The Brains of Insurance Companies
If Representatives From Insurance Companies Had Brains They Would Be Dangerous!!!!!!!!!!
For the past month I have been going back and forth with the pharmacy, doctor's office and brace company in regards to several things that need to be pre-authorized for Chris.
There are 2 medications that he has been on now for over a year. They where originally prescribed when he was in the hospital for his first stroke. The insurance company is denying them because the FDA claims that these meds are used to control seizure and not what they are being used for. I guess they honestly don't know that meds are used for many different things!!!
The 2nd thing that I have been battling is Chris' doctor wants him to have a resting hand splint. Even with therapy the fingers on his affected hand will not stay open. He constantly has too much tone and pain in the hand. The doctor wants the splint used before his fingers contract to the point where they will never stay open again. I would have thought (stupid me) that the insurance company would realize what is happening here and approve the splint immediately.
Now the insurance company wants proof of what PT has been done in the past. Well the hospital never did any significant therapy and of course the nursing home only did 3 weeks of therapy in 7 months. So I spent my day today calling for medical records from the hospital (which was like pulling teeth) Then I went through the mounds of records that I have for Chris and found the medical records from the nursing home which included PT records. Wouldn't you know it - in the PT notes it was noted that the doctor ordered Chris a resting hand splint - THEY NEVER ORDERED IT FOR HIM!!!!
So - once I get the records from the hospital, I can do an appeal with the insurance company for the splint and medications. They will look over the records and make their final, final decision.
By the time this is done - I may be in my 80's. Chris may be ballroom dancing!!!!
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