I know I haven't blogged pretty much the entire summer, so I will try to do some catch up. It is so hard to keep track of everything going on, but I really do want to document a few things and funny sayings from Chianna. Pictures will be coming soon. (I hope!)
We are so proud of our "big" girl! She started kindergarten on Monday and only had one melt down on Tuesday, but all the other days have been fine. Monday and Tuesday I was able to walk her into class, on Monday Myke came too and we got to meet her teacher and see her classroom. On Wednesday, I could only walk her in up to the front gate and then they have teachers and safety patrols to escort her to her class. I think she has to do it by herself starting next week! We will see how that goes - her class is not too far away though and there are no twists and turns.
For me, that means back to the car line, waiting to pick her up for 30 mins every day and fighting lots of traffic inside the school to get in and get out. Arghhh . . . . not fun!
We have also started back up therapies again! I am happy to report that we have been accepted to the state insurance program - which is much less money than HMOs and is designed to cover her therapies and other special needs! It's such a relief that I don't have to go through the stress, anger and lies of companies like Aetna ever again!
So here is the great little goodie bag and note that Chianna's kindergarten teacher sent home:
Soon you will be starting Kindergarten. It is an exciting time and maybe a little scary - even for the teacher! I put together this "Kindergarten First Day Kit" to help you get ready for the big day. Take a few minutes to have mom or dad tell you about the special meaning of the items in the bag and tell them how you feel about starting kindergarten. I am looking forward to getting to know you. We have lots to learn and do together. See you on the first day!
Kindergarten First Day Kit:
Starburst: You will be a shining star in school if you smile and always do your best.
Penny: To remind you that you are a valuable member of our class.
Sticker: We will always STICK together and help one another.
Smarties: You are going to learn SO much in Kindergarten this year!
Eraser: Remember, it's okay to make mistakes. That is how we learn.
Hershey Hug: We all need hugs now and then. If you need one, let me know.
Lifesaver: I am here to help you. Don't be afraid to come to me if you need something.
This kit was simple, but really means a lot to us!
It's gonna' be a great year!
Thursday, August 26, 2010
Sunday, May 23, 2010
Shortly after my last posts, I heard back from Aetna and they have told me that they have evaluated my case and have decided to credit me in the cases where we had 2 therapies in one day to make the co-pays even amounts!
I am thrilled for this decision and still waiting to hear about my credits.
Tuesday, April 27, 2010
If you are here reading about my insurance problems with Aetna health insurance, here is a timeline of blog posts in chronological order:
Feb 15, 2010 http://bit.ly/Aetna_Sucks
Feb 17, 2010 http://bit.ly/aetna_insurance_reform
Feb 18, 2010 http://bit.ly/aetna_insurance_problems
Feb 24, 2010 http://bit.ly/aetna_headache
March 5, 2010 http://bit.ly/aetna_driving_me_crazy
March 8, 2010 http://bit.ly/aetna_insurance_hell
March 10, 2010 http://bit.ly/aetna_problems
March 19, 2010 http://bit.ly/Aetna_does_not_care
March 21, 2010 http://bit.ly/Aetna_crap
April 26, 2010 http://bit.ly/Aetna_hell
April 27, 2010 http://bit.ly/boycott_aetna
THINKING OF SIGNING UP WITH AETNA HEALTH INSURANCE? SEE HOW POORLY THEY TREAT THEIR "INSURED" CLIENTS
AND MY SAGA & FIGHT WITH AETNA CONTINUES. . .. .
THIS POST IS IN ALL CAPS BECAUSE I AM SCREAMING MAD AT AETNA HEALTH INSURANCE.
I JUST RECEIVED A "RESPONSE" TO MY LAST EMAIL ASKING AETNA FOR A DETAILING OF MY CO-PAYS AND WHERE IN POLICY IT STATES WHAT MY CO-PAYS ARE.
I RECEIVED NONE OF THIS DOCUMENTATION FROM THEM AFTER ASKING FOR IT SEVERAL TIMES. ONE WOULD THINK THAT THIS IS SIMPLE INFORMATION THAT THEY WOULD HAVE ON FILE.
INSTEAD I RECEIVE NOTHING BUT "LIP SERVICE" AND AGGRAVATION!
EVIDENTLY SINCE THEY SAY THAT THEY INCORRECTLY COVERED THE CLAIMS IN THE FIRST PLACE, THEY ARE EVIDENTLY NOT GOING TO GIVE ME ANY OF THIS INFORMATION. THEY ARE NOW TELLING ME THAT ANY CREDITS WERE ALSO ISSUED IN ERROR?????!!!!!!
AND THAT ANY OF THE OTHER CLAIMS ARE NOT SUBJECT TO ANY CREDITS!!!!????
THEN THEY WROTE SOME INCOHERENT MUMBO JUMBO ABOUT THE CLAIMS THAT WERE BILLED DIFFERENTLY ON THE SAME DAY OR ON TWO DAYS. I DON'T EVEN KNOW WHAT IT MEANS: SOMETHING ABOUT THAT TWO COPAYS APPLY PER DAY WHEN BILLED BY DIFFERENT PROVIDERS USING THE GROUP'S TAX ID #.
WHILE SPEAKING TO MY ADP REPRESENTATIVE YESTERDAY, WHEN I EXPLAINED TO HER THE PROBLEMS I WAS HAVING TRYING TO DECIPHER THE COPAYS AND THE BILLS, SHE SAID IT SOUNDS LIKE YOU NEED A MATH DEGREE. I REPLIED, THAT I THINK YOU NEED MAGICAL POWERS IN ORDER TO TRY TO UNDERSTAND THE CONFUSION THAT AETNA HAS SET FORTH.
I AM VERY GLAD THAT I ALREADY COMPLAINED TO THE STATE INSURANCE COMMISSION ABOUT MY CASE.
I AM WRITING MY POLITICIANS AGAIN, WITH FOLLOW UP NOTICES AND CONTACTING LOCAL AND NATIONAL MEDIA.
I WOULD APPRECIATE YOU HELPING ME TELL MY STORY. UNFORTUNATELY, I AM NOT ALONE, I AM JUST NOT QUIET. THERE ARE THOUSANDS OF OTHER FAMILIES THAT INSURANCE COMPANIES LIKE AETNA DO THIS TO AND THEY EITHER DON'T NOTICE OR DON'T HAVE THE WILL TO PUT UP WITH THE FRUSTRATIONS.
Monday, April 26, 2010
I have really been learning to pinch the pennies lately, and discovered some really great deals at our local Winn Dixie. So, I wanted to start a new weekly post on my blog where I share my deals of the week with you!
This Week's Winn Dixie Deals:
Red Seedless Grapes: $1.99/ bag
Russet Potatoes: $1.99/5lb bag!!!! (super good deal!)
Check colas on sale for $2.50/12 pack (Not at good as the $2/12 pack they were last week though, but still a good deal for us Dr. Chek junkies!)
Package of 8 breaded white meat chicken patties: $3.50 (These are super yummy for buffalo chicken sandwiches, chicken with country gravy and mashed potatoes, and Myke's chicken Parmesan with pasta!)
Capri Sun box of 10: $2/each
Fresh Ground Beef: $1.99/lb
These specials are good through Tuesday, April 27th. But don't worry, on Wednesday, they'll have some more great deals! You can sign up to receive a weekly email of the specials and see all the current ones at WinnDixie.com.
Also, they often run a special on fruits and veggies that are "one the way out" but can be a really great deal if you use them the same day or quickly. This week, I got 10 huge bananas for $1.33. That is approximately the price 4 or 5 bananas would have cost at the regular per pound price. Three of them were partially bruised, but I still got way more than the regular per pound price out of it. They have this banana deal almost all the time and I get it very often since I usually eat a banana with breakfast every day and Chianna has about 1 or 2 per day too.
In the past, I have picked up a mish mash package of peppers, squash & zucchini for less than 50 cents, and just chop them up and use them with dinner the same night!
I hope that I can pass my good deal finds on to you and help my friends stretch a buck!
Well I've had a lot going on to keep us busy lately, so I didn't have a chance to update on what's happening with my Aetna Insurance problems, but seem to be suffering from a lack of help since I have been quiet for over a month now.
In my last post on March 21, 2010, I was ranting about how I received a collection notice from a doctor bill that should have been covered because I had met the out of pocket maximum for 2009; in addition to several other ongoing issues that I was not getting answers about.
I expected to have an immediate response due to the urgency of the matter and because of how upset and distressed I was with the gravity of the issue. By the end of the day on the 21st, I called the doctor's office that I received the collection letter from and, to my surprise, she told me that Aetna had called her about 30 minutes before to let them know that they were going to be covering that claim and that it was not my fault that the payment was delayed. I was very relieved to hear this, but still upset that Aetna did not contact me to let me know they were working on it, not to mention upset that it had gone so far in the first place anyhow!
Aetna did reply to my email on March 23rd saying that he needed to talk to me about these issues. I didn't get a call, but got an email on March 24th stating that Aetna was going to cover our occupational therapy that we had to date, but that in reviewing my plan, since it says that they don't cover chronic diseases, that they made a mistake in the first place and should not have covered any therapy at all, and would not cover the remainder of the 60 consecutive days that was originally told to me because of this review.
I didn't event know what to think about this! I'm very happy that the occupational therapy is being covered, however am I supposed to think they are doing me a favor? It appears that every time they look at my plan, they come up with a different definition of what is supposed to be covered or not covered. It's proof that no one at Aetna knows what is going on or what they cover. It's proof that they word their policies so ambiguously and verbosely that no average person can read and understand them. If you have a medical degree AND a law degree, then still, good luck in understanding an insurance policy!
I wrote them back and asked [again] for a detailing of the co-pays for therapy because the credits did not make sense and I still don't know what the co-pay amounts were or what they are supposed to be.
On March 31, 2010, I received another email update from Aetna and they let me know that the doctors that I was past due with were being paid and that I have indeed met the out of pocket maximum for 2009!
But I still have no idea what the co-pays were and why they are not consistent!
I didn't hear anything for over a week, so on April 11th I wrote asking the following:
Checking in on the co-pay amounts for therapy from August 2009 - October 2009. I would like to have an accounting of what the co-pays were for each visit and why they were different co-pays for some of the days that we had two visits, but not all the days that we had two visits. While I am thrilled to have a credit, I am wondering why the amounts are not consistent and why I was not told about it sooner so that I could have adjusted the schedule at the time and made sure that we would have had the visits on the same days.
(To re-cap: Aetna originally told me that there is a $50 co-pay per 30 minute therapy session. Then in October 2009, they updated to say that the therapy co-pays were $37.07 for physical therapy, $43.03 for speech therapy and $44.70 for aqua therapy. I was issued a credit from the therapy place. Now they are telling me that on the days that we had two therapies in one day, the co-pay was much less, however I have no detailing of what the amounts are. The amounts are inconsistent and I have credits for some of the days we had 2 therapies in one day and not others, and the credits that I was issued are not the same amounts! I was never told about this until I probed and probed!)
So, on April 15th I received a reply to that request, which did not include any of what I asked for. He basically told me that Aetna's co-pay rate is based on the procedure code, each code has an assigned rate and that I am responsible for the remainder that is not covered. WHAT!!!??? He also said that the co-pay issue was not addressed before because some of the claims were processed after????
OK, NONE of that makes sense to me, nor does it answer my question or solve my problem! And to even further add to my confusion, the same diagnosis and procedure codes were used for each therapy claim.
Then, as if to add insult to injury, he says I can dispute claims and gave me a fax number to send in a dispute to. HELLOOO!!!??? I wouldn't even know what to dispute, because Aetna is not sending me the information I need. And furthermore, when I log into Aetna.com to download the claims, they are not updated, so I cannot get an accounting of anything!
On April 18th, I received a return email from Aetna with an excel file, that was supposed to detail all the claims I asked for. At first, I was all excited, thinking that I finally have a detailing and some answers! WRONG!!! The excel file was very confusing! (Just like everything else Aetna does!) Each claim was listed in the file twice and then was listed three more times with a $0 amount next to it. I began to try to edit it and make heads or tails of it, and after 30 minutes of staring at this file, I hadn't gotten anywhere, so I decided not to waste any more time on it, going cross eyed trying to figure out their voodoo accounting of my claims. Instead, I composed my own excel file of all the dates we had therapy, the type of therapy and the co-pay amount I paid. Then I color coded the credits we were given and the same situations that were not credited and sent it back to Aetna. I sent this back on April 21st. I asked for someone to actually LOOK at the file and answer my questions as to why the credits were not consistent. I also [again] asked for the documentation of where in my policy is says what the co-pay amount is.
This evening (April 25th) I received a return email that is completely incoherent! Two sentences! Is that even a response? Aetna wrote me back to say that when service is provided by 2 providers under one name there should be 2 co-pays, and that in this case a co-pay should be applied to speech therapy and a co-pay should be applied to physical therapy.
WHAT? That doesn't answer my questions, solve my problem or make any sense whatsoever! I keep mentioned that if the claim is not submitted consistently from the therapy place, that to let me know so that I can have them fix it, since she had the same therapies and as far as the therapy place has told me, they are all billed exactly the same way.
I am really hoping that something gets cleared up soon, this is completely ridiculous!
If you are reading this for the first time, this is only a piece of the puzzle and the drama that we have been put through. You can see details on this whole insurance debacle with Aetna on my blog:http://bit.ly/Chianna and if you would like to help, feel free to link to the blog and share my story with anyone and everyone who will listen. I am not just doing this for me and my family, I am doing this for all the families who have been wronged by Aetna and other insurance companies who make it their policy to deny claims in hopes you will not notice, make it hard enough to fix problems that they hope you will give up, and state incorrect things over the phone just to get you to shut up and hang up and then they do not stand behind what was said.
Wednesday, March 31, 2010
Thanks to our awesome Fed Ex representative at work who gave us 3 tickets to see Disney on Ice! Myke wasn't feeling well, but that meant that Dee Dee was able to come with Chianna and I. We made it a "Princess Night Out"!
We got to see the show from the Fed Ex suite and eat hot dogs and drink sodas! WooHooo!!!
We got to see some of Chianna's favorites: Mickey & Minnie, Cars, Little Mermaid, The Lion King and Tinkerbelle!
Here are some pics. . . .
Sunday, March 21, 2010
I have lived in South Florida all my life and for some reason, had never visited Flamingo Gardens before. I am so glad we were invited to our friend's birthday party there and finally got a chance to experience this beautiful park and commune with Florida's nature, practically in our back yard.
We went on a tram tour of the park and here are the photos:
So serene and beautiful on this lake - I loved it here!
Look closely, there is a bird in the tree!
The nubs sticking up are actually roots of the tree!
This peacock accompanied us on our tram tour.
Here are some great photos I took of Chianna while on the tram tour:
Next we saw the wild life show and learned alot about Flamingo Gardens and wild life. Flamingo Gardens is an animal sanctuary, home to injured and rehabilitated animals that are unable to survive on their on in the wild.
First we met an opossum. This one happens to be blind, but still is able to get around really well. We learned that opossums are not rodents and also are not very smart animals because their brains are so small. They are famous for "playing dead" which is actually a reaction they have when they get so scared, they actually lose consciousness! Opossums are scavenge feeders and eat fruits and vegetables.
Next he asked if we knew what the fastest animal on the planet is. And I thought what most other people yelled out: Cheetah. Well, we were all wrong! The fastest animal on the planet is the falcon! It has speeds clocked up to 70 MPH!
We also got to see a box turtle and baby alligator up close.
Next we went onto the aviary where we got to see lots of birds and also some turtles!
We walked through the park to see all the animals, most of which are free to roam the grounds. The alligators, snapping turtles and Florida Panthers are safely enclosed though!
And our last stop was feeding the flamingos! These beautiful birds really amazed me with how gentle they are. We were able to feed them right out of our hands. Chianna was so brave, as soon as she got the hang of it, she really loved feeding them.
After seeing the whole park, we went back to the party area, where they have picnic tables and we ate dinner and had birthday cake! Happy Birthday to sweet Mae Li! What a great time we had! I can't wait to go back to Flamingo Gardens again soon!
The Birthday Girl!
My girl in blue, very festive with her drink umbrella in her hair!
Flamingo Gardens is a very beautiful place and now that I have seen it, I am sure I will go back again and again.
Here are some videos I took: