Re: need hlep

March 26, 2008

Sorry Hannah is having this issue. Her knee sounds like mine did when I

had an attack of bursitis. I am sure this is related to Hannah's

arthritis though. Not much help with either hospital, but as far as

needing referrals that has to do with your insurance. You should check

and see what the policy is. I have a PPO, do not need referrals and have

gone out of network, and while it is not a nightmare, it does require

you keep good track of the paperwork. Most drs offices/hospitals will

bill your insurance and then the ins company will pay what it will pay.

Then you are sent a bill for the remainder and there is usually no

provider discount. I see a therapist who I pay upfront for a visit, and

she gives me a receipt that says all reimbursement should go directly to

patient, and I then mail in the receipts with the form from the

insurance company. They will reimburse me for 50% of those visits. That

is how it works when I go out of network.

As to where you go right now, what about the ER at a different hospital

than the children's or seeing the dr who is covering for your ped? I

know those are not great solutions as they do not know her history, but

it may send you in the right direction. Michele ( 20, spondy)

________________________________

From: [mailto: ] On

Behalf Of Beth Yohnk

Sent: Wednesday, March 26, 2008 9:52 AM

Subject: need hlep

Last night Hannah called me from her best friend's house. She was gong

to sleepover. She said her knee hurt and could her friends mom give her

some Motrin. I talked with the mom (also a good friend of mine) and she

gave her Motrin and put a heating pad on her knees. Hannah called me in

tears about 45 minutes later saying her knee was swollen and red. I went

and picked her up and sure enough her knee was red and swollen and hot.

I was thinking maybe it was from the heating pad and I have her a

Tramadol and put her to bed. She came in my room this morning at 6:30

saying she did not sleep at all last night because her knee felt like it

was on fire. It was still swollen, red & hot.

Question #1: when your kids have these episodes is the whole knee

swollen and red or is the redness more in one area of the knee? Her knee

feels " squishy " as well, which tells me there is inflammation and

possibly fluid in it. Hannah absolutely DID NOT have an injury to this

knee (at least not lately, but this is the knee that was casted 2 years

ago).

Question #2: Please don't think I'm an idiot, but I'm not quite sure

where to take her. Her ped is on vacation this week and I WILL NOT take

her back to our Children's hospital. I'm wondering how long it takes to

get into Mayo or Cincinnati Children's. Also has anyone ever gone to

these facilities and had to go out of network insurance wise and is this

a nightmare. Also does anyone know if I need referrals to either of

these places; I don't believe I do to Mayo, but not sure about the

other.

Please any and all advice would be appreciated!!!!!! This is soooo

frustrating and I'm tired of being told there is nothing wrong with her

and being made to feel like we are ones who are crazy. I did try and

take some pictures of her knee, but not sure how they will look.

Beth & Hannah, 11, unspecified arthritis; asthma; gerd; migraines

Sending prayers & happy thoughts,

Beth :-)

March 26, 2008

Hi Michele:

I think if its still red and swollen tomorrow, I will bring her in to one of the

other peds. They are all awesome and we've seen every single one of them at one

time or another. I know I don't need a referral to Mayo, but some places ask

for referrals even if insurance does require it. I find that is more true for

specialty doctors. I can't tell you how many requests like that I get in a

week. I work for eight primary care doctors and some specialist just require

it. I will be making calls on Friday when I'm off and will get the ball

rolling.

Sending prayers & happy thoughts,

Beth :-)

need hlep