MyBlueLobsters Posted October 9, 2008 Share Posted October 9, 2008 (edited) So the short story is that Logan has a severe growth hormone deficiency and has to take daily injections or he will die due to a severe hypoglycemic reaction (his blood sugar was dropping below 20 and he was having grand mal seizures and going unconcious). Becuase of his age, it was like pulling TEETH to get our insurance to cover it ($20,000 per year) because they thought we wanted to make him taller....:confused: Anyway, it took 9 months of calls and letters to get this medicine approved and we have now been getting it for 3 months. We get a call today from the company who the growth hormones are from and they say "We are not shipping your next dose because we need medical proof that he needs this" DH told them that this has already been established and if he doesn't get these shots, he dies. They don't care, they 'can't go against their policy', so he calls the Dr's office who we have been trying to contact for a month to get the dosage changed, and his Dr's office is unwilling to call us back. So what the flip are we supposed to do?! DH is calling them back tomorrow saying that if their unwillingness to return our phone calls causes our son to die we will sue their hineys off. Hopefully that will get their rears in gear. We hate to threaten that.....but SERIOUSLY! This is a child's LIFE on the line......ARUGH. Okay rant over.....off to cry. This is why I'm so fat....... :crying: Edited October 9, 2008 by MyBlueLobsters Quote Link to comment Share on other sites More sharing options...
Miss Peregrine Posted October 9, 2008 Share Posted October 9, 2008 I'm sorry... :grouphug: Quote Link to comment Share on other sites More sharing options...
Nicole M Posted October 9, 2008 Share Posted October 9, 2008 Is it possible to show up in the doctor's office and stand at the desk until you get help? I would bypass the phone altogether. I hate it that you have to go through this. It makes me want to swear. I'm sorry. Quote Link to comment Share on other sites More sharing options...
King Alfred Academy Posted October 9, 2008 Share Posted October 9, 2008 Is it possible to show up in the doctor's office and stand at the desk until you get help? I would bypass the phone altogether. That was my thought. I would rant, yell, stomp my feet, do whatever I need to until someone listened! I am so sorry you are having to go through all this. I can't imagine what it is like. I hope you are able to get it worked out soon. :grouphug::grouphug::grouphug::grouphug: Quote Link to comment Share on other sites More sharing options...
emeraldjoy Posted October 9, 2008 Share Posted October 9, 2008 I am so sorry. Words do not quite do this situation justic. My prayers are with you. emerald Quote Link to comment Share on other sites More sharing options...
elegantlion Posted October 9, 2008 Share Posted October 9, 2008 Is it possible to show up in the doctor's office and stand at the desk until you get help? I would bypass the phone altogether. I hate it that you have to go through this. It makes me want to swear. I'm sorry. Oh, I'd be skipping the phone as well. :grouphug: I hope you are able to find a solution quickly. Quote Link to comment Share on other sites More sharing options...
sleepy Posted October 9, 2008 Share Posted October 9, 2008 Is it possible to show up in the doctor's office and stand at the desk until you get help? I would bypass the phone altogether. I hate it that you have to go through this. It makes me want to swear. I'm sorry. Yes, this may be what you have to do. You may also want to get in touch with your state insurance commissioner. This is life or death business, here, and you should not have to prove the medical necessity of his drugs repeatedly. I hope you can get this resolved as quickly as possible. :grouphug: Quote Link to comment Share on other sites More sharing options...
FlockOfSillies Posted October 9, 2008 Share Posted October 9, 2008 Call the local TV and talk radio stations, too, while you're at it. Quote Link to comment Share on other sites More sharing options...
TraceyS/FL Posted October 9, 2008 Share Posted October 9, 2008 Don't you have a coordinator at the drug company? Get on the phone with him/her (I had one at Lily). That is that persons job - they run the interference between you, the insurance company and the pharmacy. If it's Lily that you us - i can give you my reps number to get to the office to maybe get the right person. Hug that little guy - my DD is off hers right now and i cry at night about it. We have no insurance..... Quote Link to comment Share on other sites More sharing options...
Laura in VA Posted October 9, 2008 Share Posted October 9, 2008 I'm so sorry. I agree with going to the doctor's office and when we lived in the states, we had a great congressman. :grouphug: Quote Link to comment Share on other sites More sharing options...
MyBlueLobsters Posted October 9, 2008 Author Share Posted October 9, 2008 Don't you have a coordinator at the drug company? Get on the phone with him/her (I had one at Lily). That is that persons job - they run the interference between you, the insurance company and the pharmacy. If it's Lily that you us - i can give you my reps number to get to the office to maybe get the right person. Hug that little guy - my DD is off hers right now and i cry at night about it. We have no insurance..... That is who DH talked to today who said we needed to call the Dr....apparently they can't get the Dr to call them back either. Quote Link to comment Share on other sites More sharing options...
MyBlueLobsters Posted October 9, 2008 Author Share Posted October 9, 2008 I will go visit them (the endocrine Dr) on Monday if we have not heard anything. I have another appt there anyway..... Quote Link to comment Share on other sites More sharing options...
TraceyS/FL Posted October 9, 2008 Share Posted October 9, 2008 That is who DH talked to today who said we needed to call the Dr....apparently they can't get the Dr to call them back either. You are kidding???? Can you start hunting for a new Endo? something is up..... I thought only i had those issues (i had to have the genetics office transfer me to get thru before we switched, the doctor apologized for the office staff and said his hands were tied since he just worked for the Group - he couldn't fire them). What does the insurance company say? Call them and ask for a Supervisor. I got far doing that too..... :grouphug: Quote Link to comment Share on other sites More sharing options...
MyBlueLobsters Posted October 10, 2008 Author Share Posted October 10, 2008 Hug that little guy - my DD is off hers right now and i cry at night about it. We have no insurance..... :grouphug: I was totally insensitive earlier....I should have given you MAJOR hugs then! :grouphug: Does she take HGH for the same reason? We went for almost a year putting Logan to bed praying over him each night that he would be with us in the morning. That is a feeling no parent should ever have to go through. :grouphug::grouphug::grouphug: Major hugs to you and your little girl. Quote Link to comment Share on other sites More sharing options...
Jean in Newcastle Posted October 10, 2008 Share Posted October 10, 2008 Call the local TV and talk radio stations, too, while you're at it. If there is a consumer advocate at the local TV station I would contact them. They know how to put pressure where it counts. Quote Link to comment Share on other sites More sharing options...
Plucky Posted October 10, 2008 Share Posted October 10, 2008 Yep, I'd show up bright and early tomorrow morning and insist on being seen. I'm so sorry you're going through this. Quote Link to comment Share on other sites More sharing options...
Jugglin'5 Posted October 10, 2008 Share Posted October 10, 2008 :grouphug: I'm so sorry. Bang those drums, clash those cymbals, and stand on their desks if you have to! Be the squeaky wheel! :grouphug::grouphug::grouphug: Quote Link to comment Share on other sites More sharing options...
Zelda Posted October 10, 2008 Share Posted October 10, 2008 :grouphug::grouphug: Quote Link to comment Share on other sites More sharing options...
sarahli Posted October 10, 2008 Share Posted October 10, 2008 If you can't get a hold of your Dr. tomorrow morning, go to the hospital and ask to see a social worker. They deal with finding resources for patients all the time. I'm sure someone will be able to help you. :grouphug: Quote Link to comment Share on other sites More sharing options...
saw Posted October 10, 2008 Share Posted October 10, 2008 If you don't get results at the doctor's office today, I suggest asking (uber politely) for names and the right people for your attorney to contact, since your attorney is going to be very interested in keeping your son alive. Sometimes just the word attorney gets them going (I've done this once, in another situation, and it scared the heck out of the people who were trying to deny my son access to his free public education). Good luck, I cannot imagine how stinky this is for you. Your son is fortunate to have such great advocates for parents. Quote Link to comment Share on other sites More sharing options...
Kris Posted October 10, 2008 Share Posted October 10, 2008 If you don't get results at the doctor's office today, I suggest asking (uber politely) for names and the right people for your attorney to contact, since your attorney is going to be very interested in keeping your son alive. Sometimes just the word attorney gets them going (I've done this once, in another situation, and it scared the heck out of the people who were trying to deny my son access to his free public education). I'd probably be mentioning, also, that this is just exactly what those sky-high malpractice insurance premiums are for. But then, I was never known for being subtle. Quote Link to comment Share on other sites More sharing options...
Alice Posted October 10, 2008 Share Posted October 10, 2008 Couple of thoughts for you... Do you have a primary doctor? Can they call the endocrinologist to see if they can get things moving? It might not help for the primary doc to call the insurance company if they didn't order the medicince but they could call the specialist. A lot of times I can get through to a specialist and get things taken care of for patients who have been having a hard time on their own. Is the specialist with a hospital? Most hospitals have a patient advocate...that might be someone who could help. Do either you or dh work for a biggish company? If you get insurance through a company you work for the company HR person can call the insurance company and complain. This works especially well if it is a big company that is purchasing a lot of insurance. I've had a couple of situations where I have written mulitple letters using words like "this patient will die without xxxx" and made many phone calls and the insurance company continued to deny the treatment...until the HR person from the company called and made a stink. I think in once case she let let them know she would be contacting the media with this sad health care story....and they miraculously approved it. :) Quote Link to comment Share on other sites More sharing options...
TraceyS/FL Posted October 10, 2008 Share Posted October 10, 2008 :grouphug: I was totally insensitive earlier....I should have given you MAJOR hugs then! :grouphug: Does she take HGH for the same reason? We went for almost a year putting Logan to bed praying over him each night that he would be with us in the morning. That is a feeling no parent should ever have to go through. :grouphug::grouphug::grouphug: Major hugs to you and your little girl. No, she has Turner's Syndrome. She creates HGH but her body can't use it - so they have to super dose her so she grows. The goal is to get her to 5ft tall so she can function in life normally. Without other treatments she won't go thru puberty and will have to be on hormones her whole life (slight chance she will start her period and go thru menopause at 20 because of ovary issues - IF she has functioning ones). Yours outweighs us more because it is a matter of life and death - enough that if i had some extra stashed here i'd send it to you. I can't tolerate the doctors treating KIDS that way - so go kick some booty for me. :grouphug: Quote Link to comment Share on other sites More sharing options...
TeacherZee Posted October 10, 2008 Share Posted October 10, 2008 Is it possible to show up in the doctor's office and stand at the desk until you get help? I would bypass the phone altogether. I hate it that you have to go through this. It makes me want to swear. I'm sorry. That was my thought. I would rant, yell, stomp my feet, do whatever I need to until someone listened! I am so sorry you are having to go through all this. I can't imagine what it is like. I hope you are able to get it worked out soon. Oh, I'd be skipping the phone as well. I hope you are able to find a solution quickly. If you don't get results at the doctor's office today, I suggest asking (uber politely) for names and the right people for your attorney to contact, since your attorney is going to be very interested in keeping your son alive. Sometimes just the word attorney gets them going (I've done this once, in another situation, and it scared the heck out of the people who were trying to deny my son access to his free public education). Good luck, I cannot imagine how stinky this is for you. Your son is fortunate to have such great advocates for parents. :iagree::iagree: With all of the above. And :grouphug::grouphug::grouphug::grouphug: For you and your little guy!!! Quote Link to comment Share on other sites More sharing options...
LNC Posted October 10, 2008 Share Posted October 10, 2008 (edited) We have extensive medical issues in our family w/ dozens of prescriptions. This is absolutely unnacceptable and unheard of. I can't imagine a dr. not calling back about a prescriptions refill (or anything else for that matter) for a month. You should get a paper prescription w/ a year refills today by scheduling a same day sick appt with primary care if you have to. Then, fax it to the insurance company rep you talked to - get confirmation they received it. Then, switch doctors - preferably another pediatric endo for this. Last, file a complaint with the state board. I'm so sorry you are going through this. I'm praying it is resolved today. Edited October 10, 2008 by LNC Quote Link to comment Share on other sites More sharing options...
bumbledeb Posted October 10, 2008 Share Posted October 10, 2008 I'm British and don't understand how your healthcare system works, so I have no advice for you but I just wanted you to know I'm hoping for the best for you and Logan.:grouphug: Quote Link to comment Share on other sites More sharing options...
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