Ephesians 3:20 "Now to him who is able to do immeasurably more than all we ask or imagine, according to his power that is at work within us"


Wednesday, August 20, 2008

Are You Kidding Me

Okay so to continue on the nursing coverage issue:
The nursing company was starting to get their act together and had hired an RN. Totally different between an RN and LPN in home care as RNs are the only ones who are allowed to touch IVs. Due to the fact that we have never had an RN, as promised by the nursing company, I had to administer all of Caleb's IV therapies which is a daily task. He also requires different monthly infusions which require constant vitals and monitoring and once again no RN was ever provided for those. Nevertheless, it seemed like we were going to get some days of 16 hours of nursing coverage but not all just yet. It is a shame it took the nursing company 7 months to get at least a couple days of 16 hours of nursing care that he qualifies for. BUT, a big surprise happened two weeks ago. I got a letter in the mail indicating that the insurance company was going to pull Caleb's nursing care all together based upon their review of his nursing hours that were being provided and one doctor's comments who hasn't physically laid eyes on Caleb since he was about 4 months old and who knows nothing about him. Fortunately, Caleb's doctors in Pittsburgh received the same letter and called the insurance company and said they couldn't pull his nursing care because of his condition. After Caleb's docs submitted plenty of paperwork the insurance company did approve nursing care, BUT GET THIS, only for 8 hours 6 days a week. Caleb's doctors did try to get him the 16 hours that they believe he deserves but the wonderful insurance company believes that since we have been 'getting by' on the 8 hours that the nursing company has provided and because I can take care of the IV that Caleb only qualifies for 8 hours of nursing care 6 days a week. So I guess, first off who cares about that 7th day if I get sick the IV will take care of itself. Also, I am penalized for learning how to take care of Caleb's IV because the nursing company never staffed his case with an RN. Also, I guess they would rather me not go back to work, go broke, lose my house, and then when we have nothing MAYBE they will help. AMAZING!! ABSOLUTELY AMAZING!!

God Bless Caleb!!

8 comments:

spacecatsgarden said...

Great to hear about the RN stuff. :)


Chantelle
*charge adult*

Jess Tuschong said...

absolultey, 100%, horrifically disgusting.

nothing else to say there.

I do thank God every day that Caleb was lucky enough to be born into such a caring and wonderful family...and it's just such an awful shame that the STUPID insurance company can't show any level of care or concern for this amazing little boy's health needs. So STUPID!

Jess Tuschong said...

although...i guess at least they did get you back to at least the minimal nursing coverage...

ellen charge said...

yeah fake death on them and c wat they do this is a prob with so many people read max reus and others archives and youll see its all the same it so annnoying how can they expect you to do it all ur self you arent a nurse tho u could b i never will get it

Eva Nichole said...

I HATE INSURANCE COMPANIES!! I JUST HATE THEM! They do not seem to understand ANYTHING!! I am so angry for you, AAUUGGG!!
I know its hard but have you tried calling and getting on their cases about this. I know I do not always have time to call and yell at them because I have 3 kids and running them all over time to get things taken care of.
My thoughts and prayers are with you!!
Crystal and Eva

Niki Hill said...

Insurance companies are the scum of the earth in my personal opinion and your story just confirmed it.
Keep up the good fight and hopefully with the help of your doctors, you and Caleb will get the care and help needed. God Bless your soul for becoming his own personal nurse and learning all there is to know, he's always going to be safe and cared for with parents like you. Hang in there and God Bless Caleb and his family,
Love Niki

skeybunny said...

I guess what surprises me most about insurance companies' resistance to pay for home nursing, is that in the long run it probably would save them money. Exhausted parents are more likely to make mistakes that could lead to hospitalization--doesn't take a genius to figure that one out. My thoughts are with you as you continue to fight for what Caleb needs.

Hugs,
Sarah, Jeremy, and Evan

skeybunny said...

I guess what surprises me most about insurance companies' resistance to pay for home nursing, is that in the long run it probably would save them money. Exhausted parents are more likely to make mistakes that could lead to hospitalization--doesn't take a genius to figure that one out. My thoughts are with you as you continue to fight for what Caleb needs.

Hugs,
Sarah, Jeremy, and Evan