Guest guest Posted April 10, 2002 Report Share Posted April 10, 2002 Hello all... First of all thank you all for your reply posts and your words of encouragement. Clinic went very well yesterday. is doing quite well. She doesn't have any new critters growing on her chest and she has gained 3 pounds and grown 3 inches. Her chest sounds well and by the end of summer she should finally be able to get her vest (yea!!!). As for Kira, the sweat test had to be sent to the lab because it came back as 59 in the office. The office machine runs high so we are pretty sure that it will come back showing no CF be we are still waiting to see. BOTH of them are finally seeing the G.I. guy at the end of the month for their belly problems so hopefully we can get something done for them. So overall clinic went pretty welll... SWOLLWN LYMPH NODES: The lymph node that Jess has is about the size of a nickel and she actually has a whole clump of swollen nodes together but doc says this is nothing to worry about. The ones that need to be worried about are the ones that are bigger than a quarter or so. This is not something that is prone to CF children, just somehing that ALL children are prone to. Most times they go away other times they dont...JUSY AS LONG AS they are not growing there is nothing to worry about. He said we just notice them more because are children are sick more and we are always closely monitoring them so of course we will find more wrong with them. So I hope this helps... Now I am going to vent....We have HMO Ins. There is no close CF doctor in network. Closest is in Chicago (2 1/2hrs away). So they have been covering Jess for everything in network so she can go to the CF clinic that is 15 minutes away. I just found out today that Kira's appt is being covered out of network only because there are services in network that she can go to. What they are basically saying is that it is OK to take Jess 15 minutes away to the clinic but in order for Kira to be approved in network, I need to take her 2 and 1/2 hours away to Chicago!!! Is it just me, or does this not make any sense to anyone else either. NEEDLESS to say, I AM appealing their decision because it is STUPID and Ridiculous!!! OK enough venting...THANKS!! Thanks again for all of your kind worda and encouragement, It is really appreciated.... Kim (mother to 2 w/CF and Kira 6 w/o CF) P.S.: HAPPY BIRTHDAY TO JACK AND CONGRATULATIONS TO KARRIE ON HER PREGNANCY!!!!!! I AM SURE EVERYTHING WILL BE OK HUN :=) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 10, 2002 Report Share Posted April 10, 2002 Well howdee -do, that was a very clear and 'good " report. I think they sure answered questions and things they weren't sure of .checking further, That is a GOOD sign.. It is so nice when you can feel competent with your medical care. I WISH THAT WAS THE SAME WITH THE INSURANCE INDUSTRY . I know -some are good. BUT , in the CF arena-many are NOT.............I work each day with them. Many are really downright STUPID. They cut off their noses for their faces.-Wow-does that make sense?? Anyway, your right APPEAL-APPEAL-APPEAL!!! Good luck.. LOVE & HUGS. GRANDMOMBEV UPDATE: Kira, Jess and swollen nodes Hello all... First of all thank you all for your reply posts and your words of encouragement. Clinic went very well yesterday. is doing quite well. She doesn't have any new critters growing on her chest and she has gained 3 pounds and grown 3 inches. Her chest sounds well and by the end of summer she should finally be able to get her vest (yea!!!). As for Kira, the sweat test had to be sent to the lab because it came back as 59 in the office. The office machine runs high so we are pretty sure that it will come back showing no CF be we are still waiting to see. BOTH of them are finally seeing the G.I. guy at the end of the month for their belly problems so hopefully we can get something done for them. So overall clinic went pretty welll... SWOLLWN LYMPH NODES: The lymph node that Jess has is about the size of a nickel and she actually has a whole clump of swollen nodes together but doc says this is nothing to worry about. The ones that need to be worried about are the ones that are bigger than a quarter or so. This is not something that is prone to CF children, just somehing that ALL children are prone to. Most times they go away other times they dont...JUSY AS LONG AS they are not growing there is nothing to worry about. He said we just notice them more because are children are sick more and we are always closely monitoring them so of course we will find more wrong with them. So I hope this helps... Now I am going to vent....We have HMO Ins. There is no close CF doctor in network. Closest is in Chicago (2 1/2hrs away). So they have been covering Jess for everything in network so she can go to the CF clinic that is 15 minutes away. I just found out today that Kira's appt is being covered out of network only because there are services in network that she can go to. What they are basically saying is that it is OK to take Jess 15 minutes away to the clinic but in order for Kira to be approved in network, I need to take her 2 and 1/2 hours away to Chicago!!! Is it just me, or does this not make any sense to anyone else either. NEEDLESS to say, I AM appealing their decision because it is STUPID and Ridiculous!!! OK enough venting...THANKS!! Thanks again for all of your kind worda and encouragement, It is really appreciated.... Kim (mother to 2 w/CF and Kira 6 w/o CF) P.S.: HAPPY BIRTHDAY TO JACK AND CONGRATULATIONS TO KARRIE ON HER PREGNANCY!!!!!! I AM SURE EVERYTHING WILL BE OK HUN :=) PLEASE do not post religious emails to the list. ------------------------------------------- The opinions and information exchanged on this list should IN NO WAY be construed as medical advice. PLEASE CONSULT YOUR PHYSICIAN BEFORE CHANGING ANY MEDICATIONS OR TREATMENTS. -------------------------------------------------- Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 10, 2002 Report Share Posted April 10, 2002 Well howdee -do, that was a very clear and 'good " report. I think they sure answered questions and things they weren't sure of .checking further, That is a GOOD sign.. It is so nice when you can feel competent with your medical care. I WISH THAT WAS THE SAME WITH THE INSURANCE INDUSTRY . I know -some are good. BUT , in the CF arena-many are NOT.............I work each day with them. Many are really downright STUPID. They cut off their noses for their faces.-Wow-does that make sense?? Anyway, your right APPEAL-APPEAL-APPEAL!!! Good luck.. LOVE & HUGS. GRANDMOMBEV UPDATE: Kira, Jess and swollen nodes Hello all... First of all thank you all for your reply posts and your words of encouragement. Clinic went very well yesterday. is doing quite well. She doesn't have any new critters growing on her chest and she has gained 3 pounds and grown 3 inches. Her chest sounds well and by the end of summer she should finally be able to get her vest (yea!!!). As for Kira, the sweat test had to be sent to the lab because it came back as 59 in the office. The office machine runs high so we are pretty sure that it will come back showing no CF be we are still waiting to see. BOTH of them are finally seeing the G.I. guy at the end of the month for their belly problems so hopefully we can get something done for them. So overall clinic went pretty welll... SWOLLWN LYMPH NODES: The lymph node that Jess has is about the size of a nickel and she actually has a whole clump of swollen nodes together but doc says this is nothing to worry about. The ones that need to be worried about are the ones that are bigger than a quarter or so. This is not something that is prone to CF children, just somehing that ALL children are prone to. Most times they go away other times they dont...JUSY AS LONG AS they are not growing there is nothing to worry about. He said we just notice them more because are children are sick more and we are always closely monitoring them so of course we will find more wrong with them. So I hope this helps... Now I am going to vent....We have HMO Ins. There is no close CF doctor in network. Closest is in Chicago (2 1/2hrs away). So they have been covering Jess for everything in network so she can go to the CF clinic that is 15 minutes away. I just found out today that Kira's appt is being covered out of network only because there are services in network that she can go to. What they are basically saying is that it is OK to take Jess 15 minutes away to the clinic but in order for Kira to be approved in network, I need to take her 2 and 1/2 hours away to Chicago!!! Is it just me, or does this not make any sense to anyone else either. NEEDLESS to say, I AM appealing their decision because it is STUPID and Ridiculous!!! OK enough venting...THANKS!! Thanks again for all of your kind worda and encouragement, It is really appreciated.... Kim (mother to 2 w/CF and Kira 6 w/o CF) P.S.: HAPPY BIRTHDAY TO JACK AND CONGRATULATIONS TO KARRIE ON HER PREGNANCY!!!!!! I AM SURE EVERYTHING WILL BE OK HUN :=) PLEASE do not post religious emails to the list. ------------------------------------------- The opinions and information exchanged on this list should IN NO WAY be construed as medical advice. PLEASE CONSULT YOUR PHYSICIAN BEFORE CHANGING ANY MEDICATIONS OR TREATMENTS. -------------------------------------------------- Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 10, 2002 Report Share Posted April 10, 2002 Well howdee -do, that was a very clear and 'good " report. I think they sure answered questions and things they weren't sure of .checking further, That is a GOOD sign.. It is so nice when you can feel competent with your medical care. I WISH THAT WAS THE SAME WITH THE INSURANCE INDUSTRY . I know -some are good. BUT , in the CF arena-many are NOT.............I work each day with them. Many are really downright STUPID. They cut off their noses for their faces.-Wow-does that make sense?? Anyway, your right APPEAL-APPEAL-APPEAL!!! Good luck.. LOVE & HUGS. GRANDMOMBEV UPDATE: Kira, Jess and swollen nodes Hello all... First of all thank you all for your reply posts and your words of encouragement. Clinic went very well yesterday. is doing quite well. She doesn't have any new critters growing on her chest and she has gained 3 pounds and grown 3 inches. Her chest sounds well and by the end of summer she should finally be able to get her vest (yea!!!). As for Kira, the sweat test had to be sent to the lab because it came back as 59 in the office. The office machine runs high so we are pretty sure that it will come back showing no CF be we are still waiting to see. BOTH of them are finally seeing the G.I. guy at the end of the month for their belly problems so hopefully we can get something done for them. So overall clinic went pretty welll... SWOLLWN LYMPH NODES: The lymph node that Jess has is about the size of a nickel and she actually has a whole clump of swollen nodes together but doc says this is nothing to worry about. The ones that need to be worried about are the ones that are bigger than a quarter or so. This is not something that is prone to CF children, just somehing that ALL children are prone to. Most times they go away other times they dont...JUSY AS LONG AS they are not growing there is nothing to worry about. He said we just notice them more because are children are sick more and we are always closely monitoring them so of course we will find more wrong with them. So I hope this helps... Now I am going to vent....We have HMO Ins. There is no close CF doctor in network. Closest is in Chicago (2 1/2hrs away). So they have been covering Jess for everything in network so she can go to the CF clinic that is 15 minutes away. I just found out today that Kira's appt is being covered out of network only because there are services in network that she can go to. What they are basically saying is that it is OK to take Jess 15 minutes away to the clinic but in order for Kira to be approved in network, I need to take her 2 and 1/2 hours away to Chicago!!! Is it just me, or does this not make any sense to anyone else either. NEEDLESS to say, I AM appealing their decision because it is STUPID and Ridiculous!!! OK enough venting...THANKS!! Thanks again for all of your kind worda and encouragement, It is really appreciated.... Kim (mother to 2 w/CF and Kira 6 w/o CF) P.S.: HAPPY BIRTHDAY TO JACK AND CONGRATULATIONS TO KARRIE ON HER PREGNANCY!!!!!! I AM SURE EVERYTHING WILL BE OK HUN :=) PLEASE do not post religious emails to the list. ------------------------------------------- The opinions and information exchanged on this list should IN NO WAY be construed as medical advice. PLEASE CONSULT YOUR PHYSICIAN BEFORE CHANGING ANY MEDICATIONS OR TREATMENTS. -------------------------------------------------- Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 11, 2002 Report Share Posted April 11, 2002 Kim, Good luck because I have tried and tried to fight with our insurance and they won't budge on it at all. It is an endless battle. Good Luck! Deb A Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 12, 2002 Report Share Posted April 12, 2002 Thank you bev...I will do that.... --- bev bevd@...> wrote: > WOW, you won a case for one child and they refused > for the second..What did > they tell you.....She would grow out of it > ----------duh???? > You need to call Beth Sufain.1-800-622--0385.she > will call you back , if > not there .leave a message. She adopted a wee gal > last year in Oct , I don't > know how many hours she is putting in now. BUT...she > can tell you step by > step , how to appeal. what are the clue wordings, > etc...And if you need an > attorneys letter (sometimes that jives the.....she > is the one. Remember SHE > has cf ALSO (SO DOES HER SISTER) > > She is also a super person. smart...and lovely > lady!! > Call me if you cant reach her. 1- > > LOVE & HUGS, grandmomBEV > > Re: UPDATE: Kira, Jess and > swollen nodes > > > In a message dated 4/10/2002 9:57:54 AM Central > Standard Time, bevd@... > writes: > > > > Well, howdee -do, that was a very clear and 'good " > report. I think they > > sure answered questions and things they weren't > sure of .checking > > further, That is a GOOD sign.. It is so nice when > you can feel competent > > with your medical care. I WISH THAT WAS THE SAME > WITH THE INSURANCE > > INDUSTRY . I know -some are good. BUT , in the CF > arena-many are > > NOT.............I work each day with them. Many > are really downright > > STUPID. They cut off their noses for their > faces.-Wow-does that make > > sense?? Anyway, your right APPEAL-APPEAL-APPEAL!!! > > Good luck.. > > LOVE & HUGS. > > GRANDMOMBEV > > > > Well, if she does get anywhere let me know how she > did it because mine > insurance won't change for nothing. That is why we > are trying to get on the > waiver program because they will pay for what the > insurance won't. I felt > like this was the next step we had to take to get > help otherwise it was > going > to eat us up. By they way Grandma Bev we won > 's case but we are > still > battling to get our youngest excepted. If anyone has > any ideas I would love > to hear them. Deb A > > > [Non-text portions of this message have been > removed] > > > > PLEASE do not post religious emails to the list. > > > ------------------------------------------- > > > The opinions and information exchanged on this list > should > IN NO WAY > be construed as medical advice. > > PLEASE CONSULT YOUR PHYSICIAN BEFORE CHANGING ANY > MEDICATIONS OR TREATMENTS. > > -------------------------------------------------- > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 12, 2002 Report Share Posted April 12, 2002 Deb... The insurance co has actualy been very good. I think maybe once they look at the case and the fact that her sis goes to a doc 15 mins away it might help. I just think they didn't look at all the info. It' not the fact that it won't get paid (because it will...we have State card and Div of Specialized Care fpr Children as back up) so I never have to pay anything.. The whole point to this is that they say it is ok to take one of my daugters 15 mins away but the other had to go 3 hrs. They are missing something....So I will just wait and see....Thanks Kim (mother to w/CF and Kira w/o CF) --- gdattig5@... wrote: > Kim, > Good luck because I have tried and tried to fight > with our insurance and they > won't budge on it at all. It is an endless battle. > Good Luck! Deb A > __________________________________________________ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 12, 2002 Report Share Posted April 12, 2002 Deb... The insurance co has actualy been very good. I think maybe once they look at the case and the fact that her sis goes to a doc 15 mins away it might help. I just think they didn't look at all the info. It' not the fact that it won't get paid (because it will...we have State card and Div of Specialized Care fpr Children as back up) so I never have to pay anything.. The whole point to this is that they say it is ok to take one of my daugters 15 mins away but the other had to go 3 hrs. They are missing something....So I will just wait and see....Thanks Kim (mother to w/CF and Kira w/o CF) --- gdattig5@... wrote: > Kim, > Good luck because I have tried and tried to fight > with our insurance and they > won't budge on it at all. It is an endless battle. > Good Luck! Deb A > __________________________________________________ Quote Link to comment Share on other sites More sharing options...
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