Fighting Goliath

In February, I took my Kindergartener (who was then four) to the emergency room. I had watched him go to bed a happy, healthy boy – and then wake up ghostly pale, complaining of a terrible headache, and running a fever of 103 Fahrenheit. He was so sick and wouldn’t eat anything. Although I was really worried, I also knew that if he just had a cold there was nothing my pediatrician could do for him. I waited, and watched him, to see if he improved. Finally, that evening, he stood up from our couch and collapsed. I was sure he had meningitis. My pediatrician had stopped taking sick patients by that time. The urgent care that I knew about was now an abandoned building. I was left with only one place to go – the emergency room. Little did I know that by choosing to take him there, I would start fighting Goliath.

We had medical insurance. I paid my copay at the hospital happily. I was more than glad to pay $100 to find out that I was wrong. My son didn’t have meningitis, but a virus that mimics some of the scarier symptoms of that disease. I felt so incredibly blessed by God to know my son was going to be safe and healthy. I know there are parents who don’t get that type of good news, and my heart breaks for them.

A month or so later, I got a letter from the hospital and emergency room doctor. My insurance company was denying the claim because the hospital and emergency room doctor wouldn’t give the insurance company the emergency room doctor’s notes. I know I had signed all the HIPPA paperwork to release that information to my insurance company. But, I went to the hospital and signed them all again.

A few more months go by and I get a letter from the insurance company telling me that they are denying my claims again. The situation, they said, was not an emergency; and while my son needed medical attention, I should have taken him to an urgent care. I was nearly hysterical. I filed an appeal explaining what had happened and why I went to the emergency room. I called a friend (who happens to be a lawyer) and he said that many times insurance companies do this to cut their costs, but that my appeal would most likely be granted. So there really wasn’t much to worry about. I took courage from his words, and went on with life.

Just before we moved to our new town I received another letter from my insurance company. The letter said the company was denying the appeal.  We would be responsible for the entire cost of the visit because my son, while needing medical attention, was not in a life or death situation and so should have gone to an urgent care.

I was despondent. We aren’t a wealthy family and the bill for the emergency room was much more than we could absorb in our budget. I felt guilty. I had made a choice, and erred on the side of caution regarding my son’s life, and now our insurance company was letting us down. My choice was costing my family thousands of dollars.  I wanted to give up. I was, honestly, tired of fighting and felt like the foe I was fighting was too large and powerful for me to overcome. I felt really alone. It was during this time that I gained a lot of strength from an unusual source; a music video cover by Alex Boye of Kate Perry’s “Roar.”

After thinking for a little while, I decided that I couldn’t give up and had to try one more time. After talking again with my friend, the lawyer, I contacted the Governor’s Office for Consumer Health Assistance.  I filled out the paper work, told them my story, and was assigned an advocate. My advocate contacted the insurance company on my behalf and arranged for a Grievance Hearing.

I prepared for the meeting. I wrote out my verbal statement. I had my sister help me edit it. Then I had my friend, the lawyer, help me edit it. I spent a lot of time praying to God for strength and that the Grievance Committee member’s hearts would be softened, that they would understand why I did what I did, and find in my favor. I had done all I could and had to lay the fight at God’s feet.

The Sunday before the hearing, I fasted and prayed to God for His help – for a miracle. The chances of the Grievance Committee finding in my favor were very slim. I had no other evidence to offer – nothing to add that would strengthen my position. I only had the same things to say that I’d been saying for eight months. I was indeed dependent on God’s mercy and power to overcome on this crusade.

The week of the hearing started. I was told in a letter that I would be receiving a phone call to describe how the hearing would work and what to expect. I waited with the phone in my pocket. I didn’t receive a call Monday. By Tuesday, mid-day, I was a nervous wreck. I thought I hadn’t done something, so the insurance company thought I didn’t want to go through with the hearing. I called the insurance company and spoke with a customer representative. I was told to wait until Wednesday and call then, if I hadn’t received a phone call.

I didn’t receive the phone call. So, I called on Wednesday. I told the customer representative that I wanted the people in charge of the grievance committee to know that I was anxiously waiting for their phone call. Anxiously is putting it gently – I think my stomach was in my throat for most of the week. I called my friend to talk through the anxiety I was feeling, when my call waiting beeped.

It was the insurance company. They were calling to say — wait for it –

That after further review of the situation, they were going to reverse the denial. They were going to pay the claims according to our benefit schedule.

My miracle had happened. My God had granted my petition and blessed our family. And while I know He doesn’t always say yes to my requests, He always answers and always in a way that is best for me and my family.

While I had kept fighting, it was God who overcame this Goliath in my life. Just like David in the Bible, God will fight our battles – but we have to have the faith to keep fighting.

So, to all of you out there fighting your own Goliaths – keep fighting, keep praying, and have faith. God is mindful of your situation. He will help you. It may not be resolved how you want it to be, but it will be resolved in a way that is best.