Well its almost March and I think we have everything in order for Mallie have her Bi lateral implants. The insurance biller or whatever you call her finally came up for air from you know where;) I am not a fan!! Since Jan 1st we have been trying to get this all figured out with our insurance. (so not the INS fault either) We have priority health and Childrens Special Health Care (form of medicaid). CSHCS does not pay or contribute if we go with Bi lateral implants only will they help if we get just one. Got it :) Priority approved for Mallie to have the Bi laterals done - so that equals one surgery - one activation and time to move on with her life - THANK GOD! So I understand that we will have to pay some out of pocket expenses with this surgery - I am thinking $8000 is the MAX we will have to pay - our ins caps at that and then they pay in full. Seems like a lot but in the grand scheme of it all its nothing, really! The problem is that the Dr's office has their panties in a bunch because I am sure they have been burned more than once. They are afraid that they may not get paid. So after almost 2 months of them with their heads up their u know where......they finally called with the answer I knew all along. You see I am not the wait and see kind of gal as most of you know:) I was on the phone with CSHCS until I found someone who could answer my questions. Apparently the drs office was not so anxious as I was because they drug their feet as much as they could. I know this because I talked to the policy person at CSHCS who said - she was aware of the situation that Dr Daniels office was telling us. They were told to call her direct and they did not. They told her they did not have time. So in the mean time - 5 other families hung to the side like we did wondering what the hell they were doing. Some of these families had surgeries scheduled this month and were told they may have to cancel if they did not get it straightened out. I would have been flipping out!!! See Mallie's surgery is scheduled for May 19th so we had some time. All along I was getting the impression that the billing lady was just afraid she was not going to get paid because they kept bringing up my deductible....so annoying because I was up front with them from the very beginning. They wanted all of us to only get one implant because then it would all be taken care of and they would not have to worry if we could pay or not. instead of working with us they stressed us out!!! So now they want me to sign a paper stating that I understand that CSHCS will not be paying and that we are responsible for paying the balance after Priority is billed. Except they also want us to PREPAY our deductible to them. I am really reluctant because how do we know what the total will be by May 19th. Everything we do in between will count towards our deductible so it won't need to paid again later..... they want like $3000 up front. And want me to sign a paper agreeing to it. I have been doing some research on this and it sounds like they can do this or ask for it up front. I just don't want to pay anything when we don't know for sure how much. I will be talking with them again on monday to see the scoop on this and ask a ton of questions. I will update later this week with what I find out :)
So on to Mallie pie - she is doing great - she weighed almost 12.5 pounds last week - she can sit on her own for little time periods - she still wants to just fall over when she gets tired. We are working on that :) She is eating great and is happier than ever! She is just too cute for words - and I know I am partial but really she is like my little Mallie doll! She is pointing at things and mimicking just about anything we do. I love it!! Tomorrow we are trading jumperoos with our friends. We bought Mallie one brand new and she don't like it. She loves their old used one though and I am hoping it will help strengthen her legs. We still do PT once a week and are doing speech once a month right now - just working on motor skills relating to eating. once she gets the implants we will be doing speech weekly! Its going to be a busy busy spring and summer and I am excited to see where it will take our little Mallie bean :)
