Thursday, October 1, 2009

Platinum babies

First: milk production: the Fenugreek I was taking was causing some serious gas and tummy problems with the babies so I had to cut way back for their comfort. In consequence, my milk production went down again. (it had finally come back up a bit). I am still diligently pumping every 3 to 4 hours, etc. The Domperidone came in yesterday afternoon. The pediatrician was very familiar with it and discussed it with me patiently assuring me it would be just fine to take it. He looked almost as worried as I was about my decreased production and wished me much luck.

Ok, I've thought alot about discussing finances on here. Mainly because it's always a sensitive topic with people. But also because I don't want to solicit funds or fish for sympathy. Honestly, I think our bills are a bit amusing (you'll see why shortly). I follow other blogs (in my - ha- copious spare time) and much of this doesn't seem mentioned. Finally, along with the rest of this blog, I haven't left anything out thus far and really hate to leave this hilarity out now - I'd like to look back on this post and see the rigmarole we went through...Having said that, please don't feel the need to tell me "not to worry about finances". I AM NOT WORRIED!! (I promise - at least not this year - next year, maybe a little, but we'll see...thanks to the generosity surrounding the babies' donation account, much of the financial pressure has been lifted from our shoulders!) I think this side of things is interesting - especially as a nurse. We never know what the patients go through on the business end of their care.

Ok - estimated total for all hospital care for the babies (this includes Kuylen's 5 days in the NICU which was just over 200k): just under 6.5 million (I said million dollars). HA! Have you ever seen the Austin Powers movies? That's all I can think of when I hear that number. Dr. Evil asking for a bada billion fa fillion dollars. Anyhow, I've thought a bit about it throughout this whole ordeal, but with it being 2 months after the babies' homecoming, the bills have started to roll in. So it has been high on my mind this past week as my part time job of calling about our medical coverage has quickly begun to take up a bit more of my attention. (P.S. in case you're wondering, my hospital stay alone - delivery excluded - was 95k - this is not included in the total above).

We did finally find a way to get the Medicaid supplement for all 3 babies. I had so many moral issues at first with taking it but any hesitation was quickly dropped when I heard their first week alone broke the million dollar mark. I honestly went into this thinking that we had been responsible - that we had increased our insurance to the premium policy when we found out I was (finally) pregnant; that we had saved and saved in preparation for starting a family. I still think we were responsible - but could never have anticipated this!! The supplement lasts for their first year and is based solely on their low birth weights. After their first birthday, their cases will be re-evaluated based on our income and we will loose coverage from what I understand.

So, this week, David's hospital stay bill came in - this excludes added surgeries and only addresses his stay here - not the transfers back and forth or the New Orleans stay. It is 1.67 million dollars. I feel I should frame it. We got the entire bill because our primary insurance company has dragged their feet on payment. Someone is probably still standing there looking at the paper work with their mouth wide open I'd say - in total shock of a young family - otherwise healthy with no claims - and suddenly, the dam breaks...then again, I suppose this is a likely senario in the insurance business. It's fair to say you're healthy until you're not right? So, I didn't know what had happened - and why we got the entire bill at first. Brent said I should send them $20. Instead I phoned the hospital. The sweet girl on the end of the line sounded like she felt embarrassed about telling me the total - as if I didn't know what it was or something. I thought about asking who I should write the check out to and telling her, while trying to maintain a straight face, that I'd have my accountant there to "take care of it" shortly. Ha - she went over their billing processes with me and I was able to request an immediate review from our ins. and a hard copy of the records is being sent to the Medicaid office. What a racket.

The hospital bill is a bit like all of the other bills we've received. We'll get a total, denied by insurance. I'll call, and an hour of phone recordings, "press one now" later, I'll find out (when I finally stay on hold long enough to speak with a real person) that the wrong form was sent in for the claim or the claim was made to Medicaid before it was made to our insurance company. With a little determination, alot of borrowed time and perserverance, I am pleased to say that I have always been able to get the claim reconsidered and paid appropriately. I do wonder though, how much extra money the insurance company makes by denying claims for people that should have been paid on the basis of improper filing. Once you pay a claim from what I've found, there is no reimbursement.

Perhaps the worst system to deal with? The Medicaid system. I have found myself on the phone with some of the rudest most disrespectful people while trying to work my way through that mess. They originally didn't have our primary insurance on file. I had to spend 3 hours with numerous departments - most of the time on hold - in an effort to work out the confusion - and that was just one afternoon. I have pumped on the phone, fed, changed and burped babies on the phone, sung lullabies on the phone, cooked dinner, balanced the check book - anything to take my mind off of the fact that I had in fact been on hold for a full 30 minutes. I have been beraded for having multiples that I "cannot afford" by the state workers. I have been told that "I didn't do my job" when I requested a change in the listing of our insurance. Ha - I was trying to essentially save them money and still was met with snyde remarks. Ultimately though, I have worked things out to our advantage and I'm proud to say that we did things honestly and legitimately - using programs put in place specifically for situations like ours. Without getting too political however it does frustrate me that even though we did as far as I'm concerned prepare properly for expanding our family, we were basically set up for having to relying on the system eventually with the ridiculously inflated cost of healthcare.

Seriously - over 6million dollars? The first time I heard it, I smiled, then giggled out loud. It was as if it was absolutely nothing and everything all at once. Really, how does one even begin to stress about such an abstract concept? So, I've resigned to simple enjoy these little ones, every day, and be thankful that their caliber of care is even available to us. It gave us our family. Who can really put a price on that?

The babies are doing better today as far as their tummies go (this post is another that has been 2 days in the making). They slept a little more last night as well which was nice. The Domperidone seems to be working already - just 2 days in so I'm hoping that continues and appreciating what I can do now. Since Mary Louise and David are gaining in their head control each day, we tried Mary Louise (since she weighs more) in her Bumbo today. She did beautifully! Funny to see such a little thing being so grown up. Before we know it she'll be smashing Play Doh into her brother's hair!

Uncle Bean (my youngest brother Sean) came in last night to stay with us for his fall break. We've had a nice lazy visit so far...

Mary Louise and Uncle Bean
From Mary Louise in her Bumbo


Brent and David
From Mary Louise in her Bumbo


Mary Louise in her Bumbo
From Mary Louise in her Bumbo

2 comments:

  1. !!!!!! How Much!!!!!!!!
    wow! I don't think I could cope with your healthcare system, I'd have a breakdown.

    I think you have the right attitude, its not like you could find that kind of money realistically so why worry. Besides money is only money but the babies are a joy!!!

    Love the bumbo picture!!!

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  2. if you don't fight for your family, no one else will either.
    i never dealt with medicaid but i had a problem after my surgery and i spent hours on the phone getting to the bottom of it. but you just have to keep with it.
    you go girl!
    love mary louise in her seat.

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