my mini miracle!

[Guest guest]

Well, to me, this seems like a huge miracle! It appears that Regence has in fact paid for 's helmet! I can't believe it. To me, it is nothing short of a miracle, because of the fact that the denial letter, dated December 21st, 2001, was very clear in stating their denial of 's helmet therapy. They gave me my typical 60 days to appeal the claim, and I was just about finished with my research, when I received the explanation of benefits statement. I still do not know for sure, but I am going to try to call Children's in Seattle tomorrow and find out if Regence did pay. But my grandfather, who sells insurance, looked at it, and he's pretty convinced that they did pay. It says the billed amount was 1300 but that the agreed upon payment between them and the provider was 1265 or something, and under patient responsibility, zero! I am just elated, if it is true, and I guess I will find out pretty soon, huh?

Someone had asked how was doing in his helmet. Well, to tell you all the truth, he seems to be just fine. It is me who is having most of the problems. Mostly because I think he must not be comfortable, or he is sweating too much, or it slides down on his face, etc, etc, etc....He has had it for almost a month, and not once has he worn it to bed. Tonight is the first night. I don't know what is wrong with me. I feel like I am in a Catch 22. I feel cruel if it is on; I feel cruel if it's off, because I'm denying him correction. I read all of your posts religiously, but I don't have the time or a lot of knowledge to respond to many, but I read about all of you and how good you are about leaving it on, even while sleeping, and I feel really bad about it. There are times when it is off and I will look at his head and think, "It's not that bad. He doesn't need to wear it." and then I see him at another angle, and I think, "He needs his helmet on. His head IS that bad." So I put it on for a few hours at a time, and then I find a reason to take it off. last month it was because he was sick.

It was not until the day I received the Regence letter that it really hit me that I am wasting precious time that I'm lucky if we have, being that he is almost 13 months. I don't know if I feel like because he is older that we probably won't see much correction anyway, so why bother? But then that's not true because I have read so many testimonies from you all that you can receive significant correction after 12 months. I honestly don't know what my deal was, and is. I fought tooth and nail to get this helmet, and now some days I find it hasn't touch 's head all day. I feel awful!

As soon as I got that letter, I realized that it is now or never, and he's not getting another helmet. I'm not that religious of a person, but I do believe in God, and I hope I don't offend anyone, but I think no matter what we all believe, we can pretty much all agree in a Higher Power. I believe in God, and I've been praying that He would help my , and now Regence pays our claim. Yes, you can call it coincidence, but to me it is a sign that 's little head will get better, but I just have to implement the solution. I just can't get over how an insurance company who doesn't pay for these helmets, I was told not to waste my time with appealing, because "They won't pay," and then I don't even appeal and they pay? How does that happen? That's a good enough sign for me that you better believe 's gonna have that helmet on 23 hours a day for the next 10 months...it's a long time, but we have to do it.

Sorry if I sound kind of looney tonight. I am just very inspired by this and very grateful. I feel now that does have a chance.

Thanks, you guys.

Kellie, mom of , helmeted 1/17/02, born 1/17/01!

Tacoma, WA