Search Results for: blog mental health and insurance advocating for makala

Foible in Law Reveals Domestic Tragedies Nationwide

My last two blogs dealt with the Nebraska Safe Haven law which allowed parents to abandon children without fear of persecution, and with its amendment last weekend which makes the law apply to infants under 30 days only. While researching these blogs, I came across some interesting stories. Families.com readers shared my horror at the idea of what being abandoned by a parent–at an age of full awareness of what is happening–must do to a child’s psyche. However, at some other sites I found people commenting in favor of the Nebraska law, which was formerly the only one that did … Continue reading →

Insurance Company Refused to Cover than Reconsidered Too Late

Welcome to 2008, hopefully your family had a better end to the year 2007 than the family of Natiline Sarkisyan. Their year ended with a funeral for their teen-aged daughter who died after her health and medical insurance company refused to pay for a liver transplant and then reconsidered. The Philadelphia-based Cigna HealthCare insurer has a history of approving coverage for over 90% of all transplants claims requested by their insured members, with over 90% of the liver transplant request being approved according to Cigna company President David Cordani in a memo addressed to employees and distributed to the media. … Continue reading →

Why is My Pain Treated Differently at Work?

I have a close friend who works all day behind a computer and has for over 20 years. During the past five years his hands, elbows, shoulders and neck have started to feel the stress. Over the last year the pain and difficulty has become progressively worse and the company Ergonomics department has actively attempted to make his work area a custom fit in order to reduce the stress. My friend earns a great living at what he does, and over the last five months returns home a little early in order to make out with a heating pad, take … Continue reading →

Insurance Blog Week In Review February 6-12, 2007

This week in the Insurance Blogs I have focused a bit on the Business of Insurance, including some of the Career paths insurance has to offer. Next week I will be expanding on some of interesting things a person might do with an Insurance License. I have also started a series of Blogs about shopping and quoting my own personal insurance portfolio. A project I have put off for far too long. Yesterday, we were given notice that my husbands employer is phasing out the retirement pension they offer. So, now we need to add retirement options to our personal … Continue reading →

Cover Letter For Corrections to our Health Insurance Company Documentation

Dear Insurance Company: We have received the initial denial of authorization from your office. As a matter of course in our effort to advocate for the needs of our daughter we requested the copies of all documents, records and other information relevant if we wanted to file appeal for benefits. We weren’t necessarily interested in appealing the Insurance Company’s decision because our daughter is a “special needs” adoption from the foster care system and we have alternate insurance choices. Makala continues to receive the recommended care as a residential patient. We requested the documents in order to keep records of … Continue reading →

Copy of All Documents, Relevant to Your Appeal.

In a previous Blog I outlined our situation and the fact our Employer Provided Group Health Insurance had sent us an Initial Denial of Authorization for continued psychiatric residential treatment our 9-year-old daughter needs. We expected the letter, and knew our private group health policy had decided in a Doctor to Doctor meeting they would not authorize any further care. This time however, I decided to request a copy of all the documents the insurance company use to make their decision. I called the “Appeals” number provided in the initial denial of authorization letter and exercised my rights to receive … Continue reading →

Initial Denial of Authorization: The Letter

It’s not easy to parent a child who suffers from mental, emotional, and physical disabilities. Navigating the medical and mental health system can be a job in itself. Top things off with a less than cooperative Employer provided group health plan and life can become more then just a little stressful. Our beautiful 9-year-old daughter was placed for adoption with us at the age of 5. It’s been a long hard road filled with difficult parenting choices. I thought I knew everything after raising my older two children. Helping Makala has become the definition of Advocating for the best interest … Continue reading →

Doctor to Doctor Review: Employer Provided Group Health Insurance

It’s been one thing after another since the placement of our special needs siblings for adoption in 2003. We added our children to our Employer Provided Group Health Insurance as soon as possible. In order to be sure all of their needs are met children adopted from foster care have Medicaid or State medical benefits until the age of 18 as part of the Adoption Assistance provided for special needs children. Our private employer group health insurance is seen as Primary with the Medicaid/State medical as secondary. Recently the federal government has passed laws requiring insurance companies treat mental health … Continue reading →

Primary and Secondary Health Insurance Coverage

Our family has had a difficult start to the year 2007! As some may know we are the Adoptive Parents of two special needs siblings placed through the state foster care system. Our daughter, Makala, was 5-years-old and her biological brother Jeremiah was 1-year-old at the time they were placed for adoption in our family during 2003. This has been an interesting and long four years. Our little girl has had several issues no one knew existed among them Alcohol-Related Neurodevelopmental Disorders, (ARND). Special Needs children adopted from the child services system often have continued benefits. Older, or special needs … Continue reading →

Understanding Employer Provided Group Health Insurance

Working Americans fortunate enough to have private health insurance are covered under an employer provided group health insurance plan. There are two popular plans employers might choose for their worker’s benefits package. A standard indemnity health insurance policy, allows employees and their insured dependents the freedom to visit any health care provider they choose. The cost of the appointment or medical service is paid out of pocket by the employee and insurance plan reimburses covered members for a portion of the paid services. The other most common health plan employers choose is a managed care plan. Managed care plans offer … Continue reading →