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[RJ749]

Not so good news this morning:

Good Morning,

I don't often get really mad and stirred up about things, but I am hopping mad right now! I need ALL of your prayers. I just got off the phone with Empire Blue Cross Blue Shield, and after filing the appeal for Josh's Bioness on Friday, the "independent" medical director turned it down...again. Claiming that he could do just as well, with a plastic AFO device that fits into his shoe and runs up his leg, like a brace! I am absolutely apalled at the lack of medical science this so called director possesses! Josh has tried an AFO, and it can't even begin to compare to the Bioness, which stimulates the nerves and muscles in his muscles to get his leg moving correctly, to step and also to strenghten his leg muscles...all at the same time. If you haven't taken the time to look at the you tube video's I have posted, take the time to look at them.

This medical director, is making decisions from reading articles from journals, not from taking the time and visiting clinical trials and settings, where thousands of spinal cord patients, ms patients and stroke patients are making huge strides in returning to their every day walking habits. He won't even speak to me, because he is a COWARD! He won't speak to me, because he doesn't want to hear how todays science is actually working, because he doesn't want his insurance company to have to pay for it! I am really, really upset! But, I betcha, if his son or daughter were in this position he'd be thinking differently, oh, but he's a doctor and he can afford to pay for it out of pocket...good for him! He could care less, the financial devastation that comes with spinal cord injuries.

I'm so sorry to be so animated, but I really need everyone to pray hard. I have filed my last appeal and hoping that as it reaches the next desk and medical director, his or her heart, eyes and ears would be opened to the incredible technology that is available, not only for our Josh, but thousands of others, like him...who continue to be denied coverage. Medicare is now covering this, but Josh does not qualify for Medicare. You would think, that since Medicare has gotten on board, that the other major health care coverage's would start to get on board as well.

We still have a hefty price tag remaining, to pay for this equipment, that is helping him so much. I will be calling Robin, our Voc. Rehab Rep. today. They have been so awesome to help Josh with so many items, he has needed to gain his independence back. They just might come through on this as well.

Thank you once again for your prayers for us and to God be the Glory! Karen

[Gettinold]

Karen & Barry
Please keep the faith that they will change their decision. Thank you for the up date Roger. 

                           Dave

[arcticdude]

Barry,

Good luck with BCBS.  They can really be screwy.  They sent me a letter dated Dec 26, 2008, that they decided that a procedure they paid for in 2005 should have been covered by the patient's other insurance.  I had 30 days to respond and/or send a check for the amount, otherwise they'd start deducting the amount paid from my future payments.  I called them the end of January- just thinking I could put them off another month- and was told that BCBS had written the amount off on Dec 28, 2008- just 2 days later!  The right hand has no clue what the left hand is doing.  You need to see about contacting this guy's supervisor.  He's not the end all.  Unfortunately, the situation is looking like it's going to get MUCH worse with our new potus.  He seems to be leaning towards a European medical system, which means people like Josh wouldn't even get the basic therapy, because his chances for recovery were slim.  The treatment would have gone to somebody else.  If we don't keep a good eye on the whole situation to prevent this turn in direction, our expected life expectancies will drop by 10 years almost instantly.  Our children will be even worse off.  Things like macular degeneration- the leading cause of blindness in the Western world's elderly- will be "treated" by allowing the first eye to go blind BEFORE treatment for the other is instituted!  The medical electronic records system that some of our government want to make required has the ability to PREVENT treatment by deeming it too costly or the patient not worthy.  You heard me right- the government will be telling YOUR doctor what treatments to use on you!


   getting off now, before my BP gets too high


Anyway, here's wishing you guys the best and hoping you can get things squared away.

[RJ749]

Here is a recent Today Show Interview with a young woman enjoying her life again, using the Bioness, while dealing with multiple sclerosis...amazing!


http://today.msnbc.msn.com/id/26184891/vp/28872531#28872531

I made many phone calls today, starting with the Reeve foundation and ending with Rob, Josh's new therapist. He is the most familiar with Josh's progress with the unit and I am hoping his input, along with the "peer to peer" review from Dr. Stevens, will do the trick. I have contacted some national media outlets and The Bioness Company as well, in my efforts to make this a household name. And wake the slumbering idiots, sitting behind their desks @ our insurance companies.

Have a good evening, Karen

[RJ749]

We all need to say a prayer for the Heine's and Josh's bioness equipment specifically.  Karen posted on the Caring Bridge site and they were denied again, the short version is the reviewer just gave up after 3 attempts to contact Josh's doctor and denied the appeal.

Here's a link to Karen's post which was too long to post here: http://www.caringbridge.org/visit/joshheine

[MIKEYTEE]

Tell Karen, still continuing prayers for Josh and that BCBS will cover.
Mike

[RJ749]

The well wishes and prayers have come through, this today from Karen on the update pages of Caring Bridge:

February 27, 2009

GOOD MORNING

You know, I am filled with such glorious anticipation today. Despite the continual insurance denials and literal "doors being slammed" in my face, I am DETERMINED to weather the storm, with this Bioness!

I have awesome news y'all! I called Josh's Voc. Rehab. Counselor yesterday to make sure she received all the documentation she needed, to fax to the corporate office in Lexington, to pursue the payout for Josh's unit, by Voc. Rehab. Not only did Robin say she received what she needed, but a decision had already been made....to pay for 1/2 the remaining balance on it!!!!! After thanking her for all of her advocating, I hung up and started weeping. A tremendous burden has been lifted!

God has filled all of our collective lives with beautiful people, including you all, who have loved us and seen us through such a firestorm. Now, we are not completely finished with this Bioness yet. The KY protection & advocacy group is putting together a lawsuit against our insurance company. I will continue fighting, until this technology is nationally recognized for the purpose it was intended for. So, other's like Josh can benefit it. No single person, sitting behind a desk, should have the power to deny, ANY individual the right to something that has PROVEN to help in their recovery!

We still have a balance of $2,200.00 We are praying and seeking God as to how we will meet this. We all are facing tough financial situations in our current economic climate and it is very hard for me to ask this...but if there is anyone out there, now reading this, who feels led, to help towards the final purchase of Josh's Bioness Unit, you contact me at my personal email address on the welcome page.

Psalm 37:7 "Surrender yourself to the Lord, and wait patiently for him."

Whatever the outcome, wherever the funds come from, we are trusting and have already WON the battle! Josh is alive and WALKING! Now, if that doesn't put a smile on your face, nothing will Amen!

Love You, Karen & Barry

[Gettinold]

The well wishes and prayers have come through, this today from Karen on the update pages of Caring Bridge:

February 27, 2009

GOOD MORNING

You know, I am filled with such glorious anticipation today. Despite the continual insurance denials and literal "doors being slammed" in my face, I am DETERMINED to weather the storm, with this Bioness!

I have awesome news y'all! I called Josh's Voc. Rehab. Counselor yesterday to make sure she received all the documentation she needed, to fax to the corporate office in Lexington, to pursue the payout for Josh's unit, by Voc. Rehab. Not only did Robin say she received what she needed, but a decision had already been made....to pay for 1/2 the remaining balance on it!!!!! After thanking her for all of her advocating, I hung up and started weeping. A tremendous burden has been lifted!

God has filled all of our collective lives with beautiful people, including you all, who have loved us and seen us through such a firestorm. Now, we are not completely finished with this Bioness yet. The KY protection & advocacy group is putting together a lawsuit against our insurance company. I will continue fighting, until this technology is nationally recognized for the purpose it was intended for. So, other's like Josh can benefit it. No single person, sitting behind a desk, should have the power to deny, ANY individual the right to something that has PROVEN to help in their recovery!

We still have a balance of $2,200.00 We are praying and seeking God as to how we will meet this. We all are facing tough financial situations in our current economic climate and it is very hard for me to ask this...but if there is anyone out there, now reading this, who feels led, to help towards the final purchase of Josh's Bioness Unit, you contact me at my personal email address on the welcome page.

Psalm 37:7 "Surrender yourself to the Lord, and wait patiently for him."

Whatever the outcome, wherever the funds come from, we are trusting and have already WON the battle! Josh is alive and WALKING! Now, if that doesn't put a smile on your face, nothing will Amen!

Love You, Karen & Barry

Absolutely fantastic and I'm 

[SilverDawg]

Any updates on Josh?  I have been away for a while?

[RJ749]

Any updates on Josh?  I have been away for a while?

Karen made this last post on the Caring Bridge site:

Thursday, March 19, 2009 8:19 AM, CDT

Yesterday was the 17 month mark, post injury for Josh. Seems like a long time ago, huh? A distant memory, like watching something in your rearview mirror, grow farther and farther away in the distance, as you continue to drive on.

I came to the realization a few days ago, that it is time to close this site down. It has become very clear to me, that Josh is moving on, leaving his injury in his "rearview mirror." It is also time for me to move on.

His accident and subsequent rehab and everything that has been attached to that, has been nothing short of miraculous. You all know of this, as you have read his story unfold over the last 17 months.

I came to realize, that his injury started to define me, in a way that is unhealthy for me. I literally cannot move around my community without always being asked how Josh is. I'm not ungrateful for his miracles and recovery, but have realized that he has moved on, and there is so much more to me, as a person, than Josh's injury. I need to reclaim that person, before October 18th, of 2007 happened.

All the advocating, fighting, faxing, emailing, phone calling, driving, rehabbing, etc... has worn me down. I won't stop, as spinal cord injuries will ALWAYS be a passion for me. Josh has other passions in his life as well, which he is successfully navigating. There is so much more to Karen Heine, as a person, other than Josh Heine's care giver. That part of my life is over. I celebrate this...God is so good, to have gotten Josh and our whole family to where we are today!

So, as I close, Barry and I love you and eternally thank you once again for your love, care and prayers. We could not have gotten through this ordeal without all of you. I am pursuing, what has always been my hearts passion...medical missions. Josh has a new purpose in life, his beautiful girlfriend Audrey and precious Brody, & going to college. God has big plans for his life and we await, with great anticipation, all that He has for him. Josh, our "prodigal" son, as Barry & I call him, WILL make it. Why? Because we entrusted him to God when he was born, and that is where we place him today. God is in control of his life, and like the story of the Prodigal Son, Josh will return "home" too, fully restored, inside & out! While we wait, we just love him.

He's walking so good now, with his Bioness, I wish you all could see him, I tear up some days when I watch him. Some days, he walks around without any assistive devices. He's getting closer and closer to being, one day, fully restored. Our faith is strong and we continue to be resilient as we look ahead to what God has in store for us.

One more request, I'll keep this post open for a bit. I'd love it, if those of you out there who would like to, send Josh or our family one last note of hello or goodbye...whichever you call it. We ALWAYS love hearing from you. This entire journal will be bound up in an actual physical journal for us, by the caring bridge site. So, it would be lovely to have parting comments from all of our loving family and friends.

May our God, who is always FAITHFUL, and full of love, richly bless you and yours.

Barry & Karen Heine, Josh and Family

p.s. anyone can contact me @ my personal email in the future if you'd like to know how Josh is doing.

www.klhdesign@hotmail.com