insurance help

So before discharge, insurance appointed us with a liason through the mental health department of the CMO. This "appointment" has been a little off-putting and I can never tell if Ms. L is fishing for comments from me that are going to come back to haunt me in the end. It's like being interrogated by a defense lawyer. And her questions are all a little ... odd.

So today when she did her weekly call to see how things are going, I clued her in to the episode of this past weekend and my concerns that it will be at maximum, another 2 weeks before Sissy is back to full-on rage with suicidal and homicidal ideation. She asked me what I thought should be done about it. I told her exactly as I've always said, "I'm just a parent that wants to love a kid, not a trained professional. Sissy is not safe in the home without adequate intervention. She will continue to escalate and I don't know what is the best plan for her anymore. Her illness has progressed rapidly and has shown no signs of slowing down."

I think I say this comment, nearly verbatim, every single time she asks me.

But today was a smidgen different. Ms. L wanted to know what the IFI team was going to do. I told her that Ms. M filed an incident report and would be presenting her findings to "the big people" tonight at their weekly meeting so the Bigs could decide the next best plan for Sissy according to their protocol. I explained my frustration that the IFI team can only come 3 hours a week because Sissy is a CMO patient and not a Medicaid patient. I told Ms. L what IFI told me last week which is that medicaid kids get 10-12 hours a week. I added that if we had more adequate intervention for Sissy like 10-12 hours a week, then it might make her more stable in the home environment.

:)

I'm glad I told Ms. L this little extra (point of fact, I didn't know this information myself until last week, but whatevs.)

Ms. L asked me to call her tomorrow to inform her of the IFI team's decision at tonight's meeting and we concluded the call.

Twenty minutes later Ms. L is calling me back. My initial thought was crap. here it comes to bite me on the butt. I've said something out of turn and now I've screwed things up royally this time because honest, I wouldn't put OJ on the stand with Ms. L, she will get the truth out of him once and for all!

Instead, Ms. L says, "I did some research and I've learned that I can make a recommendation that Sissy's case be reviewed to bump her to federal medicaid."

OMG! WOW WOW WOW WOW WOW!!!!!!

"Ms. L!" I shouted, "If you were sitting here with me right now, I'd be kissing you!"

"Now Mom, keep in mind, this referral does not in anyway guarantee..."

I finished her sentence, "... the outcome I'm hoping for, I understand. But you just knocked on a door I couldn't knock on. It's a smidgen of hope I didn't have before and I'll take ANYTHING, even just a knocked-on door at this point!"

"Yes dear, OK then, just remember, this is just a referral and we'll have to wait and see what the review board decides. You may be hearing from them in the next few days."

:) :) :) :) :) :) :)

Let that review board call me. If I flew under Ms. L's radar, I can handle them!

PLEASE PRAY THAT WE GET SISSY ON MEDICAID! This will open up a host of other doors for her as far as treatment goes, in addition to maybe getting us to the golden door of SSDI. We can only hope.