Showing posts with label denial of benefits. Show all posts
Showing posts with label denial of benefits. Show all posts

Saturday, January 7, 2017

Oh, Joy

One of the things that I don't enjoy about being a special needs mom is dealing with the insurance company. Yes, there are a lot of intelligent  people who work for the medical insurance company, but why do I seem to get all the dunderheads?

The annual denial letter for formula and supplies came today. Some of the more redundant things that I have had put in the notes at the top of Eric's chart include when the g-tube was placed 15 years ago and why it is necessary. So it annoys me to no end to be asked for "Documentation" that Eric has a feeding tube. Is this the sole source of his nutrition, they want to know why we have not gotten him off the feeding tube yet. What is his diagnosis that makes the feeding tube necessary He has had the same diagnosis since he was 3 1/2 they just don't change like magic. The name of the formula... duh the same one he has been on for the last 15 years. An evaluation of his nutritional needs, really!!!

To boot UnitedHealthcare will not pay for supplies until we provide this information again.  They have also decided to make us do this every 6 months, really!!! I can not think of a worse harassment of parents of sick children.

Sadly there are only a few relevant things in the letter, Eric's height and weight and a new prescription. The rest is just laziness on the part of the reviewer. After 15 years of this crap, I am beginning to think they do this to us because a certain number of families and doctors will just give up and pay for these medically necessary supplies out of pocket. Aren't the profits and bonuses high enough for the insurance companies yet?

A heads up to everyone. I will be dealing with this crap on Monday, so its not you it's United Healthcare.