"For I know the plans I have for you," declares the Lord, "plans to prosper you and not to harm you, plans to give you hope and a future."
--Jeremiah 29:11

Wednesday, November 7, 2007


Connie's cold seems to be improving tremendously. He still has a lot of junk but the bulb syringe and vaporizer are a big help. Last night he slept from 7:30-11. Got a diaper change and slept until almost 2. Had a small vomit and fell back to sleep until almost 5. Got another clean diaper and slept until 7. It was great.

We're waiting on the RSV vaccine for this month. The shot is supposed to protect against it for 28-33 days and so should be given every 28 days. He hasn't had a shot for 34 days and is now unprotected. All because insurance is dragging their feet on coverage. It is such an expensive shot they won't even ship it to the home health company until they approve it. I asked about paying it out of pocket and getting reimbursed later and our nurse said it isn't possible. I asked her what this means for him and she just said strongly to NOT TAKE HIM ANYWHERE. We don't have big plans on shopping or other outings and haven't since we've been home, but he does have two appointments at the end of this week where he'll be exposed in doctors' offices to whatever else is there. One of them is at St. John's and that means walking through part of the hospital to get there. Yikes! Isn't that frustrating? I mean, they covered it last month, why aren't they covering it this month? They did the same thing with the drug Prevacid. He got a scrip for it last month and they filled/approved it and now they won't approve the refill. Ridiculous. The home health nurse suggested calling insurance myself which I've attempted before and had no luck. You sit on the phone for over an hour without ever getting to a real person and there is no menu shortcut to actually get a person. I've emailed questions via their website which have gone unanswered. Ever since Anthem took over for Blue Cross/Blue Shield it has been this way.


Anonymous said...

The latest video was great! Loved seeing the smiles :) Glad to hear his cold is improving, mine seems to be hanging on. I'm sorry to hear that insurance is being such a pain, we'll all keep our fingers crossed that they get their acts together and realize the necessity of his shots and meds. I'm sure it is super frustrating for you. Nothing worse than dealing with bureaucratic red tape of insurance when the health of your child is on the line. Hopefully it will all come together before you head in for the appointments at the end of the week.

Smiles and hugs from Omaha, Caryn

Anonymous said...

Hi Erin and Greg
Since Paul works at a place that does voice mail systems he knows some tricks to get through the voice mail web. Try this...
Listen first to all the options of what to press. If they leave out a number, press that one. You might even try to hold the button down for several seconds. Usually that button is zero. Just press and hold for a few seconds to see if it works. Who knows?? May be worth trying. It could also be the # or * button.
Love from the SC Beckemeiers

Anonymous said...


When Evelyn her Double Switch, we also had BCBS. About a month or two prior to the surgery we got a call from BCBS from someone introducing themselves as our "special caseworker". Basically they knew something big was about to happen and that sooner or later we would run into some insurance issues. This person gave us their name and a direct dial number and said that she was there to help with any red tape that we may receive. Fortunately we didn't really run into many issues (other than Synagis) so we never called back but maybe you can somehow get someone like this assigned to you. Things may be different within our plans at BCBS as I work for a company that is their largest and best paying customer in the state......

Regarding Synagis, BCBS approved us for the whole winter season (both last year and now this year). Both years they sent a letter saying that we would be approved for X number of injections between these two dates (Nov 1 and April 1 I believe). Maybe your doctor can request something differnt in order to get you pre-approved.

Also, it is every bit as expensive as what they say so I would strongly try and not get yourself in a situation where you could get stuck with a bill. Before BCBS reduces the amount I think full price is a couple of thousand dollars per injection......Our peditrician dispensed it last year and it almost bankrupted her. We have to go to the hospital this year.....

Hope Conway kicks his cold soon. We have the same mess here in TN.

Dave Knostman

Anonymous said...

Dear baby Conway hope you get better really soon!