interpretations

I have never been good at seeing shades of gray. 

I suppose I was just Wired to see things as black or white.  Right or wrong.  

So when Blue Cross Blue Shield of Rhode Island informed me (via my new case manager) to take my outpatient Speech Therapy cause up with the State Legislation.  As the Law is clear these therapies are to be provided by the schools for peoples between the ages of 3 - 26.  There may have been steam thundering from my ears.  I really couldn't say.  I was too busy fuming.  The fire was further stoked when I was asked if Trevy has Medicaid.  Because, after all, isn't that what Medicaid is there for? 

Why now that that you ask....

NOOOOOO  

I suppose I'm old fashioned or closed minded or whatever...but I'm rather convinced that's what my Health Insurance is there for!  

Because frankly... 

...if Trevor doesn't fit the bill of who qualifies to have insurance covered Speech Therapy in a hospital clinic (because it's needed in addition to what the school provides!) then why have the freaking service listed as "covered"?! 

The going broke State should not have to pick up the tab for the insurance provider. 

And furthermore, please pass on to your manager...

I calmly responded to the young lady on the other end of the line...

I'm up for a round with the Legislators and I hope he is too.  Because while Medicaid may indeed cover this extraordinarily necessary therapy...it does not mean that I will not appeal Blue Cross's decision to the highest levels.   

She passed my message on to him early last week.  

Evidently he isn't up for a battle after all.  I took a call late Friday afternoon from our case manage (who is a very sweet young lady actually). She could hardly contain her enthusiasm while informing me that the decision had been reversed!  Her advocacy...that of another nurse on staff whose family has been touched by autism...and perhaps my steaming...all worked together to reverse the decision!   

Turns out there's wiggle room in how one chooses to interpret the RI State Law as it applies to little boys who've endured radical brain surgery.  



Which works out well for me actually.  As my hands are plenty full without battling insurance coverage!