Ughhh! Trying to get kids echoed

[Chrisandgary]

What a nightmare. After taking 3 months to convince our pediatrician (with help from other pediatrician in the office) he finally gave me referrals and scripts to have them done. I made the appts. I had my first of four kiddies echoed on Tuesday. Today I get a call from the secretary of my pediatricians office that the hospital (where the echo was done) is in a panic that they wont be paid from the insurance company because there is not enough information on the scripts. She told me to get my husbands cardio to write a letter that it is necessary for the kids to have this test. So now I had to cancel the two that were supposed to go tomorrow and the last one next week. I am so frustrated. The scripts said " echocardiogram to rule out BAVD " and "father just had heart surgery" So now I guess I have to print out all of the documentation that they should have this and send to the cardio so hopefully he will write the letter? any other suggestions?? Could you guys pass along the links again as to the studies showing this is genetic and children should be tested? Thank you!!
Christine

 

[PJmomrunner]

Hi Chris:

Sorry you're getting the run-around. This might help:

http://valvereplacement.com/forums/showthread.php?t=11603

 

[Lynlw]

Did you call the insuarnace company to find out if they would be coverred? Lyn

 

[Karen]

Christine, did you talk to your insurance company about them covering the echocardiograms on the kids before they were scheduled? When I called my insurance company, I was told that it was enough that the cardiologist wanted to rule out their having bicuspid valves, even with no symptoms. But I wonder what paperwork is required beyond that. But I would have thought that the pediatrician's office would have gotten pre-approval for the procedures before they were scheduled, or at least told you that there were other hoops to jump through.

I got a phone call from my 29-year-old son from New York today. His new internist has echos done on new patients as a matter of routine. My son was happy to report to me that his valves look great. But his internist also strongly recommended that ALL of my kids be screened for this. We just need to get all the doctors and the insurance providers on the same page. We are still waiting to test the other siblings until they are out of school and insured adequately... provided there are no symptoms or red flags otherwise, of course.

Good luck... I hope it gets worked out very soon.

Karen

 

[Marguerite53]

Karen. That is amazing!! I hope that if he begins to find anything, any patterns, or that he is saving young athletes, or any usable statistics, that he can convey them to doctors everywhere!!

Christine. That is a hassle. Relax, though. Here's what I do. I take a deep breath and put on my authority, executive voice (this is what I learned from my husband!!). Very calm. Call the hospital and say that there seems to have been a misunderstanding and you are concerned that very necessary tests are being delayed on your children. Could you please speak to a supervisor (important to get the supervisor at once unless you really like repeating yourself) so that the matter can be straightened out. He or she will then explain to you what they see as the problem. In a very lighthearted way, you should assure them that the script was authentic and you are very puzzled as to why there is any delay. You can ask them for specific wording that they deem necessary to make the process go smoothly. There are usually all kinds of numbers and wording and you should write everythign down. Don't forget to ask with whom you are speaking. Always ask for a name, no matter who you are speaking to. It really makes them own up to everything honestly since they know you are documenting all that you hear. Set it up as a win-win conversation....you will get more help that way. If they insist that you call the insurance, then do so and find out what they require exactly, get a name of whom you are talking to. Then, with your list, if there is any hassle down the road, you can go back and say, hey. This is what you told me to do. I did it. You're paying!

Hang in there!! Good luck!! Let us know how the first echo went.

Breathe!! Marguerite

 

[aussigal]

I am sorry they are giving you the run-around...how annoying...


I was lucky and just asked and then reminded my doc I had asked for a referral for the kids echoes and :"voila" with 2 weeks the whole 3 had been done at minimal-cost to us.


I have 2 out of 3 BAV sons the middle-boy has trace/slight mitral regurg.

I have read there is about a 75% heritability of this and its more like 4:1 in favour of boys suffering it but girls pass it on easier...

So far my mother and sister have tested clear...now I am on a mission to get my sisters' 4 kids tested , she has 3 sons and a lil gal.


I didnt have to show any statistics to get our scans ordered . In Australia you can ask your GP/PCP for these tests. Its the same as booking a blood-test! or X-ray.


Instead of making the echo for "ruling out BAVD",,,
mine had "mother HAS BAVD and anuerysm" on it!...maybe its the wording ??

keep us posted...it will be interesting to add up all the BAV children we have produced...I may even do a lil pie chart up and a poll...wasnt Arlys doing something along these lines?