The Mudcat Café TM
Thread #146917   Message #3459163
Posted By: wysiwyg
30-Dec-12 - 12:07 PM
Thread Name: Chord Req: Chaplet of Divine Mercy (WYS surgery)
Subject: RE: Chord Req: Chaplet of Divine Mercy (WYS surgery)
SRS, wow!

She has had an attorney taking care of this stuff. Hang in there, don't let those companies off the hook.

This is exactly what Ashley does, under the umbrella of our very supportive diocesan health insurance plan. Our denom funds insurance thru a compassionate group of companies which are headed and often staffed by clergy. In managed care, PT (for example) is, industry-wide, "evidence based." Our insurance is purchased thru a "compassion-based" system, which includes checks and balances that come into play when one is SO "under water" on health expenses that were fairly incurred that one needs access to additional resources. In our case one of these resources is Ashley.

ANY member of our insurance group has access to the Health Advocate network of experienced expediters. We were additionally blessed to be assigned to a senior member of the expediting group who can do all this-- without violating a Christian preference not to bring suit the way so much of our culture is prone to do.

Going to court is a last, last, LAST recourse, for us-- and only after all other means have had time to play out in honest mediation.

It is a very different way to do business. For example, the PT person at the Home, when she heard about the notion of "compassion-based" services, had a real hard time even seeing that there is another way out there, which is working well for many people. Her "evidence-based" assessments of my progress, for example, will help me make a case to a donor organization that compassionately assists when medical expenses go beyond the red zone-- while the PT's Medicare-mindset led her to think that "no" (i.e. insurance will not cover more PT) really meant "never" (i.e. no other funds are even out there). That org may be able to help when I get past HHS PT and onto outpatient PT-- our insurance covers some of the cost, but significant co-pays would preclude my doing outpatient PT at all without some help.

Again, it is a very different way to do business. We do our part by being wise stewards of our income, and that includes significant participation in annual parochial pledge and capital programs... as well as personal volunteer service and financial assistance to people in the community; it all usually comes out OK, over time.

~Susan