The Judge Called…

And asked me if I would like to withdraw the hearing.

I didn´t know it was up to me. I didn´t ask for a hearing! I just wrote a letter..

So apparently, when the insurance company went ahead and honored the prescription, they didn’t have much of a case anymore. Covering the prescription means they admit my son needs his medicine.

I lost some sleep, an hour and a half of work, and not too much else.

It could have been far worse.

I am saving all the letters his doctors wrote for me. For next year.

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6 Comments

Filed under ADHD, Child Abuse, Child Psychology, Medication, PTSD, SIngle Parenting, Uncategorized

6 responses to “The Judge Called…

  1. Save everything…the agreement to provide coverage is based on their assessment of the case as a losing proposition. There must be an irrefutable statement of medical necessity in his file.

    You want a copy of that for your own records.

    You have a right under HIPAA law to his complete file. There are variables in the details of how a facility may process a HIPAA request but you can find out what those are by going to your state’s web portal.

    http://journal.ahima.org/2012/03/01/how-to-request-your-medical-records/

    • Yes, I did try to request his file. I could not even get a person on the phone! Thanks for the link!

      • Oh that’s not right at all. The insurance companies gamble on your exhaustion. Their hope is that you will be too weak and tired to fight. They will place every hurdle in the way of your ability to advocate for your self.

        There are laws and the insurance companies count on you to not to know which ones are there to protect you.

        The Federal Government funds agencies at the state level to enforce HIPAA compliance.

        If the insurance company is not providing you with the information that you need it can be heavily fined.

      • I wrote this down for next year. They do this to me every New Year. I am going to go straight to sending a registered letter at the first sign of trouble in 2017, so I have a receipt. I won´t even bother with the phone! This year I won quicker than last year, in half the time. So maybe next week I can halve it again.

      • Right…

        It’s a bluff based on statistics.

        Most people find the process of making an appeal confusing and time consuming. Many give up.

        When I applied for disability the Department of Social Security sent me to one of their doctors. Bear in mind that the disability that I named was psychiatric. This doctor examined my feet.

        The department of Social Security turned me down because I could stand and walk…they turned me down for reasons that had nothing to do with my stated disability.

        I realized that I’d have to get a lawyer and did.

        They got the disability started in less than three months.

        If I had tried to do it on my own It would have taken at least three appeals and I would possibly have become homeless without seeing a dime.

        We need to take back our government and pull the corporate parasites off our backs.

  2. Yeah, it´s a shame when your voice is only loud enough through a lawyer.

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