Panel Hearing for Insurance Coverage

abirk · #1 12-30-2010, 06:58 AM

Hi Everyone,

I hope everyone had a good holiday. On Tuesday, my husband and I will have fifthteen minutes to discuss at a panel hearing on why our insurance should pay for my daughter's hemangioma removal. Does anyone have any experience or advice regarding this? We have already sent in 36 pages of documentation including support letters from doctors and medical references all from the help of Basia, who is awesome!

missy · #2 12-30-2010, 02:56 PM

Seriously? 15 minutes?

I don't see why you should have to say more if they have that much documentation in their hands. They should pay it because you pay your premiums. They should pay it because it isn't a cosmetic procedure. They should pay it because your daughter has so many other things to worry about, a hemangioma shouldn't be one of them.

Additionally, you should videotape it and send it to the White House. This is the future of health care ... begging for it in 15 minute increments.

Missy

smurph · #3 12-31-2010, 12:40 AM

Wow! I can't say it better than Missy just did.

I'm also thinking of something that I once heard a doctor say. Something about it not being "cosmetic" but "restorative" if that's the right word. I'm not sure where your daughter's is located or what the whole story is, but I'm assuming she was born without it or it was very light...and then a tumor grew on her that is "disfiguring" in some way. And this surgery will restore it to it's original state. How would they feel about a vascular tumor growing on their body or their child's body...would they consider it to be a cosmetic procedure! I don't know if that would help??? Maybe you could bring your daughter with you and have her sitting their on your lap??? ... So that they will see that this is child and not a number.

This is an outrage! I will say a prayer for you that the insurance board will have open minds and hearts. Let us know how it goes!
Shannon

abirk · #4 12-31-2010, 04:30 PM

Thanks Missy and Shannon for the support. The 36 pages of documentation and the panel hearing is both part of our second appeal. We are hoping the documentation will be enough but we decided to go in person to plead our case anyway. We decided not to take our daughter because someone on the panel may think she doesn't need it or they may think she is not mentally effected by it. Thanks for the prayers. We will keep you posted.

KatieG · #5 12-31-2010, 05:00 PM

Wow good luck! Do you have a case manager through your insurance? We had one and it helped tremendously.

shannonhinz · #6 12-31-2010, 05:58 PM

I don't have any suggestions but just wanted to say good luck!

smurph · #7 01-01-2011, 01:03 AM

Good point about bringing your daughter. Good luck with everything!
shannon

abirk · #8 01-06-2011, 12:08 AM

Katie - We did get a case manager she was as helpful as she could be. She was not very knowledgeable about hemangiomas.

We went to the panel hearing yesterday and I think it went good. They seemed to be surprised about the everyday comments we get from people and also I feel that we provided them a lot information of hemangiomas that they were not aware of.

We should find out next week if we get approved for surgery. Thanks for the prayers and support.

missy · #9 01-06-2011, 10:41 AM

We will be thinking of you guys! How stressful!

Missy

adnama · #10 01-06-2011, 05:50 PM

Good Luck with everything! It's so sad that it has to be this difficult to get our kids the care they deserve!