Deep Sigh…..

Today, I am tired.  The kind of tired that you feel in your bones, in your soul.  It makes my body and mind exhausted.  I woke up this morning wishing it was time to go to bed.  I don’t like feeling that way.  

I realize I haven’t posted about my daughter and her struggles. I thought I had finally found a place to send her for treatment. I was in contact with an admission specialist. I asked all the questions I could think of regarding treatment, doctors, medication, social interactions, etc. We discussed cost, including insurance. I was ready to make the jump, take out a second mortgage to finally get my daughter the treatment. But, there was just this feeling I had. I read the emails from the admission specialist again and again. I reviewed my notes from conversations with the admissions specialist. Was this too good to be true? Or was I just being negative because so many things had fallen apart during this journey.

I can’t explain why I never thought of doing a general Google search of the facility to find if places like this were reviewed. WOW – was I in for a wake up call. Five deaths reported at the facility in five years along with horrible stories from patients that had attended programs at the facility. Now, I totally understand that there are people who will bitch and complain about anything and everything. I took these reviews with a grain of salt. No facility is going to please everyone and was the person writing the review open to treatment or did they fight it? But five deaths in five years???? The deaths really made me nervous. I did more digging, more reading, more digging, more reading…Someone posted a recommendation to search the facility name and the civil law suits against the facility. I did that and found the facility is and has been under investigation surrounding these deaths. It has been fined for not following proper protocol when dealing with suicidal patients. It has been fined for a number of violations. None of the fines can bring those people back. Law suits can’t bring those people back. And I will never know the true circumstances of the deaths. But how do I send my daughter there?

The facility admission specialist kept contacting me about the information she had provided (cost, insurance, etc). I sat down and reviewed the numbers again, with the new information I had from the reviews. I am going to copy the email from the facility, but remove names so I don’t end up in a law suit!

The email reads:

I got the insurance checked in regards to XXX. We are out of network and we would be looking to use the out of network benefits. Since we are out of network this means that we do not have a contract with XXX and we can bill them whatever we decide. Facility name has decided to bill insurance $2,700 a day. Now some insurance companies pay very close to this and those polices we can work with and then there are other insurance companies do not pay any of this, those polices we cannot work with at all. Then there are insurance companies that are right in the middle, where they pay maybe half of the $2,700 a day.

With this being said, your insurance falls right in the middle. The pay but not enough. So we are looking to collect $20,000 upon admission. This $20,000 will over the deductible and out of pocket for out of network and it will also help with the poor reimbursement that we have with this XXXX policy.

Let me know if the $20,000 is feasible and if it is not let me know what is!

After reviewing the numbers, I had questions. After reading the reviews, I had questions. My questions included how long the stay was for, would my daughter be in a hospital enviroment (as I had read in reviews) or actually be in a facility like the ones on the facility website? Here is my first response regarding the length of stay.

The response states: The $20,000 will cover however long insurance authorizes – The length of stay will vary depending on XXX’s individual needs and the authorization from the insurance company.  The authorization process requires review for medical necessity every 3-5 days.  We will do everything we can to advocate on XXX’s behalf and maximize her stay with us. That being said, there are no guarantees on length of stay, however Facility Name will guarantee a minimum length of stay of 14 nights regardless of insurance authorization, and will not request any additional funds for any nights authorized by insurance over the minimum guarantee.

So, I pay $20,000 upfront at admission, plus the facility will get about $1,300 for whatever time is deemed necessary and is authorized. Let’s be honest. We all know that the insurance will approve maybe a week. And that $20,000 gets my daughter 14 days of treatment. Seriously? What can be accomplished in 14 days? There is also a highlighted section on a financial document I was sent indicating after signing the document I agree to keep all financial terms and agreements made between Facility Name and myself completely private and confidential.

So, now what? I don’t know, I don’t know, I don’t know. I just know I’m tired.

Author: howdoilifeweb

Late 40's, wife, mom, daughter, sister, friend.

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