OK back to fucking reality....
This is the letter that I just received from the financial coordinator from Fairview/University of Minnesota....
3/3/2010
Hello Kelly,
We spoke briefly on the phone on Monday and I wanted to do a follow up email with you regarding the insurance benefits for Amelia.
I spoke with Blue Cross of Louisiana Transplant Case Management this morning in regards to the limitations on the Transplant Specific Lifetime Maximum.
As you know under the Blue Cross policy there is a major medical lifetime maximum for Amelia of $5 million, however there is a Transplant Specific Lifetime Maximum of $300,000.00 which would include all of the transplant stay and post transplant stay for all services and all providers with UMMC, Fairview.
Unfortunately with the estimate for an Allogeneic BMT for Pediatrics, I would not be able to financially secure based on the $300,000.00 for Amelia.
Also you had informed me as well as the Transplant Case Manager at Blue Cross that the Employer Group is unwilling to allow for more transplant coverage.
I did contact the prior authorization dept. at Louisiana Medicaid today and they informed me for any non emergent out of state services to be approved medically, a Referring Dr. with Louisiana MA would have to write a letter of referral with supporting documentation for Amelia to come to UMMC, Fairview and this would then be reviewed by the Louisiana State Review Board to see if they would allow for coverage for Amelia to come to UMMC, Fairview for transplant services.
Unfortunately UMMC, Fairview and most likely all other providers of services (UMP, Home Health, Pharmacy) are not enrolled with Louisiana Medicaid and would not be able to bill for services rendered.
The medical approval and financial approval are two separate processes, so if Louisiana MA were to approve Amelia to come for BMT at UMMC, Fairview each provider of service would have to negotiate a contract with Louisiana MA for payment and every provider of service would have to approve the agreement with Louisiana MA.
I have sent an email to the BMT Coordinator and I will send the email to Dr. Wagner as well.
At this time I would not be able to financially approve any services for Amelia at UMMC, Fairview other then an initial consultation.
If you would like a letter regarding our financial requirements to secure an estimate for transplant for Amelia I can definitely put that together for you and send to you through email. Please let me know if you have further questions regarding this email.
Thank you,
Beth
Beth Beamish
University of Minnesota Medical Center, Fairview
Transplant Financial Case Manager
So in an effing nutshell....She is not going to transplant where the best doctors are...period.
We don't know when and we don't know where..what we know is that her counts keep falling and she needs a bone marrow transplant before something really serious happens!
Keep praying, please keep praying!!
I promise I will get back to the vacation, after all I will need the great memories to take me away from this hell of a night mare.
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