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Parenting Children with Special Needs Blog

07/18/07

What You Need to Do Is….

Posted by : Julie in Parenting Children with Special Needs Blog at 07:06 am , 538 words, 49 views  
Categories: Parenting
I hate it when someone starts a sentence to me with those words. Some will say it’s because I am a control freak, but I submit that it’s because I’ve just heard them too many times. Those words are usually an indication that I’m about to get some unsolicited advice (or another assignment to my “to do” list by someone trying to pass their work on to me).

My latest encounter with “what you need to do is…” came this morning in a situation that has some Mom Guilt attached to it, so I was even more frustrated. Last spring our request for the insurance to cover having Kay’s wisdom teeth extracted was denied. It was obvious from the x-rays that there is no room in her mouth for the teeth to come it, but the insurance dentist determined that they don’t need to remove them until they erupt.

I was annoyed, because we had scheduled the extraction for spring break. But in the shuffle of our chaotic life the only action I took was to call them and complain. They told me what needed to be done for an appeal (narrative and new x-rays from dentist), but I didn’t follow through. And poor Kay, who frequently gets ignored when I’m dealing with the challenges of parenting LuLu, got ignored once again.

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Fast forward to Monday at dentist, regular cleanings. Kay has been biting the inside of her mouth because her cuspids have shifted (from pressure placed by her wisdom teeth). Did she tell me this before hand? Not really…she mentioned about two days before the appointment that she keeps biting the inside of her mouth, but didn’t really complain.

So now the heat is on, and I have lots of people…dentist, dental hygienist, insurance company, insurance fillers at the dental offices…all telling me what “I” need to do. What I did do was go home and immediately call the insurance and inform them that the dentist now wants to do a $250 procedure to grind down the offending teeth all because we didn’t remove the wisdom teeth back in April. A procedure, I might add, that’s not covered by their insurance!

“What you need to do is get the dentist to write a narrative telling us this,” the insurance company says.

Back to dental office. “What you need to do,:” says secretary, “is talk to our insurance person, she can help you get the narrative.”

On to insurance person. “What you need to do,” she says, “is call the oral surgeon’s office. They need to write the narrative.”

On to oral surgeon’s office. “What you need to do, as her mother, is call the insurance and tell them the problem so their doctor will review the files again.”

After each member of this situation had passed the buck, I landed on the poor woman at the oral surgeon’s office. So now I believe that she’s clear that THEY are to write a narrative and get it back to our insurance.

“What I need to do…” is follow up early next week to make sure they’ve done exactly that!

UGH!

Comments, Pingbacks:

Comment from: lmg1567 [Member] Email
I have been through the same situation time after time. I am currently paying on a credit cards I've used for PT/OT, oral surgery (x 3 kids), neuropsych evals. and various other out of pocket expenses that the insurance company refused "after the fact". I get so frustrated going from person to person, re-explaining the situation over and over again, just to have them pass the buck. I've obviously given up several times (hence the huge balance on my credit card). I've become completely disallusioned with the whole "insurance scam" in our country. Nothing ever seems to be covered when I "try" to file a homeowners insurance claim so I raised my deductible to $2,500 recently, same with my cars. Talk about tempting fate :) Anyway, hang in there - I know what you're going thru with the healthy kids getting the short end of our time and attention sometimes. We just have to keep trying!!

Lisa
PermalinkPermalink 07/18/07 @ 11:38
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