Wednesday, December 16, 2009

Reason for Denial

1. His hearing loss is not significant enough.  (Not true.)

2. There is no proof of auditory delay.  (Not true.)

The audiologist already appealed it, but we realized that we get new insurance in January anyway, so we will have to start over with authorization from them.  We think our current insurance is just trying to put off authorization until we are off of their coverage.  So now everything is pushed back.  We can't start the authorization process again until January, which was when he was supposed to be having surgery, if not the end of December.

The speech therapist did some developmental testing Tuesday.  Ethan was extremely grumpy and uncooperative, so he failed beautifully - thus giving the insurance proof of auditory delay.

I am disappointed with the whole turn of events.  I want everything in the world for him and he is really missing out.  When his hearing aids aren't in, he is desperate for them.  He stops talking and gets into more trouble.  I sometimes wonder if he has a theory that if he can't hear me, I can't hear him.

We head to the audiologist next week - Tuesday and Wednesday.  We will also see the ENT while we are there.  I still can't figure out why we need to see him - other than so that they can take my money - but supposedly it is just to develop a relationship with them - just incase we have any trouble after surgery.  In my mind, having a relationship with an ENT will do us no good if we end up in the ER in Soldtona - 3 hours away.  BUT, I am doing what I'm told, just like my mom taught me.


Alicia J said...

I'm sorry this is happening. Hopefully things move quickly in January! These are the times when being a mom is tough.

Anonymous said...

Argh! Insurance. I hope the little guy gets everything he needs soon. You guys take care and hang in there. You're doing an awesome job Erin!

Unknown said...

That sounds very frustrating Erin. I am sure though that everything will work out just fine. And sometimes you should do what YOU feel is right (after much praying of course) I don't agree that we should always just do what we are told. Your theory is cute and probably true. I had a similiar one when I was a child. I thought that if I couldn't see my mother (when I covered my eyes) she couldn't see me.

Landon and Mandi said...

I wish I could be there with you. It's hard to read things that you know upset someone and you can't be there to help. Everything will work out. It also does.

Landon and Mandi said...

Good thing English is not my major!! Ha ha ha