Today Will had his last feeding therapy (Vital
Stim) at the hospital. He is still not eating much by mouth. He still puts food in his mouth, chews, then spits it out. So why are we stopping the therapy that Will has shown so many improvements with, because of our insurance, that's why. Our insurance company will only pay for 20 therapy sessions during one calender year. They will pay for 20 sessions of speech therapy, 20 of physical therapy and 20 of occupational therapy but nothing more than that. It completely blows!
I have tried to appeal the denial but that is like fighting a battle with both hands tied behind your back, in the dark, while underwater, blindfolded...you get the picture. It is just ridiculous.
Appealing the insurance company is a battle that I just will not win. It is much like the battle that I have been fighting with them since August to get them to pay for Will's
pediasure. I can call and talk to one person that says it is covered, we order it from our supplier and then 2 months later we get a bill saying that our insurance company denied the charges. I call the insurance company and the same person who told me 2 months ago that it would be covered then tells me that the
pediasure is a non-covered item on our plan. (insert head banging on the wall here) This cycle has been ongoing since August...it can wear on a person.
Will has been showing good improvement since we started the vital
stim in January but is still not swallowing much. He swallows the "juices" that he gets from chewing the food in his mouth but doesn't swallow the food. He can stick his tongue out and wiggle it around. He can clear a spoon with his lips. He can drink baby food from a straw. And has been making many more sounds since starting the therapy in January. But today was our last day until 2010 because our insurance company blows.
I just really wish that insurance companies would let the doctors do the deciding on what treatment would be best for the patients and not base treatment on whether or not it is covered by the plan.