Thursday, July 14, 2011

Chronic Otitis Media and Speech vs Aetna

Once again, Aetna Insurance Company and I are about to enter the boxing ring.
WE went round for round two years ago and it sucked.
But I won.
And they knew that I won...they just wanted to play hardball with me.

No, no, no.

You picked the wrong Mama to play hardball with, Mr. Aetna.
Especially when our pediatrician writes a letter like this:





"...Andrew has suffered from chronic otitis media since October 2008. He had
bilateral PE tube placement performed in April 2009 and received speech and
language services through the State of Illinois Early Intervention Program. He
developed a dysfunctional tube in his right ear in February 2011 which lead to
recurrent ear infections through May 2011. Thus, he required a second surgery to
replace the right ear tube in May 2011. He is currently free of infection.
However, his speech and language skills are moderate-to-severely delayed and not
that of a typical developing child his age.
The first three years of life are considered critical to speech and language acquisition. Language acquisition requires a child to recognize speech sounds from the ongoing stream of speech in context, attach meaning to these sounds, and abstract the rules of language. Because children with recurrent otitis media or chronic otitis media externa experience fluctuating hearing loss, the concern is that they may be unable to organize and interpret speech sufficiently, leading to difficulties in speech development. A child with impaired hearing may not receive the entire acoustic signal and may lose important information. If partial hearing loss occurs repeatedly, the child experiences continuous changes in the database upon which good speech and language are built. It should also be noted that there is a strong family history of apraxia of speech within his immediate family as
evidenced in his older sibling, Kaitlyn (DOB 10-21-2003). It should be noted
that many speech and language disorders have a hereditary factor. While the
severity of the disorder varies, siblings often share similar speech traits.
That is why I feel that speech therapy is of utmost importance for this child..."



Yes, we are trying to get speech therapy covered for Andrew now.
This is something that I was hoping would work itself out on its own with PE tubes and some good old-fashioned home speech therapy.

Ain't happening.
So professional therapy with our great SLP is now the prize for this fight.

*DING!*
There's the bell!
And the fight is on!
May the best (Mama) win!








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2 comments:

  1. I'm fighting with stinky Aetna, too! Good luck mama, and may the force be with you!

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  2. Fighting insurance companies is just exhausting. You will win this one, but I'm sending you virtual strength and endurance for this one! Why do things always have to be so hard? Sigh...

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