Friday, March 28, 2008

Still Appealing

We hope everyone had a wonderful Easter!
Peyton is doing well. She did see her regular Ophthalmologist last Thursday and was given a good report. I asked about her eyelid pulling away from the eye as the other doctor had mentioned. She said that she really didn't see a problem, so nothing to worry about there apparently. She's happy with where Peyton's vision is right now, so doesn't need to see her for 4 months!! This will be the longest time between visits!
Peyton followed up with her Neurosurgeon on Tuesday. He wants her to have another MRI to make sure nothing has changed. That will be in June.
Therapy continues to go well for Peyton. We're approaching crisis mode, however. The company is having issues with my insurance company (for all clients with that insurance). They are gearing up for another round of denied claims, like what we experienced between October and December 2007. To that end, they are unable to provide services under our plan and if we want to continue past the 25th visit, we must private pay. So, that's about $800-$1,000 a month I don't have. Now, it's possible that the insurance will pay, but in order to prevent being out all that money for their clients, they want the private pay rate to cover the sessions in case the insurance company does start denying. Seems to me they are about to lose a lot of clients!
I'm still in the fight of my life with insurance as I am filing my second appeal to have those 13 denied claims reversed and paid. I do not feel optimistic at all. I'm mailing the package out today. I think they have 30 days to notify me of their decision. So please be sending up some prayers that this stress and burden will lifted and that the insurance company has a conscience and does the right thing.
Will keep you informed of our progress.

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