UHC Approves Care for Short While
We know firsthand what this family is going through. It happened to us last summer when we were literally being told every Thursday of a decision to send Ryan home. For us, the most frustrating was were left in limbo to decided about renewing a lease. This life they are living is all too familiar to us.
Joseph and his mother
It’s a travesty (and awfully cold-hearted) for this family that every two weeks it becomes another battle in an endless war. Yet, they did score a small reprieve. Thank you Team Diviney for helping them.Following is the email from Jane Martellino (Yes! Grace Rocks):
Email: jmartellino@——-.net
Ken,
I do not expect you to post all of this. I just wanted you to get the update since you were so kind to rally your troops together. Since my young friend Grace suffered trauma to her brain from the brain tumor, I have been passionate about helping others and raising awareness of the fight these patients and families endure. Thank you and your team for lending their voice.
Jane
Here is Joseph’s mom’s update:
“I’ve explained it in previous posts in greater detail but the bottom line is Joseph meets the criteria for in-patient rehab UHC just doesn’t want to pay for it. It would be much cheaper for them to only pay for outpatient therapy but it isn’t even comparable to the quality of therapy he’s getting at TIRR let alone how impossible it would be in managing Joseph as a totally dependent patient in an out-patient environment. The Medical Director said that they were concerned that Joseph’s “FIM” (Functional Independence Measure) score was the same as it had been since his admission. Dr. Tastard explained to him that you can’t use that measure on brain injured patients as they are not going to progress like other patients in a rehab hospital who have a spinal cord injury, hip replacement or other injury. Joseph is a long way from showing independence for goodness sake. His entire brain was severely injured!
TBI injuries take time to rehabilitate!!! Dr. Tastard told the Medical Director from UHC that all Joseph’s therapists had been providing very detailed documentation of his progress instead of the standard “check a box” system in order to give UHC a thorough report on his progress since the FIM is not an appropriate scale for TBI patients. In the end the Medical Director’s comment was “well, let’s speak again on May 18th meaning Joseph’s been approved until then. Dr. Tastard thanked Rob and I for staying the course not just for Joseph’s sake but for all TBI survivors because too many are kicked to the curb without family able to go to bat (or should I saw WAR?) for them.”
Thanks to a great “Team Diviney” for helping Joseph and his family get another 2 weeks….So sad what UHC and a lot of other Insurance companies do to people that need help badly….Inhuman is a good word to describe it:(:(
What is to become of our world if people are viewed as nothing more than a dollar sign?
This story is played out on a daily basis in every hospital in the United States. Anyone I know who has been in the hospital with a loved one who suffered trauma, goes through it. It is all about the money. Early on, someone, whose daughter is a TBI, told me that taking care of our loved one “is a business.” In other words, not a business to make money, but constantly having to deal/fight/negotiate with companies, government, doctors, etc. to get your loved one what they need. Unfortunately, it takes time away from the person that needs attention. It is also draining, depressing, infuriating, annoying, and other verbs I can’t think of right now.
p.s. and don’t forget, it’s Tuesday, and you know what that means!! Lunch/dinner at Ruby’s and $$ for our boy!!!
It is shameful. So this is what it has come to — a person has to fight like hell every time a loved one needs care and is cruelly denied it. I feel great sorrow for those who do not have the energy, will or ability to take a fight like this on. If you’re reading this, and you’ve never experienced what it’s like to be told, “there’s nothing more we can do, you have to take your Dad/Mom/son/daughter/grandmother/grandfather/friend home, then you can understand the utter fear, confusion and panic that goes to your very soul. Don’t think it will never happen to you; with the way insurance practices are going, it most assuredly will. Now is an opportunity to “pay it forward.” Go ahead, step up to the plate for this family. You can do it, it’s easy!! A group of teens I know is already on it. It will take but a moment of your time to write/email/call and simply say you cannot believe an insurance company would treat a human being so deplorably. If you have the desire, go ahead and take it to the next level, and the next — and keep going until you feel you’ve done your part. That’s how positive change happens, and that’s how you make a real difference in the life of another person. Thanking everyone in advance who decides to be a voice for this family today. Love & prayers, Paula
I agree and will go so far as to say that this type of treatment is inhumane. Unfortunately, for many hospitals, it’s all about “rotating beds,” i.e. maintaining a steady flow of relatively healthy patients that can be treated cheaply and sent home quickly. After all, more money is made this way. This basically means that the gravely ill have to fend for themselves not only with hospitals who don’t want to provide many insured individuals long-term care because the institution only makes a fraction of the profit by keeping them, but also with the insurance companies who don’t want to offer coverage once the accrued medical expenses are deemed “too costly.” It would help if more hospitals created long-term care units, but, from what I’ve read on the internet, such facilities began shutting down en masse during the 80s. Again, this whole situation, and others like it, is extremely disturbing because it seems to reiterate that health care companies value money over the human lives that they’re supposed to care for.