Monday, August 24, 2009

Bad News, Good News- Which First?

Well I guess I'll start with the bad news first.

Insurance isn't accepting the claim for Lola's DOC Band.  The HR rep from HPB is trying to help us and so is CT.  We will pay in cash and hopefully be reimbursed by insurance at some point, but risking the possibility of not.  And it just so happens, I chose the most expensive company costing $3,600 for one DOC Band.  I feel confident that one DOC Band will be enough, but please be in prayer that it is and that insurance will have some leniancy towards us.  They really have been very nice so far and the severity of Lola's head may be reason enough for them to accept it.  The official no has not been received yet, but our policy excludes DME that is used to reshape a part of the body including cranial molding.  Sometimes when they receive measurements and a letter from a medical professional stating the need for one, they do accept it.  The HR rep did say she has dealt with this same issue with another employee and it all worked out in the end.  So fingers crossed and some prayers please!

Good news is Lola will receive her DOC band next Wednesday.  This Wednesday she has her photo study and evaulation.  We also were able to go back and add an appointment for her DSi, which is a scan of her head so they can make the mold.  Leila, from Maysa's Blog, actually suggested doing that, which was fabulous.  So she will get her band that much sooner now!  And the DSi replaced their old way of making the mold which didn't look pleasant for Lola or me.  So I am very happy about that.  It was the one thing I was hesitant on.  Yaya! The band comes plain so I will have to decide if I want to decorate it.  I think I will get use to seeing it on her then decide what direction I want to go with band decor.  Most I have seen have been decorated.  I am hoping Lola will be out of hers by Christmas, so I am glad we are able to move so quickly with CT.  They have been super so far.  I'll have to write after her appointment on Wednesday.  Clay is finally going to be able to make an appointment so we are super excited about that.  He should be at this appointment and the one next week.  :) Smiles for that!

Chick-fil-A job is going well.  Dad and I met during the hospital stay for Maw-Maw and I was able to start my part today.  Mom kept Lola and I got almost 4 hours in.  I plan on working tomorrow and Wednesday as well.  Then some during the weekend.  I like how I can work out my hours on my own.  This is fabulous.  Dad was right that I would like this. :)

My Maw-Maw had shoulder surgery and is doing well.  They took her pain pump out on Saturday which was probably helping with pain more than she realized.  She saw the doctor today and all looks good.  I have been trying to check on her and Paw-Paw as much as possible.  Lola and I are going back over tomorrow morning to help her out.  Lola entertains Paw-Paw while I try and take care of Maw-Maw for a bit.  Paw-Paw and Lola have gotten to be buds.  I have some cute pictures I'll post soon.  I'm on Clay's work computer right now!

Last, but certainly not least, church.  I went to church at Lakeridge Bible Church this Sunday.  It's quite different going from Watermark to Lakeridge, but I did like it.  Clay is going with me next Sunday (remember he was out of town).  It was funny because Kebby, Lola, me, Laura, Sarah and her son Collin all went.  I was wondering if we looked like polygamists.  Should I have said that?

Well Nurse Jackie is on and I need to watch it so I can go to sleep!

And it's real nice to have Clay back!  Lola and I picked him up at the airport but the drive kind of put me in a sour mood, especially after some irate BMW man cursed me out and flipped me off because I got stuck in the Toll Tag lane.  My Toll Tag wasn't working and it worked like 2 days before that!  How was I suppose to know?  That man got so mad- I think he needs to see a doctor about those anger issues.  I'm paying almost $4,000 for a baby helmet- and I am still smiling.  LOL

Good night moon.

Oh wait moon... It's 11:30 p.m. and I am trying to talk Clay into going to get us some milk.  We ran out! He said he would run to the gas station on the corner, but I told him that milk has poison in it.  I don't know why, but I just can't drink gas station milk.  So off to CVS he goes, which is closer than Wal-mart! No poison in their milk! Yaya!

Okay moon- Good night again.  

1 comment:

Anonymous said...


It's too bad insurance is not paying for the band up front. Maysa's first DOC band was covered from the start, but not the second. I had to call the doctor who denied it and talk to him over the phone. I also sent him a letter explaining things a little further and I even sent him the latest report I had gotten from Orthomerica showing that her brachy was still significant and that considering her age she could still benefit from a second band. I remember being on the phone non-stop to try and get a hold of him. If I hadn't been able to talk to him, I was planning on seeing him in person...

Start gathering everything you can now. The photostudy from CT will help. Ask them if they'll give you a photostudy of a baby her age with a normal head shape to make your point that your daughter needs help. Also, submit the report from Orthomerica and try and get a letter of necessity from your pediatrician. Build your case showing them that you know about plagio/brachy and the possible consequences. There are some appeal letters on the Yahoo Plagio Group that I never used but that might be useful.

In the meantime, if you pay in full up front, you should get a $300.00 discount. Otherwise, they should also have CareCredit which I think will allow you to pay for the band interest free for a certain number of months...

Good luck! I am glad CT was able to fit you in for a DSi on the same day as Lola's initial evaluation. That is awesome! You will have fun decorating it. Some people are crafty enough that they can paint it and feel good about it, others just use stickers every 2 weeks or so and some other people get the band wrapped/airbrushed and though even more expensive, theirs look absolutely fabulous.

I'll be looking for your next post.