ARGH. I have a long ventish post, and if anyone has any ideas on how to fix this I'm open to them!

Here's the thing...everyone knows our insurance has been a HUGE pain since Jayden was born, right? Well this is EXACTLY the issue. We have Health Net for our children. Jacob and Justin are on it and they see a Dr. B through Golden Empire Managed Care (the medical group - we'll call them GEMCare from here on out). So in September I called Dr. B's office and asked about Jayden seeing them, they said no problem, I registered at the hospital and specified Dr. B as her pediatrician. I had Jayden October 28th and Dr. B came and saw her. When we got home we found out that Dr. B's medical group - GEMCare no longer accepts new patients of Health Net as of October 1, 2007, the boys are fine, just not Jayden.

I called around the other two medical groups in town - Independence Medical Group and Bakersfield Family Medical Center - NONE of their pediatricians, probably 60 or so, are taking new patients right now. NONE. I CANNOT find her a ped. So we decided we'll appeal it and pay cash for Jayden to see the boys' pediatrician. So we've paid cash since then.

On Monday night Jayden got sick enough, I realized we hadn't even gotten her insurance card yet and so I called on Tuesday and found that they hadn't added her, they had all the information it just was "sitting there" so I made them manually add her to the policy right then and took her to Urgent Care. Then when I went to fill the prescriptions they didn't add her to the rx plan so her prescriptions weren't covered.

Wednesday I took Justin to Dr. B's office and the dr said that Jayden needed to be seen again, that she looked terrible and to take her to the Pedi Center. Later that evening (the Pedi Center doesn't open until 5:30 PM) she looked ok so I kept her home. During the day Wednesday though I called GEMCare and spoke to a few "managers" and "supervisors" (I think it was the person sitting next to the original person I spoke with but whatever...) and they swear that this isn't something THEY did, that Health Net won't place anyone in their medical group and to get them to do it because they'd be happy to take Jayden. So I called Health Net and they say it's GEMCare and I royally flipped out on the "supervisor" I got, he called around town and he couldn't find Jayden a pediatrician either. I told him to file whatever he could that I want her on GEMCare NOW with the boys and he got snippy with me but when I said I was going to involve the media he agreed to try - yeah whatever.

Anyhow tonight Jayden is grunting alot, having a hard time breathing and hasn't eaten almost all day, is so weak she's just sleeping. So I decide it's time to take her to te pedi center, so at 5:30 we went in. The doctor looked her over and said I'm going to give her a breathing treatment and send you to the hospital, she needs to be admitted. So a breathing treatment happens and they tell me to take her to a certain hospital and that a doctor will meet me there to admit her.

So, I get to the hospital and they are agreeing she needs to be admitted because her oxygen is at 86% when she's eating and she can't just not eat until she gets better. All of a sudden she throws up like 2 lbs of mucous. Her color slowly starts to come back as we wait for the chest xrays and RSV test to come back. So the pediatrician shows up and he's chatting with us while we wait and asking about our ped situation because he saw she's a Dr. B patient with Health Net and he can't get anymore patients right now because GEMCare and Health Net are frozen. I said yeah and explained all of the above, he got a worried look on his face and says "if I admit her to teh hospital as a GEMCare doctor I don't think that they'll cover it." I tell him REPEATEDLY that I don't want our insurance to be a factor in her treatment, it'll work out. And he leaves the room for a few minutes.

He comes back with a prescription for a nebulizer and the breathing treatments and says to me, "how about if she's RSV negative you take her home and give her breathing treatments and if she's RSV positive we'll figure out a way to admit her." I agreed, that seems reasonable, right? So he gives me the Rx's and leaves. She gets another breathing treatment and afterwards her oxygen is at 94% while nursing and not, either way she seems pretty good, better then before at least. So the test comes back - RSV POSITIVE, so I say, "then I guess we're staying?" to the nurse and she says "no he's discharged her either way." WHAT!!!!!!

Now, on one hand, the treatments are working, she's showing improvement and she doesn't need oxygen anymore when she's on them, on the other hand, she went south quickly, and most importantly, I HAVE FREAKING INSURANCE AND THEY SHOULD NOT BE A FACTOR IN HER CARE!!!! I truly feel as though if this insurance barrier didn't stand in the way she'd have been admitted, and I think on alot of levels she needs to be in the hospital. I can't fill the prescription tonight either, so it's going to be a long while until she gets another breathing treatment.

My baby BETTER be ok is all I have to say to that doctor and Health Net. And tomorrow, I'm going to gather all the names of everyone I've spoken to and the dates and I'm going to send an email to the local news, what else can I do? I've exhausted every phone number and address I've had.

Gosh, I hope she's ok tonight, I just don't know...

A post for another day will be, "where was Kevin while our daughter was being admitted to the hospital..." Grrrrr again.