Guest guest Posted June 20, 2007 Report Share Posted June 20, 2007 Yuka- Again thoughts on the pulse ox - if the pulmonologist recommends it, and insurance denies, then the obvious recourse is for the pulmonologist to state that the child will have to stay in the hospital because he must have this monitoring - which is medically necessary, of course. Then the insurance co faces a decision - pay for full hospitalization or pay the costs associated with home monitoring and care. Michele W Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 20, 2007 Report Share Posted June 20, 2007 Gosh, the things that I'm hearing about insurance coverage and lack of respite support are absolutely horrible. Sounds like some of these families should have been featured in s new film, Sicko. Jeanie from Canada Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 20, 2007 Report Share Posted June 20, 2007 This family needs to flat out refuse discharge. There is absolutely no way this child should be coming home without some type of monitor. I have learned by reading about other's experiences on this list that Children's in Seattle is a very conservative hospital. I truly believe that is why my son is still with us today. They advocated that he needed the oximeter, a suction machine, oxygen, a feeding pump, and home nursing when he first came home. For a time we had an oxygen concentrator. We have a CPAP and a nebulizer. We have " rented-to-own " some of this equipment--we've had it so long. If this insurance is going to play hard ball, then this family needs to also--and refuse to be discharged until all of the nursing and necessary equipment is in place. Our experience was that the insurance gave in when faced with an indefinate hospitalization. I agree with whoever said it's much harder to get it once you are " out. " (mom to Evan, 23 months) Yuka Persico yuka@...> wrote: Dear - The baby is not trached, and post his gtube and fundoplication, his oral and nasal cavities have been adorably healthy and dry, which pleases me to no end. At this point always looked and sounded like he had just been rescued from drowning along with having recently caught a nasty head/chest cold. Their trial night was plagued by both faulty monitors and faulty oxygen set up (O2 not traveling through the humidifier - therefore not to the baby at all). Monitors alarming every three minutes for no good reason, even after resolving the oxygen set up, and the cleaning crew was scouring the floor outside their room with industrial machines! Definitely horrid conditions for a trial night with one's baby and his equipment. The " parent sleep deprivation " test went well - the mother affirmed what she already knew - she is a person who really requires adequate sleep for a sense of well being. However, the sleep study did have a reading of 21 - which even if incorrect, the baby's numbers are probably still far off from the normal 4. The pulmonologist is recommending a pulse oxymeter, which the insurance flatly denies covering. Hopefully the body of responses on the list to advocate for sufficient care for their son, not only in his best interests, but as an entitlement to adequate care, will support the family through this challenging transition. Coming to grips with the diagnosis and prognosis is hard enough. Having to advocate for rights for conditions that are still vibrantly new seems even more so. Thank you again- Yuka Re: Yuka-Need words of support for a family coming home Yuka~ I see we're all on the same page-this baby should not be discharged in this condition. Nor should the parents be asked to care for him alone. I know this isn't the " helpful words " and support they were looking for- but it's truth that will protect and possibly save their child. Good luck, in Ma. ************************************** See what's free at http://www.aol.com. Quote Link to comment Share on other sites More sharing options...
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