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Author Topic: Insurance decision will be issued this week  (Read 1422 times)

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Offline Cinammo

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Insurance decision will be issued this week
« on: September 09, 2006, 11:49:34 PM »
Talked to the paralegal regarding my son's case and he stated the final review was over and that it had to go to the director for review.  I think he may already know the decision.  He was very nice and told me after my tearful message I left him that this is horrible on my family.  He said you can call anytime and I will call you the day I hear anything.  Wish I could have read more in his voice.  I did hear sympathy.  Hope that's not a bad sign.

Eli's left knee is doing horrible now.  It is grinding and locking up.  The local OS suggested we do the lubricant shots that he would get once a week for 5 days.  Lets see how Tricare handles this.  Considering his age they are probably going to have trouble with this also.  I hate insurance companies.  Wish I had a rich relative that I could ask to pay for this frickin surgery.  Better yet I need to win the lottery but I guess I can't win unless I play it first,huh?

Thanks for listening to a very frustrated mother.  To top that off.  My 20 year old daughter just got dx with Systemic Lupus and Discoid Lupus.  We are a family that is falling apart :-\
My 17 year old son had the OATS procedure on November 29th, 2006.  He has two previous scopes on the right knee and one on the left.

knee deep in Goo

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Re: Insurance decision will be issued this week
« Reply #1 on: September 10, 2006, 04:39:12 AM »
The Orthovisc shots are really not that bad. They will stop the raking pain hopefully.  It is a higher density product.  Costly too  750.00 for three shots.

Offline brattkids

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Re: Insurance decision will be issued this week
« Reply #2 on: September 10, 2006, 05:39:09 PM »
I sure hope you get good news this week on the decision!!!!! I am praying for you both!!!

I had the 5 series of shots and it really helped me!! Mine were called Supartz. I am 3 months out from getting the shots and am still doing pretty well considering I am in nursing school and on my feet for hours daily now! If your insurance will pay for them it may be a great thing to do before the surgery to get some relief until your son can get in!!!

p.s. I hat insurance companies too!! They always seem to know what is best for you with out even seeing you.

4/04 microfracture
5/04 debris removal
8/04 OATS with synthetic plugs
11/04 OATS traditional autograft medial femoral chondyle
05/05 debris removal and OATS assessment
6/05 Cadaver Allograft OATS lateral femoral chondyle
9/05 OATS redone could not save allograft plug
12/2006 2007 and 2008 scop

Offline kalyjoe

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Re: Insurance decision will be issued this week
« Reply #3 on: September 13, 2006, 02:14:24 AM »
Just wanted to empathize with you regarding the insurance company.  It can be very frustrating...I had to go through a similar situation when my son was younger and in desperate need of speech therapy.   I totally know how you feel.  I wanted to drive to the persons house who makes these decisions and deposit him on the doorstep and have them look at him and listen to him and tell me he didn't need it.  It's a very helpless situation to be in; some strangers deciding your kids fate.....I really hope they approve it so your poor son can get the treatment he needs.  You sound like a great mother and he is very lucky to have you fighting for him.  I'll keep him in my prayers and check back for hopefully good news. 

2 x 1.2 cm defect of right medial femoral condyle
Microfracture, right knee, October 18, 2004.
MACI using CaReS, same knee, November 30, 2006