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Insurance. What a Mess!

12/28/2015

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Insurance. What a mess! 
Any time the Insurance changes we go in to freak out mode.  Having a child with multiple medical conditions and trying to manage it all is a super daunting task if you are not extra organized, like me.  I’m getting better over the years but it has been one long road mixed with a few tears. This topic is one AIM would love to give our readers a few tips about especially for those things we’ve found out the hard way.  Our goal here is to help you a smidge before things get too crazy. 
INSURANCE
I’ll be honest, the days of having excellent insurance coverage are far and few between now.  If you are fortunate to have decent insurance in the first place, you often find it’s more fluff and fine print than coverage or “benefits”.  With the amount taken out of a paycheck monthly, then co-pays, deductibles, out of pockets and co insurance who can really afford insurance these days when it comes time to actually use it?  It often becomes a game of balance and really getting in to the fine print of the plan itself to actually capitalize on the “benefits” to your family. 
Below are a few things highlighted that we have found helpful either by mistake, necessity or when navigating through a momentary crisis.
CERTIFICATE OF COVERAGE:  Get your “Certificate of Coverage” free of charge BEFORE you sign up for your latest plan if possible. If already in the middle of the plan, you can request one simply by calling your employer HR dept or even the insurance company itself.  Either can issue this to you.  I’ve been given the COC easily through email but it can also be mailed in paper form as well.  Sometimes you can even find it online if you have a third party type plan and access with a user name and password. Just ask.  Promise it will be worth the two hours of time it takes for you to read through it and discover all things excluded or available to you that even the customer service people fail to know.
The fine details and conditions (benefits, exclusions, obligations, co-pays, pre-certifications, appeal process, and preferred healthcare provider networks) will be listed in this 200+ page pdf but I promise you, you’ll learn a thing or two and be in a better position to decide if the plan offered is something your family can live with or not.  So important when literally every penny counts these days.

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6 Tips for Out of Town Doctor Visits

6/2/2015

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I will never forget the first time we had to travel across the country to see a specialist with our daughter.  I couldn’t understand what this doctor was going to be able to tell me that I haven’t already heard from 26 others. I was nervous, semi pessimistic, and hopeful because I had no other choice. I was desperate. At that time Olivia’s behavioral issues were still pretty severe so traveling 8 hours from Houston to Little Rock seemed down right terrifying.  We had yet to make a successful trip anywhere over 2 hours without having to stop to clean vomit, feces, or urine. However, there wasn’t a doubt in my mind we would get kicked off a plane so, driving was our only other option. 

I remember being so angry when I finally heard her ask if we were in “AR-PAN-SAW” yet for the last time at 3am.  Angry that we hadn’t received the appropriate care for almost a decade. Angry that I allowed a disgusting amount of vaccines to be injected into my gorgeous, healthy baby. Angry that we were in this crappy ass hotel because we couldn’t afford something better.  A few short hours later when we were expected to arrive for labs the entire family was showing signs of a seriously short fuse. It didn’t take much for me to exchange words with a nurse. Especially when it was painfully obvious that it was going to take 5 different sets of muscles to hold her still. Olivia sensed Daddy’s pity from a mile away and decided this would be her chance to fight.  

I’m sure you can visualize the fantastic first impression we left with the doctors by the time we left the consult that immediately followed the extreme lab pandemonium. The word frazzled doesn’t even begin to cover it.

I vividly remember leaving the office with my head spinning. I had no idea what the heck just happened in there. I had plenty of time to reflect on the 8-hour drive home and quickly came to the conclusion that the only person to blame was me. The mental list of could haves and should haves was getting more brutal by the second.

1.    Get organized. Hopefully most of you are already requesting records following every visit. If not, you should start doing this immediately. Check with each office regarding their records request policy, but remember you have the right to your medical records. Some offices may have a copying fee or specific request form but please do not accept no for answer. If they refuse to comply they should be reported to the medical board. Period.


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8 Tips for a Smooth Hospital Experience

3/26/2015

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Do you have a new baby on the way?  Check out these pointers for a smooth hospital experience.

Whether you’re delivering your baby at the hospital, birthing center, or at home, planning ahead can reduce stress and help to make the new arrival go as smoothly as possible. Hospital deliveries come with some special considerations and here are a few tips to avoid problems when the time comes.

1.       Talk with your doctor or practitioner early. Be sure to review your birth plan with your practitioner early in your pregnancy in case you need to change practitioners. Make sure they are comfortable with things like not vaccinating, no vitamin K injection, delayed cord clamping, etc. Finding this out early will help if you need to find another practitioner as many will not take you on as a new patient if it’s late In your pregnancy. Be respectful, but ask your practitioner directly if they are comfortable with all items on your birth plan. Let them know you will not want to encounter difficulties on delivery day. It’s important that you work as a team.

2.       Select a setting that meets your needs. If you’re in a high risk group, you may have limited choices. If you plan to deliver at home, be sure to find out where you would be taken if you needed assistance from a hospital. The best way to find out which hospital you would be taken to in an emergency is to call your closest firehouse/EMS.  Be sure you contact that hospital and talk with the nurse manager to let them know you will be delivering at home and want to find out information about being brought to that hospital if needed. Touch base with them again when it is closer to your due date.

3.       Keep your birth plan simple, one page if possible. Be sure the most important items are listed in bold letters across the top. The doctor or nurse should be able to quickly identify your non-negotiable items immediately. Contact information and emergency phone numbers should be included as well. Email a copy to the nurse manager ahead of time to be sure there are no problems honoring all your requests. Email copies to your emergency contact list so they are aware of your plan and provide extra copies to your partner for day of delivery. Don’t assume this will “be on my chart”. Keep a copy in your room and post it on the wall if necessary. Be sure all staff is aware you have a birth plan and that they have reviewed it.

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