Posted By Posting
Sep 03, 2008
BRANDON-Zantac and Bethanacol; Neocate formula, 2 sets of ear tubes, Adnoids removed, Vasomotor Rhinits, Asthma. Currently on: Xyzal, Omnaris, Flovent and Xopenex,
AUBREY-Zegerid 2x a day, Soy Milk, Tubes put in and adnoids removed (11-7), Hypotonia, ECI therapy for low muscle tone throughout trunk and hips, oral motor issues and sensory integration issues, delayed speech, Teething, probiotics
PICTURE: Aubrey in her cute cat outfit. If you look you can see how her right foot turns in. She walks that way as well. It is not as exaggerated in the morning's but gets worse in the evenings. This was after her nap.
OK-on top of everything I have been dealing w/ I got a bill yesterday in the mail for AUbrey. It turns out to be when I had to take her to the pedi on 7-11 and she had to have the cathetar and blood work and was super sick. My insurance will only cover half (my half is almost $100) of the cath insertion. The insurance claims it is a surgical procedure and that applies towards my deductible. I was fuming. I told her my dd had one done at the first of the year and we never got a bill. The nerve of that woman-she really said this-if you want I can pull that bill and we can run it through again and if it was processed wrong we will send you the bill...WTH???? I told her that there were no needles, knives or sedation of any kind used. She said for it to be considered a surgical procedure there doesn't have to be.

I guess I am confused on what a surgical procedure is. I mean there was no anesthetic used-nothing. I am of course appealing it, but am at a loss of how to word the dang letter. I had no other option of getting a urine sample from an 18mo old.

Whew. My keyboard is smoking I am typing so furiously right now. Any ideas on what to put in the letter would be awesome. I just can not believe what a crock insurance has become.

Of course I would pay it no matter what as opposed to deny my dd medical attention but that is not the point. Thanks for letting me rant. My uterus is a contracting so I am going to go get my heating pad. When will the saga end????

Sep 03, 2008
Donnessa, mom to Halley born 3/10/07
Reflux (mostly) resolved at 14 months
and Addison born 8/17/09. Currently exclusively bf and on 7.5mg Prevacid
If the billing department at your pedi's office is any good, I would ask them for suggestions. Hope you're able to work it frustrating.
Sep 03, 2008
Jessica, Mommy to Jedd, severe reflux, severe food and oral aversions, Finally G tube free!!! VSD repair 4-24-07 (open heart surgery), hypospadias, repaired 3 times and Ear tubes Visit Jedd at his CB site:
I second talking with te billing office. They can be pretty creative...LOL

Jedd got cathed in the pedis office and we weren't charged for it...HHMMMM

I hope the appeal goes well.

Sep 03, 2008
Tracey, mom to Katie. Diagnosed with reflux at 3 weeks and put on Zantac. At 8 months old she was removed from Zantac as it was giving her migraines, currently on Prevacid. Switched to Elecare since she is not gaining weight; trialing solids after being off for a month. Geneticist said reason she isn't gaining weight is she is stubborn. Upcoming appts.: Neurologist for developmental delay and EGD scheduled for September. She is one funny baby!

Aarrrgggg is right!

When I worked for a daycenter center in college we couldn't remove a splinter with tweezers even if the splinter was sticking up high enough to grab it with the tweezers. Using tweezers constitued "minor surgery". I am unfortunately not joking. We had so many kids who just needed two seconds worth of pulling but we couldn't do it. Eventually we just would do it and tell them to not tell anyone cause we could get in trouble. Nice to tell a child "don't tell because you can get me fired" over a splinter.

Sep 03, 2008
Maggie is now 3 years old and reflux free (knock on wood). I still check in some to see how everybody is doing :) Hugs to all!
Girl, you don't want to hear what I'd put in that letter right now. I do things based on principle too. It's not the $, it's the principle. All I can give you are understanding hugs!
Sep 04, 2008
Sharon, Mom to Elyse, 17 mos (15 mos adjusted-preemie). Zantac/Elecare. History of: Respiratory Distress Syndrome with ventilation/CPAP/cannula, tpn, n/g tube, PDA, jaundice, apnea, bradycardia/tachycardia, severe anemia, blood transfusion, reflux, Sandifer's Syndrome, intestinal malrotation, hemangiomas, MSPI, feeding issues. ICU inpatient 53 days! 2 surgeries, 2 UGIs, barium enema, pH probe, endoscopy. Developmentally on target now! PIC: Yobaby Beard
I second (third??) talking to the dr's office...they might change the ICD9 code for you. Like Jessica said, they can get pretty creative in order to get insurance to pay...
Sep 04, 2008
Mary & Nicholas 7-17-03 (non-refluxer)allergies, asthma on Singulair and Flovent & Aidan 1-28-07(my refluxer)Nissen Fundoplication on June 20, 2008, FTT, MSPI, DGE, ear tubes, allergies and severe GERD now currently taking just Prevacid and drinking Elecare Vanilla 1+.
I want to just ditto everyone else and say you should call the billing department and see what they can do for you. My insurance wouldn't pay for a $32 x-ray earlier this year because the hopsital coded it as an injury and so my insurance wouldn't pay the bill until I signed a waiver saying they could sue a third party for causing the injury. I was like HELLO he was in the hospital for an ALTE and they were checking his lungs for aspiration. No injury people. Luckily, the billing department just recoded the x-ray differently and resubmitted it and of course my insurance paid it lickety split.
Check with your
doctor first!