Mike received a letter from our insurance that was sent to his old, OLD address but fortunately he is friends with the guy who is there now and the new guy picked it up for him. The Insurance needed further details for the claim, specifically, diagnosis codes to the fourth or fifth digit. (For example, if HPE is 177, Lobar HPE might be 177.2, Alobar 177.3 etc) If the information was not provided in a timely matter the claim would be denied (is it funny to anyone that it was sent to such an old address with this threat?) So Mike brought it to me and asked if I would call the hospital to see which codes they have billed with in the past.
I looked up my claim (that *I* sent in, not him... ) and the only diagnosis without the fourth or fifth digit was CVI. Which, given the other diagnosis, we could just take off the list. So I called the Insurance company directly... upon which I was informed that the claim was closed out as denied. WOOT! See, one of the family!
The "system" closed it out automatically... thank goodness for the rapid resolution team. On the same call it was reopened and approved. Do you think they were just hoping that we wouldn't get the letter and/or call? Random!!
Don't get me wrong, we are so BLESSED to have great insurance. I can't believe we haven't had a problem before now given how pricey our kids are (especially one... but let's not name names...). I was told by our home health company that this insurance never pays for interal tube feeding formula, they still pushed a claim through and we found out they are paying for it. The home health company was shocked. Her formula is sold at Walmart for $125 for 24 cans, she would be getting pureed Mac and Cheese if it wasn't paid for! We have been lucky, LUCKY up until now and I was pleased as punch that one call got this issue resolved as well.
Though, we did get an answer on how much of PT they will cover, and it's a lot at 60% once the out of network provider deductable is met... So uhmm... really nothing. I doubht we will meet to out of network provider deductable. Oh well, worth every penny!
As threatened, I took Asher in to the doctor to have hi bili's checked. He looked much better Monday morning but I figured I should probably be safe and just have it checked. When I called the nurse told me they purchased a machine to have it checked in the office. (Get out! I know!) So we packed up and the other kids went to grandma's with their dad and I just took Asher. It took forever, the appointment... I guess that's what happens sometimes when you shove yourself in to an already packed practice (and day!). In the end he was at 14 on day 10 which isn't entirely bad. On day 3, 14 is bad... on day 10, on it's way down. I wonder if he would have had to go in the suit case if I had been more aggressive... The suit case stinks. So skirted that!
And the good news is that because he was ten days old they could do the poke for his PKU and basically take all of his two week measurements, saving me from a Friday appointment! He weighed 8 lbs exactly, reaching his birth weight on day ten.
I also ran into an old friend I haven't seen in a loooooong time. It was fun seeing her and her new baby who was four days older than Asher. In fact, she made a comment about Asher not having hair which I thought was pretty funny given that he has more than Ian! Then I saw her baby who had light brown hair that was abut an inch and a half long!! He had a good pound on Asher as well even though he was only 2 ounces bigger at birth! So fun.
Matthew and I have been talking Dylie beds for a little while and we are on each extreme. He suggested a mattress on the floor. I am not all about that because she won't know to get back in bed to sleep. There are these AMAZING Sleep Safe beds I have been seeing friends get. They are like twin sized cribs, the sides can come down and the mattress can be lowered all the way to the floor. I heard that you have to have all kinds of doctor's notes submitted to insurance for a purchase and it takes quite some time. Well, Matthew wasn't about the big beds because he thought it was a wee bit of over-kill.
We were both right. When Mike was over this Wednesday I asked him about a bed for her.
Talking to Mike he said all that she needs something similar to a toddler bed by preferably not more than 6-8 inches off the ground with an additional railing of 5-6 inches. High enough to keep her from rolling out but low enough that she won't try to stand up to it. I was surprised, I asked if he thought she would 'get it' and he said "Oh yea, she's smart... she will totally get it!" I think he's going toward being able to have a normal big bed instead of one made for special needs. Leave it to him to give her this much credit!
Most of the toddler beds I can think of are a little too high... but I took him in to Dylan's room to show him Dylan's crib and asked about having Matthew modify it to be exactly what she needs right now. He described again what he thinks it would need to look like (envision Matthew wringing his hands in excitement) and left.
That night, Dylan got a new bed... custom build by her daddy! (He's so wicked handy!) Isn't it AMAZING!
The first night she wouldn't get out of it but by the second night she had found the path of least resistance and was driving her daddy bonkers when she should have been sleeping! I think it's awesome, and so do all of the boys! Go Matthew!
Someone looks just like daddy... (Matthew was out cold, I am sure he will love this picture...)
More big brother love!
Eden, Bridger and Lanie came for a visit. We remarked about how dainty Lanie's hands are compared to Asher's big man paws! It's hard to see in the pictures but his hand's nearly twice as big as hers!
More cute little hands...
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