The Elecare Jr. Saga

Waaaaay back in February, we trialed KayTar on Elecare Jr. and it made a big difference for our little lady! On Februrary 27th, I asked her pediatrician to write a prescription change from Pediasure, KayTar' previous formula. Remember that date, FEBRUARY 27th!

My last update on the blog about her formula was on March 17th. At that point it had been 2.5 weeks and the HHC still did not have correct paperwork from the pediatrician's office. KayTar had been surviving on samples provided by the GI clinic up to that point. I think in all, they gave her 12 cans of formula. An Internet acquaintance then shipped us a case of 6 cans at no cost, just to help us out. I'm sooo thankful for that gift! I don't know what we would have done without it. It took forever for the pediatrician's office to get the script corrected, at one point it was written for 6 cans a day, which would have been 11,256 calories PER DAY! I think they were under the impression that it was RTF formula like her Pediasure had been, not cans of powder. We got that ironed out and the CORRECT prescription was finally sent on the 19th and the HHC (home health company) sent it to insurance for authorization that day. Throughout this process, I was talking to the HHC every 1-2 days. Oh, and during this time the HHC sent me a sample can to help float us...and it was INFANT Elecare, so they wanted it back and shipped us a new can. The poor Fed-Ex guy brought me the new can and said, "Are you sure you want this? Because I've been doing a lot of dropping off and picking up of the same boxes here." Haha! You know there is a problem when the Fed-Ex guy notices something isn't quite right.

I gave insurance a few days to authorize and send back before calling the HHC again, but when I did, they said that insurance hadn't sent authorization yet. So then I continued to call. I learned their names and voices and I'm pretty sure they learned mine. They continued to tell me that insurance had not sent anything back to them and I started to get pretty anxious, because the kids' insurance plan changes as of April 1st and then we have to do this all over again. I really need ONE shipment before that happens, because this process has taken a month! The HHC re-faxed the forms on the 23rd, but continued to tell me they had not received anything back, so I called insurance directly. The rep told me that they had faxed approval on the 19TH! The day it was originally sent! What?!? I had been waiting over a week for something that had already been sent?! So, the rep gave me the authorization code and I called the HHC back. She pulled up KayTar's file and still could not find any authorization. I gave her the authorization code and THEN she found it in the system, not attached to KayTar's main file. Oopsie! But, there was a problem (who is surprised??). The letter said that it was authorized for 6 months, from "3/19/12-3/19/12" A simple typo!! That second 3 should have been a 9. That is all. We had been waiting a week and a half for something that would have taken seconds to correct if I had been notified of it one of the 10 times I had called to check on her file since then! Maddening. I found all of this out on Thursday, which was getting PRETTY close to the insurance change deadline, so I called insurance and told them the issue and they said the HHC had to call directly, so I had one of my new BFFs at the HHC call insurance to request corrected paperwork. Then my HHC BFF called me back (all on her own!) to tell me that insurance had assured her it would be faxed within the hour and she even got the rep's name for me. I called back in the afternoon to check on the status and one of my other HHC BFFs told me that it had been received and the shipment was scheduled to go out on Friday. On Friday morning, I called and another of my HHC BFFs told me that the shipment had already left the warehouse!! I got so excited that it made her laugh! It was a beautiful moment!

It was a comedy of errors, getting this script filled...everyone involved made mistakes.
1. Pediatrician took forever to send it out, incorrectly.
2. HHC guy gave me incorrect info about how the pediatrician should fill out the form.
3. Pediatrician took forever to get it out CORRECTLY.
4. Insurance authorization made an error on the letter.
5. The erroneous authorization form was not attached to KayTar's file and nobody told me about the error.

Soooo, that is why it has taken from FEBRUARY 27th to MARCH 31st to get this glorious shipment of formula! Here's hoping that it takes less than a month to do it all again. Clock starts again on Monday!

Food, Glorious Food! :)

Happy Belly.

KayTar has been on Elecare Jr. for roughly two and a half weeks now and it has been EXCELLENT! She has vomited once, but it was due to respiratory junk, not GI issues. She has had no tummy pain, no complaints to being too full, nothing! In less than 3 weeks, she has gotten back up to full volume feeds (8 ounces) and she is *almost* back up to full rate!! It has been over six months since she's been able to tolerate this! She is also eating a lot more by mouth, which is wonderful. We didn't realize how poorly she was doing on Pediasure until we switched.

However, getting her prescription changed has been a NIGHTMARE. After the first few days on it, I talked to her pediatrician about getting it changed, but there have been multiple delays on both ends. The main issue is that the clinic is on the HHC's (home health company) Do Not Call/Do Not Fax list...so even if the HHC finds errors in the paperwork, they don't contact the pediatrician. Basically, if I don't call and find out the error and communicate it to the doctor, it doesn't get communicated. All paperwork has to be delivered/picked up by hand, so even if the doctor does what I ask...it can still take a few days before the HHC picks it up and processes it. At this point, we are over 2 weeks out and it has not even made it to insurance for authorization. AGH!

The GI clinic has been floating us with samples, but it has been TWO WEEKS. Two weeks is more than enough time for a script change, honestly. The nurse I spoke to this morning didn't know if they would be able to give us anymore samples, so we were in limbo all day waiting to hear back...meanwhile, we're on the tail end of our very last can. Boo. She is doing SO incredibly well on it, I would really, really hate to change anything. Unfortunately you can't just pick specialized formulas up at the store! I have Pediasure, but she was doing so poorly on it that I don't want to put her through that again. I was thinking that we might need to switch to Alimentum temporarily while we wait for the prescription change, but I got a call from the HHC this afternoon saying they would ship us ONE more can. Then I got an online message from someone who is willing to ship us 6 cans, no charge, just shipping (6 cans cost roughly $130!). Then I got a call from the GI nurse saying that the doctor gave the okay to give us 6 more sample cans we can pick up tomorrow. So that is 14 days worth of formula, I HOPE that 2 more weeks is enough time for the HHC and pediatrician to work out the prescription change. It is pretty miraculous we've been able to keep her on it this long without the paperwork in place, but I am incredibly thankful that it has all worked out so far!