Friday, April 10, 2009

And... Back to Stanford... We Think...

Well, there are all sorts of curves and twists for us today but hopefully we have made a significant step forward. Today, Mia was officially assigned a Case Worker from our insurance company. Her name is Renee and I got the chance to speak with her about Mia's needs and trying to get her transferred to California. Renee listened very intently and asked a lot of questions and then said that she would start working to see what she could do.

After talking with Renee, I started to call some of the other hospitals that we know accept our insurance company to see if they had facilities that could handle Mia. I spoke with a lady named Kim that works at Dominican Hospital in Santa Cruz and explained the situation and that we had tried for Stanford but Stanford had denied Mia. She explained that Dominican was actually a sister hospital of Stanford and that they work really closely together. I was thinking to myself, oh great, the one other hospital in the bay area that can take Mia and she will probably get denied by the same doctors that denied her at Stanford itself... Kim asked a lot of questions and said that she would look into seeing if she can pull some strings for us.

Later in the day we heard back from Kim who explained to us that she had found out that Stanford had denied Mia because they were of the understanding that TriCare would not fully cover the hospital. Kim then contacted Renee the case manager at TriCare and explained this to her at which point Renee was very surprised and said that was not correct and that TriCare would cover all of Stanford. Armed with this little bit of knowledge, Renee and Kim combined are going to try to get the mess straightened out on Monday and get Stanford on the right page.

So... in essence we are back to working on Stanford. IF they fall through for a third time (knock on wood), our insurance company said that since there are no other options in the San Jose area that we can then look for an out of network provider. In that case, then Mia can go to the Santa Clara Valley Medical Center (that has already accepted her) and we don't have to worry about insurance not paying.

Mia, on the other hand, is doing really good. She is getting a lot more stimulation with different things now, including her swing, bouncy seat and toys! It's fun to watch her look at the different lights and colors and I'm sure she is enjoying looking at something other than a white ceiling. We really can't wait for her to get more tummy time and have more physical therapy. (In photo: Mia enjoying her toy from her primary nurses Patricia, Karla and Jessica. Thank you so much, ladies!! She LOVES looking at it and listening to the music!)

On a different note, Rachael had Mercedes blow her nose yesterday and then she started crying and said her ears hurt, so we got an appointment for Mercedes for today and found out that she has a mild double ear infection. So she is on some antibiotics to clear that up. Please pray that she will get over it quickly. Other than that, she's been her usual cheerful self!

Well, that is about all we know right now. It doesn't look like we will hear anything until Monday but we are hoping that once we get the go ahead then we might be out of here on Tuesday or Wednesday. Thanks again for all of your thoughts and prayers.

Robert

2 comments:

  1. My name is Amy--you don't know me but I'm a friend of Mike Steelman's, and saw your story on his blog and decided to start following your story. Your faith amazes me. Know that you are in the prayers of many that you don't even know.

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  2. The steadfast of mind You will keep in perfect peace, because he trusts in You. Trust in the Lord forever, for in God the Lord, we have an everlasting Rock. Isaiah 26: 3-4
    May you rest in Him during all this insurance/ hospital jockeying. Thank you for the updates, it gives us direction for our prayers for you all. From Laura McHenry

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