amaya at lake

amaya at lake

Tuesday, July 17, 2012

Still fighting a bill

     This morning I had to follow up with our bill for Amaya's surgery. Thankfully the woman I spoke to this morning was kind, patient, friendly, helpful and explained a lot. She looked into Amaya's claims. She said that there were "many" for her from her surgery date. She said that things are broken up so much and billed separately, she said, "it's actually crazy" how much the claims get broken down and itemized. It's pretty confusing. Some of the bills have to go directly to our insurance then others have to first be filled through our primary doctor's office. She finally got a hold of the claim in question and had to look into why we were being billed for it. She said that the hospital billed them for the actual orthopedic services Dr. Nelson performed (it's crazy it actually breaks it down into specifics "incision in hip," "apply fixator," "bone graph," "lengthen femur,"etc.). She said that one of the procedures was a compound procedure, (which means it was billed twice, once on its own and then once under another category). She said that they had denied it, but instead of appealing it the hospital billed us instead. She said that unfortunately some families will just pay the bill, and that I was doing the right thing by questioning it. She told me exactly what to say when I called the billing department back at the hospital and that no I should not have to pay any more than my co-pay. I was so relieved to finally have some understanding, clarity, and a helpful person on my side. Later I called the hospital and told them what the woman in the claims department told me. They said they would need to get a specialist to work on it and would call me back as soon as it was resolved. So its still not fully resolved, but at least were moving in the right direction. The other woman did give me her direct extension and offered to help me even more if I needed it. I'm so thankful for people like her (I believe her name was Cindy. Thank you Cindy for all your help and professionalism). They make these battles so much easier to fight. Hopefully we'll hear something before we leave for our trip tomorrow so that I'm not worrying and wondering about it then. 
As we were walking into therapy today I noticed that Amaya's skirt had a whole in it. Her fixator pins have poked thru several dresses and skirts. Amaya walked all the way in and was working on her three main things; walking heel to toe, bending the knee and keeping her toes pointed forward. 
Melissa had Amaya start by working on the total gym machine doing leg bends. 
     After that she walked over the gum drops. She had a hard time today stepping over the gum drops completely. She had to redo a couple of them, because she didn't clear them at all. There was a teenage boy using the parallel bars so we worked next to them. He was wearing a fixator on his femur, but it didn't go below the knee at all. His looked so much smaller in comparison to Amaya's. I'm not sure why his didn't have the bottom parts, but each case is different so who knows. I did notice though that he was a bit grumpy and short with his mom. I sympathized with her a lot. Amaya has also been grumpy with me us at times too. But, it seems like adding a teenager to the fixator equation might be a bit trickier. But, who knows, I guess it depends on each child. 
Next the girls rode the big loop on the bikes today. I asked Melissa bout how long it is, and she said she thought about three hundred feet. Amaya was going so fast today that we had to keep asking Lidie to pedal faster so she wouldn't get run over.  
Once we were back in the gym Lidie worked on her balance on once of these toys.  
While she did that Amaya did several bends, lunges, sitting into a bending position, etc. Since she's distracted with throwing balls at Savannah she doesn't quite realize how many she's doing. Amaya had to work hard at keeping her right heel on the ground as she would lean forward to bend the left knee. 
Then Melissa had her face the ball pit and throw twenty balls while she bent her knee back for her. It's a bit of a stretch, but Amaya didn't complain of any pain.
      The last thing before bends was this. Amaya pulled on the blue strap that Melissa had tied around her ankle. As she pulled her leg up Melissa helped it along. It pulled on Amaya's skin and pin sites a bit, but other than that it wasn't too bad. But as you can tell by her face she was working hard. I was amazed by how much she got done in forty five minutes. Amaya's knee measured at 47 to start but got up to 61 with a few scoots. Then she started her bends. Her goal was 98 for today, but after a few minutes of bends she got stuck in a lull in the 90's. Melissa asked her to do five big pushes which got her to 97. Then she asked Amaya if she wanted to stop there or go for her goal. Amaya said, she might just stop, but Melissa told her to just try to get there. She let her know that it was only one degree. And sure enough she did. I reminded her that it's important to work hard to reach the goals she sets for herself. 
maya picked a book out called Do you know what its like to be in a wheelchair? She loves it. It's a really neat book and explains in kid-friendly terms the many reasons people use wheelchairs and why some use them part of the time and some people use them all the time. We tried signing Amaya up for the summer reading program, but unfortunately it ends next week. We have been so busy with therapy that we haven't gone in this summer. Usually Amaya participates the entire time. She was a bit bummed about it, but the lady was nice enough to give Amaya a reading log. She'll fill it out at home then I'll give her prizes after she reads ten books. She was happy with that compromise. While we were there Amaya noticed a lot of kids starring at her leg. There seemed to be lots of kids out today, at the store and library. Amaya finally said, "I wish I could wear pants so that then people wouldn't look at my leg, just at me." So I''m going to try to work on some pants for her after we return from our trip.
One of the great things about the library we went to today is that it has so many animals there. Lidie was able to get this bird to turn around by following my keys. We all thought that was pretty cool. 
As we were getting our stuff ready to go beach camping tomorrow Amaya showed Lidie how to use the boogie board. Last summer was Amaya's first time using it and she's planning to try it again with her fixator on. We'll be gone until Sunday so I'll have lots of pictures to share then. Until then, thanks again for reading along and sharing in our journey. 

1 comment:

  1. I got a call from the billing department at the hospital this morning before we left saying that they would be renting the insurance. She said it would take 30-45 days to hear back. So for know, were good. Then I made a call to Cindy to thank her for all her help.