Regarding Dr. Asshole

This is the letter I wrote to appeal the insurance co denial for Chucky Cheese to go to Boston Children's Hospital.

DISCLAIMER: Names have been changed for privacy issues.

To Whom It May Concern:

Subject: Appeal

I am writing this letter in response to your recent decision to deny approval for my son, Chucky Cheese, to receive medical care at Boston Children’s Hospital. I am appealing the decision that I was verbally informed of on May 29 of 2012 around 5 pm. I feel that you should know a little more about my son if you are going to make life-altering decisions regarding his medical care.

C.C is a wonderful six-year-old boy who struggles with the everyday battles of autism. He has achieved so much in a short amount of time and I admire that about him. He was non-verbal till he was almost 4 and completely disconnected from the world. He now speaks and interacts with others. He learned how to ride his bike last summer and was so proud. It is hard to imagine what he used to be like if you did not know him then.

Within the 2011-2012 school year, he has encountered many difficult challenges. What started as small physical challenges has regressed into a much more involved case. A case, that has many specialists and doctors confused. He has now lost a large amount of skills including, riding his bike, sitting unassisted, physically keeping up with his peers, and toileting.  He has three adaptive chairs that he uses in school and one at home. My son was completely toilet trained, yet within the last six months he has been having incontinence issues in school and at home. He is not even able to stay dry at night. As a parent; this is heart breaking to watch. Chucky has also been battling severe constipation recently. He is now taking Mirolax once a day and about once a week he still requires a suppository to maintain bowel movements. His leg is bowing and he is losing mobility.

If all of the above issues were just isolated issues, I would not be requesting to go to Boston. However, these are all new issues and they have progressed very rapidly. We have traveled to many doctors without receiving any definitive results. My son is traumatized with all of the travel and testing. I really feel it would be more effective to have all of the specialists dealing with him in one facility, where they can communicate and coincide the appointments making it easier for them as well as my child. I want someone to look beyond his autism and help to figure out what is causing his recent losses. As any other parent, I want the best treatment available for my son.

I was very discouraged by the manner in which the determining physician, Dr. Asshole, dealt with this case. I remained in contact with Sally, the review nurse, throughout the process. She was very helpful and amazing. The physician was notified of the time sensitivity involved in his decision due to the date of the appointment. Sally was notified of the denial the evening before the scheduled appointment. Not only did this inconvenience my transportation, and me but also it did not leave enough time to cancel the appointment. It wasted a slot in Boston’s schedule that could have been used for another child struggling with medical needs.

Two months prior to the discussed appointment, I called Fidelis asking for help in locating a good children’s hospital. I was informed to call around and ask different hospitals. Yet, when Dr. Asshole denied this claim, he was able to call around and find a facility he felt was sufficiently qualified to manage my son’s care. While I do appreciate that, it is now taking longer to get my son care and Cohen’s cannot coordinate his appointments the way Boston could.

I am willing to give Cohen’s Hospital a chance, mainly because my son needs to be seen, my ultimate hospital preference was and remains Boston Children’s Hospital. I am basing this on their reputable position as one of the top 10 hospitals in the country and their services available. I also feel that the staff went above and beyond to schedule things with the understanding that we have to travel.

I am enclosing with this letter some records from his school which shows his regression and their areas of major concern. I encourage you to review them along with his medical records and consider my request. Ask yourself what you would want if this was your child. Would you keep pushing forward and want the best care?

Sincerely,

A Bitchy Mamma Bear