After posting on Wednesday, we received a call from AJ's audi. She stated that she received our fax, but doesn't actually submit the paperwork to the insurance companies herself, they have someone on staff that does that. She gave me this person's name and contact information. (I've called this person twice since and left two messages). Hi audi then asked how we were doing and answered my other questions. Here is a breakdown of the information exchanged and where we currently stand in this process:
+ Our surgeon currently has OR time on Wednesdays
+ Our surgeon is booked out already until late February 2009. Given this, we are hoping for surgery in February/March with activation in April. Better yet-a cancellation that we could fill.
+ There are a few other kiddos ahead of AJ who are in the same boat (waiting on State Insurance approval)
+ State Insurance implemented a new computer system three months ago. They have yet to work out the kinks. AJ's audi thinks this may be part of why we have not received approval yet. She also thinks the holidays and people's vacations may also be stalling our approval.
+ It is possible that state insurance approved AJ's surgery, but due to the holiday, it may be sitting on someone's desk...just not mailed yet. Doesn't think sound like Guatemala PGN all over again?!
+ We are on day 41 of waiting for state insurance approval (this does not include weekend days). State insurance has 30-60 days to approve. I asked what happens if they do not approve in 60 days...his audi stated their insurance person would start making phone calls.
+ The insurance person called yesterday and stated she received our new insurance information and that we were SUBMITTED TO OUR NEW PRIMARY INSURANCE YESTERDAY-1/2/09.
+ I have put two new tickers on the top of the blog...one for submission to our primary insurance and one for submission to state insurance.
+ Given this extension of waiting for a CI for AJ, we are contacting his ophthalmologist to see if we can schedule his eye surgery sooner than later. She had wanted to wait until after his implant surgery when we though it would be around Christmas. Hopefully we can give him better eye sight while we wait for his "ear".
Wow. My daughter is on medicaid and we were approved over a week-end!
ReplyDeleteCan you look into other hospitals after approval? We had Miss Kat's surgery at a hospital other than the Children's hospital because it bumped us ahead 2 months. It was the same surgeon, but she went from being the oldest patient to a special youngest one. They were great and we got the best surgery time and treated with lots of TLC.