Well. I have been pretty frustrated and upset for the past two days. I have been dealing with BCBS of Alabama Peehip. One minute they say one thing and the next minute something else, last time I spoke with them they said Hayden would be covered if medically necessary and the surgeon said she could take care of that. So we figured everything would be taken care of at the out of network rate subject to our deductible. Well today, I called back and asked if they would send me am authorization approval letter. I supplied the with CPT codes. They then proceeded to tell me one was not covered. After further discussion and a transfur to a supervisor, I was told it would be covered only with the medical diagnosis of hearing loss and that payment would depend on the improvements in his hearing. Well, I am assuming since we are not going to put Hayden through a canalplasty they are going to rule this cosmetic and deny everything.
That is so disheartening. I mean a child can have his ear bitten off by a dog and the insurance will reconstruct it but be born without one and you are pretty much left to fend for yourself.
I am awaiting to hear from the surgeon but it sounds like costs are about to skyrocket. According to the insurance specialist, BCBS is the most difficult insurance company to deal with and they always deny the claim. Seriously. I am just so confused right now, I have no idea what to do. If Hayden's claim is denied we would be left paying an astronomical bill we can't afford.
I just wish The Lord would take this off of me and show me the way. Maybe this is Gods way of telling me that Hayden's needs to stay the way God made him, which is what we have taught him his whole life.
The only reason we decided so quickly on reconstruction is because because of all the reform in the healthcare system and that the surgeon we chose, like many was possibly going to a cash only system.
Cash only options for microtia repair are astronomical as if 20,000 isn't already.
Summer