Day 352 - Finally Insurance Authorizations!
Friday, December 17th, 2021
This cover photo is of James waking up after a nap. He always wakes up smiling! 😁 😊
We tried a new position with the boppy to support James sitting up. His move is to typically squirm his way flat onto the bed. Instead we had him wear it like a pool floaty.
We had Physical Therapy in the morning. This was Dad's first time working with the Physical Therapist and James. During this time, Mom had an interview over the phone to try and get approved for assistance with GI costs. Well if you make over $45K for the total household you cannot get any help. We did not get approved. Next step will be to speak with the Doctor about insurance codes. Fun!
We did get some good news regarding insurance coverage, finally! Yesterday our RT stopped by to do her monthly vent check and Mom reminded her of all of the things that we are still waiting for approval on. She said she would try and see what information she could get and help nudge things along since she works for the same DME company. Today she let Mom know that she found out that the back-up ventilator was finally authorized by insurance. This was going to be a $25K cost to us but finally after our pulmonologist did a peer-to-peer review with the Cigna director, they received a call from Cigna that the authorization was approved and would be sent over. Yes!
Mom also did some digging through insurance claims and chatting with Cigna customer service reps to find that our Medical Crib was also covered by insurance. That is another $12,500 we don't have to worry about! 🙏 Thank the Lord.
These only took only 4 months! 😆
So now to get the custom trachs approved! This is the next and most important battle to get James off this ventilator! We found that the peer-to-peer review that was done by our Pulmonologist was also for the trach as well as the back-up ventilator. Sounds like we are waiting to hear on that approval. Fingers crossed!🤞
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