Medical Mutual of Ohio

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Posted by Christy Ford (24.210.36.236) on May 28, 2003 at 17:25:35:

Yet another injustice for my daughter Abbee.

May 26, 2003

Polaris Benefit Administrators
Medical Mutual of Ohio
Appeals
Attn: Pam Y.
P. O. Box 2010
Westerville, Ohio 43086

To Whom It May Concern:

I am writing to formally appeal your decision to prevent my child from walking unassisted. If it were not for these injections, she would not be able to walk.

I quite frankly don’t care what the FDA has approved or not approved. I know it is working. I know it is working so well that she is beginning to walk independently. It is working so well that when she was sent to have serial casting, which most children would have weekly for a month or so, she only required one cast.

You have set your own precedent by paying for the injections twice since we have been on your insurance plan. Even in your own comments in correspondence to Pediatric Rehab at Cincinnati Children’s Hospital, your “qualification” for her getting the second round of injections that you did cover, was her progress from the first set of injections you covered.

Please do not take the ability to walk away from my baby. She is now 3 ½ and all children should be given the chance to walk. Now that you have allowed her to have a taste of that freedom, please do not take it away from her. Yes, you will be responsible in my eyes, for taking that away from her. Without these injections, there is too much tone in her legs and she is not able to walk at all. You wouldn’t cover a set of crutches for her or a wheelchair and then suddenly decide to take them away. Your halting these injections, again after allowing them twice, is the equivalent of doing so.

I wonder....if Mr. Klapp of Medical Mutual had a child like mine, who has had to fight for every breath she takes, every thing she has received in life, would he be so anxious to deny my child? I think not! As I understand it he has been blessed with five children. I would think that 1.6 billion dollars in revenue is more than enough for any one insurance company. I would think that denying my child, while making that kind of revenue, should be constituted as a crime.

Please advise as to what it is that I need to do next in the appeal process as I intend to appeal this all the way to the top.

I find it interesting that on the Medical Mutual website that one of the first things you read is “Keeping your fingers crossed doesn’t work”. However, by denying my child these injections you may as well be asking me to do just that, cross my fingers! It also states that they have 2,500 employees dedicated to meeting and exceeding the needs of their customers (Abbee) so they can enjoy the peace of mind that comes from having quality health care insurance that is affordable, convenient and easy to use. Where is her peace of mind? It states also that they will seek to work with health care practioners and facilities recognized for the quality of their medical services and clinical outcomes and to assure freedom of choice for the consumer (Abbee). Again, where is her freedom of choice? The choice to walk independently! It also states that in conjunction with the Cleveland Browns football team, Medical Mutual will be having a summer camp??? My daughter wouldn’t be able to attend that camp if we lived in Cleveland because if your wishes are granted as opposed to mine, she wouldn’t be able to walk.

I am asking you to reconsider your decision and allow my child to continue to walk.

Sincerely,

Christy Ford
114 Holder Road
Baltimore, Ohio 43105
740-862-5352

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Comments:
: Yet another injustice for my daughter Abbee. : May 26, 2003 : Polaris Benefit Administrators : Medical Mutual of Ohio : Appeals : Attn: Pam Y. : P. O. Box 2010 : Westerville, Ohio 43086 : To Whom It May Concern: : I am writing to formally appeal your decision to prevent my child from walking unassisted. If it were not for these injections, she would not be able to walk. : I quite frankly don’t care what the FDA has approved or not approved. I know it is working. I know it is working so well that she is beginning to walk independently. It is working so well that when she was sent to have serial casting, which most children would have weekly for a month or so, she only required one cast. : You have set your own precedent by paying for the injections twice since we have been on your insurance plan. Even in your own comments in correspondence to Pediatric Rehab at Cincinnati Children’s Hospital, your “qualification” for her getting the second round of injections that you did cover, was her progress from the first set of injections you covered. : Please do not take the ability to walk away from my baby. She is now 3 ½ and all children should be given the chance to walk. Now that you have allowed her to have a taste of that freedom, please do not take it away from her. Yes, you will be responsible in my eyes, for taking that away from her. Without these injections, there is too much tone in her legs and she is not able to walk at all. You wouldn’t cover a set of crutches for her or a wheelchair and then suddenly decide to take them away. Your halting these injections, again after allowing them twice, is the equivalent of doing so. : I wonder....if Mr. Klapp of Medical Mutual had a child like mine, who has had to fight for every breath she takes, every thing she has received in life, would he be so anxious to deny my child? I think not! As I understand it he has been blessed with five children. I would think that 1.6 billion dollars in revenue is more than enough for any one insurance company. I would think that denying my child, while making that kind of revenue, should be constituted as a crime. : Please advise as to what it is that I need to do next in the appeal process as I intend to appeal this all the way to the top. : I find it interesting that on the Medical Mutual website that one of the first things you read is “Keeping your fingers crossed doesn’t work”. However, by denying my child these injections you may as well be asking me to do just that, cross my fingers! It also states that they have 2,500 employees dedicated to meeting and exceeding the needs of their customers (Abbee) so they can enjoy the peace of mind that comes from having quality health care insurance that is affordable, convenient and easy to use. Where is her peace of mind? It states also that they will seek to work with health care practioners and facilities recognized for the quality of their medical services and clinical outcomes and to assure freedom of choice for the consumer (Abbee). Again, where is her freedom of choice? The choice to walk independently! It also states that in conjunction with the Cleveland Browns football team, Medical Mutual will be having a summer camp??? My daughter wouldn’t be able to attend that camp if we lived in Cleveland because if your wishes are granted as opposed to mine, she wouldn’t be able to walk. : I am asking you to reconsider your decision and allow my child to continue to walk. : : Sincerely, : : Christy Ford : 114 Holder Road : Baltimore, Ohio 43105 : 740-862-5352

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