Appeals and Grievance's

Appeals and Grievance's

Over the past few weeks, our daughter has had some medication changes. We also have had some positive family sessions by video and made some progress in our communication skills. In last weeks family session we completed some exercises on communication, facilitated by our daughters therapist.  

My wife and I are mentally exhausted due to the thought of our BCBS coverage being cut off in just 9 short days. I have filed several appeals with BCBS, all of which have been denied. This past Monday, I filed a grievance with BCBS in reference to the refusal to afford us a case review. I have also reached out to the Florida state insurance we have due to the adoption of our daughter. Unfortunately, due to some red tape, the Florida state insurance can not cover her in Tennessee in our case.

I was able to get some assistance in organizing a "Family Team Staffing". This is a special meeting in which my wife and I meet by video with all parties who have had a hand in our daughters care over the past several months. This includes the appeals Coordinator with BCBS. The purpose of this meeting is to hear the recommendations of all medical staff involved in her care. It is our hope that these recommendations may persuade BCBS to grant special permission for coverage in our case. There is a possibility however that BCBS may not even show up for the meeting. The meeting is set for 7/13/2022 at 10 am.

If we are unsuccessful in this step of the process, we will be facing an overwhelming amount of financial strain to keep her treatment going. The admissions department has informed us that the cost of treatment is $1,000 per day. If we aren't able to resolve this financial issue, our daughter will be sent home having not received the full treatment she desperately needs. We fear that without the continued treatment, she will resume the behaviors that compromise her safety and well-being.

Please pray that God grant us favor in this situation, so that we can get our daughter the help that she needs. We have exhausted what we can do, only God can handle it from here.