Thursday, September 28, 2006

Who Are You?

I never put too much thought into "when were you born" psychoanalysis, but then I came across this site and

Your Birthdate: March 28
You have a Type A personality so big it makes other Type A's shrink away in shame.(I am Type A, but not that big)

You never shy away from adversity - and you love to tackle impossible problems. (True)
Failure is not an option for you, and more than a few people are put off by your ego. (True for #1 and Yikes! for #2)
You tend to be controlling, and you hate leaving anything up to chance. (Sometimes..more of myself than others....I strive for perfection, BUT only in certain things. The rest is normal, I swear.)
Your strength: Your bold approach to life (True )
Your weakness: You don't accept help (True, but has changed considerably since Gabe's diagnosis)
Your power color: Bronze (Really?)
Your power symbol: Pyramid (Huh..)
Your power month: October (I love fall)

What about you?
Go see at.....

Thanks for the cool site Karmyn at Dreaming What Ifs...(

Wednesday, September 27, 2006

So Not Surprised

Got the call from BCBS.....Denied.

I would love to go into the details, but am choosing not to until the claim is settled. I am waiting for the official written reason for the claim being denied, sometime this week. Then, on to the appeal.

Bring it on.

Sunday, September 24, 2006

One Ticket Please... To Crazy Town

These past few weeks I have been busy, very busy. Almost as if I was a squirrel gathering and burying nuts, building a nest that will ensure a safe journey through winter and of course, putting on my winter fat. Except, I'm obviously not a squirrel, but my gathering and burying could be compared to my constant faxing and phone calls to our insurance company and doctors, my nest is always challenged by my growing children and well, my winter bulge happens to mysteriously appear during very stressful times. Ice cream is at a premium, but my daughters birthday cake has leapt into 1st place as a necessary sedative at the end of the day. Where is the end? I am anxious to get there, nuts or no nuts. I need an end.

My claim has now passed through to the fourth level in my insurance company. It was passed from the customer service agent to the auditor, to the team of managers and now to the Medical Advisory Commission. It has take an entire month to know.....absolutely nothing. One thing I know is that out of all 6 doctors documenting in their evaluation that Gabe should receive at least 25 hours a week ABA therapy, half in network from a neurologist, pediatrician, doctor from a leading university, that they, BCBS, are trying to find a loophole in the one doctor's BCBS's out of network referral. Ah yes......that damn referral. You think you have got all your ducks in a row, turn your back and one looks cross eyed and an amazing amount of money goes out the door, not in your direction. I thought my parents expectation of being perfect was daunting....

So, I am waiting for the Medical Advisory Commission to rule on it and I should know by Thursday. I know it will be no and ...That's OK. I am already 4 steps ahead and am planning my appeal to the State of Michigan, who will be the "outside party" who evaluates appealed claims outside of insurance companies. BCBS will say no about three times, me appealing each time, then a new slate and a new appeal occurs with the state, hopefully in a couple months. I kinda want them to say no, just so I can make a point. So, my son and I can be heard in a forum not swayed by the insurance company and their shareholders. I just have to hope that the person that evaluates our claim from the state did not attain their job placement due to a shake of the hand with BCBS. Who knows? We're crossing our fingers, toes, legs, arms....cats get the picture.

Meanwhile.........Gabe has been talking even more. His tone at times is "normal". Normal!!! I wish I could post a UTube short movie showing Gabe's high pitched talking. It is the one thing that really makes him stand out. It's common that children with speech difficulties that see a female speech therapist to mimic the tone that their therapist uses, especially if they are Autistic. Gabe is very literal, he will repeat something exactly as you said it. If I say it high, he says it high, low he low. BUT, now he seems to be finding his voice. It mostly comes out when he is mad at me. Here's an example, I was upstairs the other day grabbing something before taking both kids to school, and I hear Boo yell, "GABEY HAS EGGS!!!!GABEY HAS EGGS!!!"
"Eggs?"I thought to the plastic Easter eggs? Surely not.......
As soon as the thought crossed my mind I was already at the bottom of the stairs starring at Gabe , who was sitting at the kitchen table carton of eggs in front of him.
"Eggs." He smiled at me.
"Oh no, Gabey we do not play with eggs sweetie." I take them and put them in the fridge. He has never done this before and what is the deal with eggs? What exactly was he going to do with them?
"EGGS!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!EGGS!!!!!!!!!!!!!!! He screams, tears in eyes.
I turn off the TV in order to direct him into the other room with Boo and away from the fridge.
Clear as day.....perfect variation of tone. I stopped dead in my tracks.
"It's on in the other room." I say stunned.
He gets down off his chair runs in the other room.

I just heard my son.

It's hard to explain what it feels like to hear or see a glimpse of your child within their disability (Gabe's speech). It's the same beautiful view that you see everyday with them, but right there, to the left, you see the most amazing rainbow. That's the only way I can describe it.

Saturday, September 09, 2006

My First Fax

I faxed 15 pages of "referrals for ABA Therapy" from 5 doctors in and out of network dating from the day that Gabe was diagnosed March of 2005 to an associate at BCBS. When I called to confirm this associate had received the fax, I was met with a surprised tone in his voice. I then came to the conclusion that he had definately underestimated me.

Stay tuned for the "Plan B" referral, detailed explanation of the code used for treatment that BCBS provide (Again, "Why do you provide codes that you don't know what they mean? If they are too vague, maybe you need to create some more specific codes for doctors to use."), my 2nd Fax experience (Yippeee!) and (Oh Yes!) The Preauthorization Request!

"Oh! Get out!...My life is so much more exciting than yours!"

Monday, September 04, 2006

Personal Pronouns are awesome

After going to see our pediatrician, I normally stop at Burger King for small fries (wheat free) for Boo and Gabe. Saturday we had an appointment, because of a cough Gabe had. SD and I decided to go to a park instead since it was too early for fries."Let's go to the park!" we cheered.

"Want French Fry"(pause)

"Go McDonalds"(pause)

"Eat their food"(pause)

Eat their food? THEIR! Did I hear a THEIR?!

Gimmie a "T"...Gimmie a "H".....Gimmie an "E" ......Gimmie an "I"....and an "R"