Playing the Insurance Game

I have talked to my health insurance company four times since yesterday to try to figure out this rechargeable battery issue. I have talked to the audiologist twice (once by email and once in person). First I was told the doctor's office would need to get this all precertified and check a website...this was after I PROVIDED the insurance code for the batteries! After several more phone calls, and being transferred over to the pharmacy department when one of the customer service reps didn't listen very well, I think I know what to do. The audiologist will write a letter of medical necessity  for Elijah to get the batteries. I will fax it to the claims department of the health insurance company. I will then receive a letter stating if the batteries are covered. If they are covered, then I will order the batteries and file a claim...keeping the letter of approval from them in a VERY SAFE PLACE! I have played this game before and had to wait six months to get $600 back from the insurance company, but it is worth it in the end.

Elijah has $300 left before reaching his deductible, but if he goes to the pulmonologist before I order them (he goes on July 14th) then that will put another $200 towards his deductible. His pulmonologist is considered out of network, but we didn't want to switch doctors. My "insurance year" starts on September 1st, so I want to get this all done and ordered before that date! Hopefully, I will get around $400-$500 to go towards the $800 total for four rechargeable batteries!

Visit to the Audiologist

Elijah went in to see the audiologist today for his yearly "check up" If he is not having issues, we go in once a year to just his map and see how things are going. Elijah did well and participated in the mapping session. He has not always been cooperative in the past. However, I did have to promise a "treat" on the way home (edible treat) in order to get him to cooperate. It does drive me a little crazy that I have to bribe a 16 year old.

Even with a bribe in the past, he has been known to complain and still not participate so it was nice to NOT have that happen today. The audiologist showed him his map and played a tone three times and asked him if it was too quiet, too loud or just right. He answered for each one and some of his answers were that it was TOO loud or TOO soft or NOT right, so he was trying. This is really huge for him. He did this for both the comfort level and threshold level for EACH ear. The comfort level is the loudest sound he can hear without it being TOO loud. The threshold level is the quietest sound he can hear, but not so quiet he can't hear it.

$160 for THIS battery rack

While we were there the audiologist checked his processor on his right ear, because it would not connect to the computer. There was some "residue" on the connector part of his processor piece. She cleaned it and got it working. When we put the battery cage back on it, we could not get it to turn back on. After some trouble shooting we determined that the battery cage was defective for some reason. She gave us one to borrow and I came home to order a new one ($160 OUCH). I will mail the other one back to her when our new one comes in. You can see the picture of it on the right.....this is just the rack, I have the cover that goes over it already...OUCH again.

The audiologist also told me that it is better to use rechargeable batteries, because when the air circulates through the disposable battery rack cage (not sure of the official name) it can cause issues with moisture and the processors. This may be why she had to clean the connector piece on his processor. For those who don't know what I am talking about the processor is actually two pieces. The top part is the processor and is the "computer" part of his "ear". The bottom part holds the batteries. These two pieces can be twisted apart, so you have two pieces. When we use the rechargeable batteries, that battery twists onto the processor.

Nucleus 6 processor
 

I called our insurance company and got some information on how to determine if they are covered. The gentleman in customer service was actually very nice and LISTENED. He finally understood what I was talking about and I provided him with an insurance code. They are considered durable medical equipment (DME) and he gave me the info for the doctor's office to get me a letter or assistance with pre-certification. We also have to meet a deductible, but he is actually CLOSE on his personal deductible. This is not my first rodeo, so I will see what I can do. I do prefer the rechargeable batteries to the disposable ones!

Making the Switch to Disposable Batteries

Elijah upgraded to the Nucleus 6 processor back in June 2014. Since that time, he has used the rechargeable batteries that came with his processors. I really like the rechargeable batteries because they last all day and we never have to worry about switching out batteries during the day. He has four batteries and we would switch them out every other day. About a month ago, one of the rechargeable batteries would not take a charge anymore when I put it in the charger. I had already been doing some research and had decided that I would switch him to disposable batteries. Purchasing two rechargeable batteries would cost about $400 and I would have to fight the insurance company to get reimbursed for that. The two rechargeable batteries would last about one year (four batteries lasted about 2 years).

I can purchase 60 batteries on Amazon for $18.25. This would mean I would need on average about 4 boxes of batteries each year for each processor, costing me $146...approximately. The disposable batteries last about 3 days for each processor. This is a lot cheaper than $400 a year. Now, when Elijah swims he has to use the rechargeable batteries if we use the waterproof coil and sleeve to put around the processor. I want to save the rechargeable batteries that are still functioning to use with swimming.

Now, we have used rechargeable batteries in the past, so I made sure to have a few packages of batteries in my purse. However, when we go into the recreation center or the library I usually don't take my purse in. So, there we are in the rec center today when one of the processor's batteries dies. Elijah had to go without hearing in one ear for about an hour. He survived and so did I. As soon as we got home, I made sure to put a package of batteries in my key ring holder!

A Parent's Wish

I wanted to share this website from Cochlear Americas. It is a website for parents of children with hearing loss. The parents can get more information about cochlear implants. Here is the website:

IWantToHear.com

I am a strong supporter of parents having the right to choose what communication method they want their child to use. We chose to sign and speech with our son and to have him get a cochlear implant at the age of 17 months. He received his second implant at the age of 4 1/2. I believe that signs were a bridge to him learning language and learning to speak.

I believe that LANGUAGE is the key for all children but especially for deaf children. Whatever a parent chooses for their child, they also have to follow that child's lead. Parents have to realize that it will be WORK, but it can be fun. It will be HARD, but it will be REWARDING. Elijah chose to be oral after we worked a LONG time for him to learn to speak. He dropped expressively signing, I didn't make him stop. He can still understand what I sign to him when his processors are off. We can't have an in depth conversation, but we can communicate!

Whatever choice a parent makes...sign or speech or both, it should be remembered that this is about the CHILD and not about what is RIGHT. There is no right, there is what is needed.

I could ramble on for days, I know, but I will get off of my soap box. ALL parents need to read more with their children (hearing or deaf), spend time with them, have conversations and be their first teachers!

Sxi Weeks Later

It has been six weeks since the hail storm and we are just NOW getting our roof fixed. They started two days ago on Saturday and I mean they JUST started. The removed the old shingles and planks from the back side of the house. They have replaced the planks and laid down some other roofing materials that goes under the shingles. They don't work on Sunday (don't blame them) and it rained today, so no work today. It is supposed to rain ALL week. This is ONE reason why it has taken so long for them to get to our roof. The holes in the back were the worst and at least there is new planking now.

The contractor stated that he wants to get everyone's roofs fixed and then start working on the inside. I am not sure where that leaves us as far as when they will start with the inside of our house, but I am hoping it is before the summer ends!

Jacob is busy looking for a job. He has had three interviews in three weeks and applied to a LOT of positions. One of the jobs looks promising, but he doesn't want to get his hopes up too high. Elijah and I will be finished with school next week. We are both so ready. My honey will still be working all summer and I plan on continuing to mystery shop. I will also be supervising repairs! We may have to move out for a few days while they replace the ceiling. We don't have any major plans this summer and I am glad of that!

Keep your fingers crossed we have a new roof by this weekend....it really depends on the rain! Also say some prayers for Jacob, he really wants one of the jobs he interviewed for!

THE STORM

We had a hail storm here in town this past Monday, April 11, 2016. It was even on the national news. Elijah and I were home alone when it started. OH MY, was it loud. Water started coming in by the back door and when I went to get towels, there was water in the master bath. The water was coming in through the AC vents. There was water coming in from three ceiling fans. It was WILD. The hails stones were huge.

My honey arrived home right after it started. Thankfully my car was in the garage and she wasn't home so neither of our cars were damaged. We cleaned up some of the water, and then went to look up in the attic. There were HOLES in the roof, I mean HOLES. You could see the sky. While we were doing that the ceiling in the kitchen FELL. It landed on the dinner table and on the floor. It was a mess. We spent three hours cleaning that up. We had just signed a contract with a construction company to fix the roof the Saturday before. The roof had been damaged from a hail storm, a much smaller storm, but still damaged. I called them and they came out to take a quick look. The rain had stopped and he promised to come out the next day to tarp it. I stayed home from work on Tuesday and took care of some things. We had not gone to bed until around midnight because more of the kitchen ceiling had fallen later in the evening.

The adjuster came out today and cut us a check. I have to get the bank to endorse it since they are the lien holders on the house. Once we do that, the company can begin fixing things. We are getting all of the ceilings replaced....for the entire house, two new ceiling fans, a new roof, new planking for under the shingles, new duct work for the AC, staining the fence and a lot of other things done. I had to buy a new mattress for Jacob because his had gotten wet when water leaked from his fan and it was a lot water. Now we just have to wait until it can all get started. I have added some pictures to show the damage!

Transition

I  went up to the high school today here in town to meet with Elijah, two of his teachers and a DARS (Department of Rehabilitative Services) representative. I had asked for the DARS rep to come to Elijah's ARD but she had something come up last minute and could not attend. One of the teachers we met with is the transition teacher at the high school and the other teacher is his case manager. Elijah will be graduating in just over three years and his unique needs require us to start planning now.

Overall, it was a good meeting. Elijah was not too interested in participating. He had been pulled out of his computer class and he really wanted to get back. He did state that he wants to possibly work on disassembling computers for their parts or maybe working with animals. After he left, we all sat around and discussed what Elijah is capable of. His teachers and I agree that he is smart enough to go to college, but his writing skills are not where they need to be for college. At this point (now remember we still have three more years) we aren't sure about a technical school either. We did agree that when he is doing something he likes that he does a good job. He also needs a schedule and likes to stick to it. He doesn't handle change well.

The nice thing is the DARS representative works exclusively with deaf and hard of hearing students. She can work with the school for Elijah to find a job his senior year and provide a job coach to assist him at work. When he becomes frustrated or flustered he may melt down or cry. The plan is for him to take a transition type of class his junior year. He would learn about resumes, job interviews, and do some volunteer work through the class (working in the school or working at the local animal shelter) and then his senior year he would have a job. He would be able to leave school early and go to the job. The school would even provide transportation to work and then I would pick him up.

I wanted he representative from DARS to meet him now so she would have an idea of what he might need. She can then be on the look out for possible jobs for him after graduation. She will attend his ARD (IEP meeting) next January and help in making his plan for his junior year. I am hoping that Elijah will mature in the next three years and that his social/personal skills improve. I am glad we met today and I feel like we are at least heading in the right direction. The DARS representative stated that he  had employable skills. Now we just have to continue down this road and see where it takes us!