2 days out from the phone call from the pedi notifying us that the insurance company is denying the last round of Synagis, I'm feeling more comfortable with the situation. We did get the packet stating the reason for the denial, and honestly I can understand both sides of the pancake so to speak: I get why they're denying April's dose. The season is winding down, and there aren't indications that it will be unusually long. Plus she already had 5 doses this season, and that's the normal average of injections. But I also know that there are enough people out there testing positive that Judith's pedi is concerned and thinks she should have 1 last dose this season.
Last I knew, her pulmonologist was working on the doctor to doctor review. I haven't heard either way what's going to happen. We were supposed to go in this morning for the shot, but I called yesterday afternoon and made the decision with the nurse that we would cancel the appointment and reschedule if necessary.
Do I still think it sucks that she's not getting April's dose? Absolutely. Is it something to get super stressed over? Probably not. I've been talking with John, and we're formulating plans to put in place to help protect her until the season really winds down. We'll just have to be a little more proactive, a little more careful. It won't last forever. And if anything, it'll be good practice for next year since she more than likely won't qualify for the injections because of her age.
Here's hoping that she doesn't manage to pick up RSV in the next few weeks...
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