Batttling the insurance company for Isabella .....

[Guest guest]

Hi everyone,

Isabella, my 2 year old daughter, needs your help so that HBOT can

be paid for by Medical Mutual. I have filed 3 appeals, all to no

avail. There is great documentation in Bella's file about the

improvements that ALL of her therapists, even the most skeptical

ones, witnessed. Her family doctor wrote 3 great referrals. She

did so well that we were able to leave her feeding tube out, her

breathing started to regulate so she could breathe easier as she had

severe stridor which interfered with everything she did. Her

cognitive abilities improved dramatically, etc, etc.

Bella had 19 treatments in Texas in June, and 10 treatments in

September. We had to fly home on October 6th, October because my

dad was dying from brain cancer and I didn't have a chance to return

as of yet (thanks to the Fort Lauderdale Mc House -

that story in another post). My dad died on October 7th. Isabella

was down in Fort Lauderdale in September with Dr. Neubauer. He has

been a tremendous help with getting my appeal ready and I keep in

contact with him on a weekly basis.

Now that the HBOT has stopped, Bella's health is slipping rapidly.

Her stridor (breathing) is back to where it was and is making life

very difficult for her. She has stopped eating and drinking and I

have had to re-insert the NG tube for feeding and will be getting

another G-tube for her. It is amazing that the insurance company

will pay for all this surgery, feeding tube supplies, nursing care,

etc, but not for HBOT, which helped her tremendously. The 3 weeks

we were down in Florida, she gained 2 pounds, and was starting to

put weight on her legs and take steps and was doing so well!!! No

more. Her improvements, again, are documented.

I have sent a copy of the formal denial to Freels,

Hartsoe, and Anita Duncan. I can't seem to copy it from my fax

software onto the message board so that everyone can read it. If

someone wants a a copy of the denial letters, just email me at:

moscarello8@...

and I will send you a copy of their denials. Unless , ,

or Anita can figure out how to put it into a post on the board, or

if they have any suggestions on how to do that.

One very important note:

This is important, especially to all of battling the insurance

company, medicaid, or other insurance carriers/providers. Medical

Mutual promised to contact Dr. Neubauer BEFORE THEY MADE A

DECISION. Dr. Goldie, the independent physician hired in California

to make decisions about my daughter, a little girl he has never

seen, to review the records. He called Dr. Neubauer on Thursday,

October 28th. Dr. N. and Dr. G. talked for about 30 minutes about

Bella. I talked to Dr. N. later that night about what Dr. G. had to

say. Dr. N. was upset as he had to tell me they were going to deny

it again because Dr. G. could not find it medically necessary. I

fully expected that to happen.

HOWEVER, the next day, October 29th, I got a copy of the denial

notice in the mail. Gee, I thought to myself, how did they get a

copy of the denial in the mail that fast? Dr. N. just talked to Dr.

G. not even 24 hours prior to me getting that letter. I opened up

that letter and the DENIAL WAS COMPOSED AND DATED OCTOBER 26TH AND

MAILED ON OCTOBER 27TH. How could that be? Dr. G. did not talk to

DR. N. until OCTOBER 28TH. Does this mean that Medical Mutual lied

to me when they said they would wait until after the conversation

had taken place? Yes, because then Medical Mutual sent a letter in

follow up to the denial that states:

" Upon review of your letter of appeal, case documentation from

previous reviews, medical records and your subscriber certificate,

AND FOLLOWING CONTACT WITH DR. RICHARD NEUBAUER, it is the decision

of the Independent Review Organization to uphold the denial. "

Flat out and out lying. Medical Mutual made this decision BEFORE

they called Dr. Neubauer. The reason for the second denial was

supposedly because they could not get in touch with Dr. N. and since

my attorney only gave them 72 hours to make a decision (Bella's

health was declining rapidly at that time), they decided to give us

a denial.

Quote,

Member appeals representative in reference to the second appeal:

" Well, we tried to get in touch with Dr. N. but he was unavailable " .

My response, " Did you leave a message or a number where he could

return your call? "

Their response, " No, because you only gave us 72 hours, and by the

time we would have gotten a return call,72 hours would have been

up "

My response, " So you would rather just deny life-saving treatment

for my daughter because a time restraint had been put on you? "

Their response, " Yes, but that was because your attorney only gave

us 72 hours " .

After checking with Dr. Neubauer, a phone call regarding the second

appeal was NEVER received in his office by anyone from Medical

Mutual as he logs his phone calls. Plus Dr. Neubauer is available

24/7 on his cell phone.

So, lovely, you deny a claim, without any investigation because it

is my lawyer's fault for putting the time restriction on an

insurance company.

Okay, time to take matters further.

What I need is this. PLEASE.

Everyone, please, please email my local senator, Senator Kirk

Schuring to help with this effort. His office was real optimistic

they could help, etc, etc, etc. They did offer to have Senator

Schuring show up at any fund raisers for Bella. But I really need

him to make phone calls instead.

Also, please email the Canton Repository (our local paper) about

Bella. They know Bella's story and have reported on it many times.

I need the pressure put on Medical Mutual.

Also, please email Channel 3 news as they have also covered the

insurance fiasco in September with Isabella. Channel 8 has covered

her story as well. MORE PRESSURE!

Also, please email Dr. Neubauer's office as him and his staff have

worked very hard to help me with this effort.

Also, please email my husband, Mark Moscarello Sr. a copy of what

you are sending. He has been working so hard to pay for Bella's

treatments. He has organized fund raisers and is beaten down tired

trying so hard. Plus we have 5 other children, but we keep battling

because our kids are worth it. An email of support would be so

helpful right now for him.. :>)

The more coverage, the better. This is not only for Bella, but all

of the other kids too.

I am also going to go to Ohio Medicaid next.

And BCMH, which is the Bureau for Children with Medical Handicaps

which is an Ohio program. I already have some parent advocates that

will be helping me with BCMH.

If I have to go to court myself, then so be it. I have done all the

work up to now myself anyhow. I am not afraid of the insurance

companies, the media, or lawyers. There is only one thing I am

afraid of, and that is having to bury my beautiful little baby

daughter in the hard, cold, cemetery ground. Afraid I will have to

choose what dress to bury her in. Afraid that one day I won't be

able to hold her anymore. Mark and I have already picked out where

to bury her if the time comes. I don't want to have to make that

decision later. The rest of this battle seems easy compared to that.

I will keep you updated in my battles. It has already been 6 months,

and I will keep on going.

God bless, and thank you. This effort is for all of your sweet

children and their families too.

Ann Moscarello

330-354-8330 cell phone

330-497-4889 home phone

moscarello8@...

Okay, here are the email addresses. Just copy and paste all of them

on one email and send your own message to all of them at once. If

you would be so kind as to forward it to people who you think can

help us, then please do so. Ask the people you forward it to, to

change the subject line to something like:

Baby Bella needs life saving treatment! Please sign our petition

http://www.thepetitionsite.com/takeaction/868776015

Please forward it as well, but if you just forward it, it will show

up as FW:: Etc, etc, ost people just delete a forwarded message.

That won't happen if you change the forward to a message of your own.

1)Senator Kirk Schuring, 29th district, state of Ohio

>>>>>>>>SD29@...<<<<<<<<<<<

(Tell him he needs to help our family out more by making those

important phone calls!)

2)Channel 3 news and Pax 23 News

Phone number 330-535-4105

They did a tv news report on Labor Day about our battle with the

insurance company, etc, etc,

They need to do an update story on Bella and hear how the insurance

company is playing games with us.

Reporter: Friess

>>>>>>>>>>>johnfriess@...<<<<<<<<<<<<<<

3) Fox 8 News - WJW - Cleveland Ohio

They also did a story about Isabella when she was born. This is

call for action so they can do a story on CP and brain damage and

how HBOT helps as well as the insurance battles.

Call for Action!

>>>>>>>>>>>>>>>>fox8cfa@...<<<<<<<<<<<<<<<<<<<<<

4) Mark Moscarello Sr. - my husband and Bella's daddy

>>>>>>>>>>>>>>>>>mjmsr@...<<<<<<<<<<<<<<<<<<<

5) Kent State University - my husband's employer who could be

helping a lot more in getting this coverage for Bella as they are

SELF FUNDED! Come on KSU, help us out as our little girl needs this

treament so she can live a life as a child and not constantly be

hooked up to drugs and machines!

Carol Cartwright - President of Kent State University - She is the

President of KSU. She could very easily help with this matter,

though we continue to be ignored. She is aware of Isabella's dire

medical condition and her needs.

>>>>>>>>>>>>>>>>>carol.cartwright@...<<<<<<<<<<<<<<<

Alvin - Associate Vice President for Human Resources. Alvin

is also very aware of Bella's medical situation, but also has done

nothing to offer Mark or I any assistance with working this out so

that Bella can get the healthcare treatment that she needs.

>>>>>>>>>>>>>>>>>>>>aevans3@...<<<<<<<<<<<<<<<<<<<<<<

6) Kent Stater - Kent Ohio's newspaper -Lots of great students

there. I am sure they would be interested to know that their

college is not allowing life-saving treatment to an employee's

daughter and that KSU has done nothing to help us either.

>>>>>>>>>>>>>>>>>>stater@...<<<<<<<<<<<<<<<<<<<

7) Canton Repository - Rossetti

>>>>>>>>>>>>>>>>>>>>diana.rossetti@...<<<<<<<<<<<<<<<<

She was working on a story about how much Isabella was improving

with HBOT. She needs to continue with the story and update what has

happened since we left in September as well as the exciting

possibility that HBOT will help many children in our area.

8) Dr. Neubauer - Bella's treating HBOT physician

>>>>>>>>>>>>>>ran@...>>>>>>>>>>>>>>>>>.

Thank you! Thank you!!! With all of your help, this will also help

the organizations set up right now to get insurance and medicaid

approval. I am trying to battle in this war too, and I am keeping

all my documentation and paperwork.

Last but not least, Isabella's website:

www.childrenofpromise.net/isabellam.html