A few weeks after we arrived home from the Maggie's stay in the NICU we received a letter in the mail stating our insurance company had denied paying the claim for my one night stay at OHSU. The letter stated that it was denied as I did not need to be placed in a higher care facility. Basically, they were saying it was not necessary for me to be transferred and get higher care at OHSU. Generally, if you are to transfer from one hospital to another you would have to get pre-approval from the insurance company that this is a necessity and they would then cover it. Well, in an emergency situation such as we were in the doctors and us all made the best decision we knew. Mom and baby needed to be together. We believe this no matter what. The whole time Maggie was being worked on in the nursery at Silverton Hospital, AJ was standing right along side her. He was transported with her and was with her when they checked her in to OHSU. The only time he left her was at 5am on Monday morning after being awake for over 24 hours! He needed some rest and wanted to be with me. Having a traumatic birth and a baby in the NICU and the mom in recovery has got to be hard on the dad and family. Who do you be with?
Anyways, so my one night stay at OHSU was denied. Not the doctors that treated me, that was covered, the stay, room and board. $2200. Denied. Well, we were floored to say the least. How can you deny the mother who is postpartum, who has just pushed a baby out, who is unsure of if she will live or not, who believes that nursing and skin to skin contact is vital vital vital in the first few seconds of their life. How can you deny that? Even though we couldn't do all that with Maggie, the mere fact that what if she was to take a turn for the worse like she did on Monday night and I was sitting in a hospital bed miles away in another city? How do you deny all this?
So we called ODS and explained our situation and they very kindly told us to submit an appeal. We filled out the form, had our delivering doctor write a letter and we wrote a letter explaining our appeal. We had six months to submit it and about 2 weeks shy of the 6 month date, we sent it off. A week later we got a form I had to sign and I sent that back. Then on Saturday another letter arrived from ODS.
Our denial had been overturned and they stated they would be covering the claim! Praise Jesus! Insurance companies do have hearts after all!
We most likely will still owe some money but not all $2200. FYI, one nights stay at OHSU is about $2200 in case you are price shopping. :)
Again, God has shown himself to us in His way and reminded us He is in control, we just have to place all our trust in Him.