Tuesday, June 14, 2016

"Up with your chinny chin chin!"



Day 50: I have that "Chin up!" song from "Charlotte's Web" stuck on repeat in my head... I don't know if any of this will make sense, but here it is...
- My neurosurgeon is not considered a preferred provider with my insurance, but other than the pediatric neurosurgeon's at Primary Children's, there aren't any doctors in the IHC network who can do this surgery. We thought there was one who could, but we found out yesterday that he doesn't feel qualified to do it and turned down our request for his help. His boss, Dr Peter Maughan (to whom I'm 90% sure we're related because my third-great grandfather is Peter Maughan), is reviewing my case and my appointment with him is set for July 19. Yes. JULY. And this is the same surgeon who told my pediatric neurosurgeon friend last week over a few rounds of golf that he doesn't feel qualified to do my surgery!
- My neurosurgeon's billing/insurance team were supposed to start the process to have him approved as in-network three weeks ago, but they didn't submit the paperwork until last Thursday. It might **MIGHT** get approved today, but not in time for this morning's surgery.
- We considered having the surgery anyway and hoping we could appeal after the fact, but that's roughly a $15,000-$20,000 gamble and a little to high for my comfort.
- If my insurance denies my neurosurgeon as in-network, then we will appeal the decision. We don't think it would be difficult to get it approved the second time around now that we know the other adult neurosurgeons in the IHC hospital system don't feel qualified to redo my ETV.
- Yesterday we started exploring the idea of having my pediatric neurosurgeon do this operation at Primary Children's, but it's a long shot. It would be AMAZING if they'd allow it, though!!
So here's to more waiting and praying and hopefully not more crying. The latter only makes my head hurt worse. I never imagined we'd have to deal with the runaround like this. It's absolutely ridiculous, but the alternative is receiving another shunt and I'm not going down that road unless we absolutely have to.

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