in her left ear. We figured we'd have that done while she was getting the scar revision handled...one round of general anesthetic for two procedures.

Because we are now denied the "cosmetic" procedure, we are forced to go through two surgeries with Dayna in the coming months.

I'm absolutely disgusted with our insurance company. I have never heard of a company denying care ("cosmetic" or not) for a cleft affected child. Her lip was repaired (beautifully, I might add) when she was 14 months old. Since then, her face has grown, skin has stretched, and her scar and lip need to be revised. I don't fathom how the insurance company doesn't consider this medical. Do I really WANT to put my child under the knife? Do I just arbitrarily schedule plastic surgery for a five-year-old because I don't like how something looks? Seriously, now!

Okay...my ranting is over...for now.

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