Wednesday, February 23, 2011

February 23, 2011: insurance threat again

Jim and I were having a nice visit. Then, at 4 PM, Nishani, the social worker at Sharpview, came into the room to tell us that Aetna has decided to send Jim home next week. She actually seemed happy about it. She's supposed to be on the side of the patient, not the insurance company. She said that Kevin from PT said that he couldn't do any more for Jim.

I immediately went down and asked Kevin. He said that he said that he could not meet Aetna's timetable. I guess Aetna thinks that Jim should be up and walking around after 4 more weeks of therapy.

I left a message with the case worker for Aetna, Laverne. Hopefully, she'll call me back tomorrow. I will have to start the appeal process.

Jim looked like he was going to cry. He was even ready for me to go home early. I am reacting very well. I'm not crying and having suicidal thoughts like last week. I sure am glad I found a doctor and she prescribed wellbutrin for me.

I don't know what we'll do if the appeal doesn't go through. I'll have to set an alarm for every 2 hours so I can turn Jim in bed. If the insurance company doesn't provide a lot of home health care, he will have to suffer when I'm at work. He's not strong enough yet to move himself in bed. His recovery will slow way down without the intensive physical and occupational therapy that he needs so badly.

I tried contacting Barbara Jackson at TIRR last week for help with the insurance company. She had told us that Jim would stay at Sharpview and then go back to TIRR. She acted like Aetna had agreed to this plan. I called her again today and left another message. Tomorrow it will be one month since Jim left TIRR. Barbara's obligation to help us ends tomorrow. If she continues to not return my calls, I'll have to go track her down at TIRR.

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