Friday, March 12, 2010

The Insurance Story

Shoot! I better get this post done, people (aka sisters) are calling me for the story...

I think everyone knows that we owe over $100,000 for Carter's last surgery. OUCH, right? When Carter had the procedure we had primary insurance coverage from PEHP (through my job with the School for the Blind) and secondary coverage from Select Med (with Jason's job). So, long story short, PEHP has denied EVERY appeal that has been made and they have consistently refused to pay anything. Even though they have a letter from Carter's previous doctor that states his birth defect is too complex to be treated by a doctor in Utah and he needs to be allowed to seek more specialized treatment.

Here's the cool part. I got a phone call from the nicest lady, Val, with Select Med. She asked me some questions about Carter and we talked for a bit. At the end of our conversation she said, "We don't think the decision your primary insurance company has made is fair, so we are going to see what we can do." Yahoo! was what I was thinking. But wait, it gets better, Val goes on to tell me that she has a nephew with the exact same diagnosis as Carter who has undergone numerous surgeries. I almost fell over. I have NEVER met anyone who knows about this birth defect, let alone is related to someone who has it! I knew in that moment that Val was on our side and she was going to help us in anyway she could.

We recently received notice from St. Mary's Medical Center that $53,000 had been paid toward our bill by Select Med. THANK YOU, Select Med and Val, for doing the right thing!

I am a believer in miracles and I am a believer in the power of positive thinking. Actually, not just positive thinking, but KNOWING with everything inside you that a desired outcome will be achieved. I have know that a means would be provided for these medical bills to be paid, I have visualized it happening. Of course we still have a ways to go... and the expense of another surgery on top of that. But I am firm in my belief that a means, or several for that matter, will be provided. Opportunities that we haven't even thought of will come our way and it will all work out in the end.

Thank you to our sweet friends and dear family members who have kept Carter and our family in your prayers and who have combined your belief and faith with ours. Miracles happen.

Update: Carter's surgery was moved to June 1st due to a scheduling issue.



9 comments:

Amy said...

Thank Goodness! What a relief! I am so happy about that. Jamie, have you guys ever thought about getting a lawyer re: your battle with the first insurance company?

MaloneDad said...

Catching up. Happy birthday to the boys - Carter tomorrow!

Glad to hear about the insurance.

Have the boys check out my blog to hear about Jake.

Melissa said...

Oh, I am so happy to heat that! I hope it continues to get better! Congratulations thus far! What a blessing!

Cristina said...

That is great news!!!

Tyler and Jess said...

Yahoo!! There are good people in the world and this proves it! Things do always work out. Life is good!!

Tyler and Jess said...

HAPPY BIRTHDAY COLBY!!! You are getting so big! Jamie I'm so glad you are back to blogging. And Amy I wish the picture was bigger too!

The Kent Family said...

Happy Birthday Boys! We love you! Congrats on the insurance too! I'm glad Carter is getting another surgery, but June 1st doesn't work for me. I want you guys here when we have the babe! oh well I guess we'll have to come visit in Florida!!

Ty and Juju Brown said...

That is awesome!!!

B&L Belnap said...

We're glad some of the weight is lifted off your shoulders! Awesome! Thank goodness for Val.