Wednesday, August 6, 2014

Updates {8/6/14}

So, you might have noticed that the blog is a little quiet lately. That's because I have had extreme morning (noon and night) sickness with this pregnancy. It never seems to let up at all. I've even woken up sick in the middle of the night. I don't really like to be a complainer, so I've been not really saying anything at all. That, plus the fact that by the time I get uninterrupted computer time after the kids go to bed, I'm too wiped out to want to blog.
I managed to rally up some energy a couple of days ago and took the little kids to the splash park. Our unusual stretch of actual Summer weather is still holding strong and I decided that cooling off a bit would be good for all of us. I, being me, planned our trip for the coolest day in weeks so far, but it was still warmer than typical for around here. Brenna refused to go near the water and instead cuddled on our blanket with a towel.
She had plenty of fun on the regular playground equipment though. We've been busy around here implementing our new chore routine and doing some extra pre-school year cleaning and organizing. I've gotten our curriculum choices decided and have started making purchases. It's so much fun to see my kids all excited about new school materials! They've had to play with several of them already.
I've been working on sewing some maternity clothes since it seems I gave everything away after Brenna's birth. I bought a particular pattern for maternity/nursing tops that I had high hopes for. I hate putting a lot of time and money into maternity clothes that are only going to be worn for a few months. Nursing clothes get worn a lot longer so I don't mind putting more into them, but I'm having a horrible time fitting it. I've finally decided it's a pattern flaw and not my fault, now I'm just trying to see how to fix it. What it means though is that after a week of working on it, I still don't have a finished object to show. I started some baby knitting too, but then it got hot and I haven't felt like knitting. So, I have a finished sweater missing buttons and ONE matching bootie. Yep, only one. So, no pictures there either.
I've also been spending an inordinate amount of time on the phone with our new insurance company trying to get Owen's prescriptions approved. See, they have a system. If a drug isn't on their "magic" list, the doctor has to fill out a bunch of extra paperwork explaining why Owen needs it. In our case with one of the disputed drugs, he has to have the brand name instead of the generic because the generic has too many carbohydrates to be acceptable on the ketogenic diet and the other is too new to have a generic version. Once the insurance company gets the paperwork from the doctor, they have to review it to see if we really need it. This review process takes up to 14 business days. That's 14 business days that Owen can't start on the medication his doctor wants him to have. Then there's an extra blip. If the Owen is already on the medication and the doctor changes his dose, we still have to fill out all the approval paperwork and wait the 14 business days, but they also won't approve payment if they've already filled a prescription for that same drug that month until the normal renewal time without the doctor calling the insurance company (I can't call, only the doctor can) and getting an override. So, it goes like this. We refill Owen's Onfi prescription on the 12th. The doctor looks at his EEG results on the 22nd and decided that we need to increase his prescription. The insurance company won't give us the increase until the 10th of the following month if we get all the approval paperwork filled out and they decide that he really needs the medication that he's already been on for almost 2 years. If he needs the increase sooner than that the doctor has to waste time on the phone and try to get an override to start the increase right away, but that's still subject to the 14 day approval process.  Make sense yet? Not to me either. So, I've spent several hours on the phone threatening the insurance company with a child endangerment suit and asking them if they'd prefer to have him admitted on an inpatient basis to get his medication while they, not our doctor decide if he really needs it.
After several phone calls, we now have a new plan. When our doctor decides Owen needs a new drug or an increase to an existing drug, I call the insurance company and they approve it immediately. I think that will work out much better for us.

1 comment:

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