Insurance won’t pay for Gavin’s testing



We have another issue that I haven’t spoke about yet but as the day is drawing closer, I should bring you up to speed.

When Gavin saw his pediatric neurologist st the Cleveland Clinic last month, it was decided that he needed three additional appointments.

The first appointment was with the Cole Eye Institute because the doctor suspects that the lens in each eye has become detached. It apparently requires a special exam and wouldn’t otherwise be detected. This would explain the visual problems he’s been experiencing.

The second appointment was an EEG. Gavin hasn’t had a witnessed seizure in a long time but he is epileptic. The doctor wants to make sure everything is okay.



The third and arguably most important appointment is supposed to take place in two days.

On Friday, Gavin is supposed to undergo six or eight hours worth of NeuroPsych testing. He had this done many years ago but because of how much he’s declining, we need to establish a new baseline.

Unfortunately, insurance has decided that it’s no longer covered and so we’re left waiting to find out what’s going on.



If it’s a go, we have to be in Cleveland before 8 AM and that requires the boys to spend the night at my parents house, so they can get the boys to and from school.

I’ve been texting back and forth with Gavin’s insurance case manager. She’s working very hard to get this pushed through but it’s not easy.

The case manager and the doctor at the Cleveland Clinic are both fighting to make this test happen.

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It’s just one more thing that I have to worry about. I need to stay on top of this because it can’t fall through the cracks and this testing will help us to know how to better help Gavin.

Sharing things like this help to put our lives into better context.

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Pony
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Pony

Why was it denied? Did they give an explanation? What do you have to do on your end to try and get it pushed to approved status?

Suzanne
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Suzanne

Probably a good idea to find all the paperwork possible and make sure that it gets seen to. If not take action against them because it’s obvious that Gavin is going through a nasty, life threatening health concern. Best of luck with the testing.