Upcoming surgery & helpful advice

We really don’t talk about it. Those difficult days back in September of 2010 when we had to turn over our newly adopted baby to a well-intentioned but unknown staffer of Children’s Healthcare. The desperate look back and outstretched arms. The tears and confusion. The pain that followed. We don’t talk about it because it hurt deeper than we could ever imagined.

This Wednesday, we have to do it again. Tracy asked that I be the one to hand over Meili this time – the pain is just to great for her. I agreed to it like someone volunteering to take the punishment for another. We both have begun the zombie walk of a loving parent forced to make difficult choices for their children that they know result in unimaginable pain.

So we just don’t talk about it.

What I cannot say enough about – and gives this over emotional parent hope – is the resilience of children. Meili has taught me so much as I have watched this little girl defy the odds. She lived through her own abandonment at birth in the dead of winter. She lived through 16 months in a Chinese orphanage – her frail body showing the scars of her struggle both internally and externally. And she continues to participate in our family like an unassuming guest not wanting to upset the rhythm of our home. Yet in her is a fire that cannot be extinguished – only marveled at for its ability to glow no matter how strong the winds of life are blowing in her face.

What an amazing person!

Before I close out this post, I did want to give you some insight and a few things I have learned that we did not know last time. Most special-needs adopting parents face additional challenges in the realm of healthcare with costs that could potential dwarf the expenses related to the adoption. Fortunately, we have fairly good health insurance coverage to help but even that has become so expensive that we have had to raise our deductive over the years to keep coverage going. However, just like everything else, insurance coverage has loop-holes and somehow Children’s Healthcare swamped us with bills. We were so unprepared for the financial assault on top of the emotional assault of Meili’s surgery.

For all those parents out there like us, the following are a few bits of insight that you may or may not already know as you move into difficult choices for your special-needs children:

First, you can shop around for the best price on the procedure you are having done. I am sure many parents are like us and only want the best for their children but sometimes the best choice for your family means being conservative in your choice of doctor/surgeon. To that end, there are several websites out there that make this process much easier! So here is what I did for Meili:

  • Called the Doctors office to get the specific procedure they were recommending for Meili. They gave me the exact names but I was hopelessly weak in spelling these awfully long names. So they offered the medical/insurance codes – which is much easier to deal with. In Meili’s case they were the following: 42235, 42225, 42215. Furthermore, the helpful assistant told me exactly what they would be invoicing our insurance for each procedure.
  • I then went to the following site to figure out what those codes meant: https://ocm.ama-assn.org/OCM/CPTRelativeValueSearch.do?submitbutton=accept¬† . This site was amazingly helpful because not only did it show me what the procedure was, it told me how much the government through medicare was reimbursing doctors for said procedure. Below is a list of each code for Meili, their medicare reimbursement total and what our doctor will be invoicing our insurance for the same procedure:
    - 42235 = Repair of anterior palate, including vomer flap ($767.33 / $1,923.00)
    - 42225 = Palatoplasty for cleft palate; attachment pharyngeal flap ($931.51 / $4,054.00)
    - 42215 = Palatoplasty for cleft palate; major revision ($961.81 / $3,860.00)
  • After getting the exact procedure names, I went to another great website: http://www.healthcarebluebook.com/ where you can look up on the private/commercial market what each of these procedures are going for. All I searched was the first listed procedure and got the following information: Physician services = $1,783.00, Hospital Services = $4,305.00, Anesthesia Services = $722.00 for a grand total of $6,809.00
    Now of course, your mileage may vary! In our case, the doctor is “in-network” and “on-contract” which means the insurance will never pay the almost $10,000 he is asking for but if he wasn’t, we would at least be able to negotiate with the doctor’s office knowing the full range of pricing available for the procedure on the open market.

Secondly, don’t hesitate to negotiate! You have to balance the healthcare needs with the financial health of your family – pressing the doctor or hospital to give you a better deal doesn’t mean you love your family any less! :) Here are some tips to follow if you are like us and have just chosen to go with a well-recommended doctor and ignored the price component:

  • Ask if there is a cash discount. Credit card companies take around 3% of every charge on their cards for processing fees. On a $10,000 procedure, that is a hefty $300. Many doctors offices and hospitals know this and have begun to recognize that offering a cash discount will get them paid right away and save them money.
  • Again, negotiate with your service provider. As all these bills pile up, your hospital and doctor’s office know they only hope to recover a percentage of the total bills from their patients. That is why pricing has gone sky high – they are asking for $10 hoping to get $5. Of course, you are honest person and wish to pay for the services rendered in their entirety but what are these services worth? Have the courage to haggle a little bit. If you give the hospital the option of getting their full invoice paid today by cash for a discount versus paying it off over the next year by check, one month at a time – 9 times out of 10 they will take the sure deal. Here is a great resource for learning how to haggle with your doctor or hospital: http://www.healthcarebluebook.com/page_ContactDoctor.aspx
  • Don’t give them your credit card when registering at the hospital! This will greatly reduce your negotiating power if they know they have access to your account at any time. Pay with cash or check and keep them honest.
  • Be careful what you sign. The biggest advantage to your service provider getting around the pricing controls instituted by your insurance coverage are in the form of a pile of waivers given to you upon registration at the hospital. If you are not careful, you could end up giving your doctor or hospital permission to provide services not covered by your insurance at will. Try to slow down, and take your time reviewing documentation.

Lastly, just remember that the hospitals and doctors are providing you a service. It is a highly skilled and important service but it is a SERVICE. Don’t hesitate to recognize that you are ultimately in control and responsible for making the best decisions on behalf of your child. Study up and be prepared to understand what is going on. Our first child, Corbin, was the only child born at a hospital. Shortly after birth, they wanted to stick a huge needle in his arm to take blood for testing of a venereal disease – a common practice back then (not sure if they do it now). I knew they were going to to do this because I had researched it. Knowing Tracy and I were most certainly disease free and this test could and should be administered on the mother, I told them NO! Tracy offered her arm because you are not going to stick that needle in my hours old Corbin! They said OK and walked away.

You have the power and should wield it with knowledge, courage and wisdom.

I snapped the picture at the top of this post a couple nights ago while checking on our kids before Tracy and I slide our tired bodies into bed. We do this every night because it is inexplicably touching to see these beautiful children resting softly in a cocoon of safety that we work so hard to provide. Meili has always had the most peaceful sleepy face. Clothed in her princess night gown holding her princess doll, she is drowning in fluff every night! :) However, this Wednesday we will have to do what no parent ever wants to do for the second and quite likely, not the last time. For a couple days next week, this peaceful face will be altered by confusion, hurt and sadness. She will once again not understand why we are doing this to her and wonder when it will all be over. Her faint voice will be silent again for a little while in the hopes that we are giving her a stronger voice for the rest of her life.

So, if you happen to think of us Wednesday please send goodness and healing our way. Tracy will be staying at the hospital both nights with Meili and carrying the heaviest emotional load so keep her in your thoughts. We will do our best to keep everyone updated throughout the experience. Thanks again for your heartfelt support and being a part of our amazing journey.