Dear Insurance

So Aidan fell out of bed this weekend. We knew it would happen eventually because the rails on his bed are not appropriate for him. Actually, they’re a joke. I took Aidan to the Emergency Department mostly because I wanted documentation for the insurance company. He had a bloody mouth. He was miserable and in continual pain for the day.

This morning when he woke up, Aidan made it pretty clear that his foot was in a lot of pain so I took him back to the Emergency Department. More documentation. He’s going to be fine, though I suspect he won’t be walking well for a few days. We’ve requested a Sleep Safe bed.

Insurance has denied us once and is now considering our appeal. I’m sending them the following letter with our ED discharge papers. This bed, though very expensive, is cheaper than a head injury or continual trips to the ED. I don’t need them to care, but I’m sure they want to make a sound financial decision. This bed is it.

I don’t love writing negative truths about Aidan and I certainly have better things to do with my time then visit the ED and I really really don’t like waking in the middle of the night to reposition Aidan or knowing that we rigged up a piece of plywood to keep him safe for the time, but it’s all part of this parenting journey.

I sent in an appeal regarding a Sleep Safe bed for my son Aidan and I have new information. This bed is medically necessary because Aidan is at risk for falling out of bed. He lacks the motor control and muscle strength to maneuver safely away from the edge; he also lacks the cognitive comprehension to understand that being close to the edge of the bed is not safe; he also has seizures that result in strong uncontrolled movements involving his entire body which could easily propel him out of bed. 

Currently Aidan is sleeping in a hospital bed that is being covered as a rental by this insurance.  On the morning of June 9, 2013 Aidan fell out of bed. I took him to the Emergency Department. He had several cuts in his mouth. Aidan was discharged and spent the rest of the day at home. Because of the cuts in his mouth, he did not consume his regular caloric intake, which he cannot afford because he’s underweight. Aidan did not display his usual mild-mannered behaviors, and instead was indicating that he was in pain. Because he is non-verbal, it’s very difficult to determine exactly what’s wrong. He usually walks with assistance but that evening he cried when bearing weight. Aidan also woke up crying in the middle of the night after having a seizure, which is an unusual response for him

On the morning of June 10, 2013, Aidan was still distressed so I took him back to the Emergency Department. They took x-rays of his right foot. While they did not indicate any fractures or breaks, it seems that he probably sprained his ankle. It will take more time than expected to heal as Aidan’s seizures will continue to strain his injury.

This one fall out of bed resulted in minor injuries to Aidan but cost us two trips to the Emergency Department. Every night he sleeps in this bed, he is at risk for greater injury, including a head injury. Aidan is in danger while his injuries and this hospital bed are costing insurance money. The Sleep Safe bed has sides that, unlike hospital beds, are solid and will not only keep him in bed but will also not be an entrapment hazard for his skinny little body parts. Please take this information into consideration and understand that covering the Sleep Safe bed is the safest and most cost effective decision.

And just so you can see how cute he still is when he’s in pain…..

*******UPDATE 7/2/13 Insurance denied us again because “a bed can be used in the absence of medical conditions and is not considered Durable Medical Equipment.” Now we apply for an external review by an independent organization. It’s exhausting to be the squeaky wheel and may get us no where but onward we go.