CLYDE, N.C. (WLOS) \u2014 A North Carolina family says it is moving forward with plans to take their 12-year-old son to Boston for a heart procedure, despite an insurance denial that arrived days before their scheduled trip.<\/p>\n
Rowan Lowry was diagnosed with Kawasaki disease when he was 7. The disease affected the blood supply to his heart and left him with multiple aortic aneurysms and narrowed arteries. He has already undergone open-heart surgery.<\/p>\n
Rowan is scheduled to have a stent procedure at Boston Children\u2019s Hospital on Oct. 19. His mother, Cheryl Presnall, said the family received a denial letter shortly before the trip.<\/p>\n
\u201cI got the letter of denial yesterday from our insurance, and they said that the cause of denial was because it is deemed medically unnecessary and experimental,\u201d Presnall said.<\/p>\n
She said Rowan\u2019s condition could worsen if the procedure is delayed. If an artery becomes too narrow for a stent, doctors may need to perform another open-heart surgery, she said.<\/p>\n
CLYDE FAMILY SHARES SON\u2019S KAWASAKI DISEASE STORY TO RAISE AWARENESS<\/a><\/p>\n \u201cRowan is not a science experiment,\u201d Presnall said.<\/p>\n Miranda Yaver, an assistant professor at the University of Pittsburgh who studies insurance denials, said patients with less typical presentations of a condition can face challenges getting treatment approved.<\/p>\n \u201cThings that maybe are lifesaving are ultimately getting denied because it\u2019s not a textbook presentation of the condition,\u201d Yaver said.<\/p>\n Yaver said navigating the denial and appeal process can take a psychological toll on patients and their families. Rowan\u2019s family said they did not have time to appeal before the scheduled procedure but plans to travel to Boston.<\/p>\n NONPROFIT LEGAL TEAM HELPS NC MEDICAID PATIENTS WIN BENEFITS APPEALS<\/a><\/p>\n \u201cWe\u2019re getting on the plane,\u201d Presnall said. \u201cBecause at the end of the day, we\u2019re going to do whatever we have to do. We\u2019re going to fight.\u201dWhat to do after an insurance denial<\/p>\n Yaver recommends that people who receive a denial:<\/p>\n Contact their physician\u2019s office.Reach out to their local legislator.If they have employer-provided insurance, contact their human resources department.Seek help from patient advocacy groups.<\/p>\n Rowan\u2019s family is accepting donations.<\/p>\n You can click here<\/a> for Rowan\u2019s GoFundMe. You can click here<\/a> for Rowan\u2019s Amazon Wishlist.<\/p>\n","protected":false},"excerpt":{"rendered":"CLYDE, N.C. (WLOS) \u2014 A North Carolina family says it is moving forward with plans to take their…\n","protected":false},"author":2,"featured_media":883765,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[59],"tags":[97,252,253],"class_list":["post-883764","post","type-post","status-publish","format-standard","has-post-thumbnail","category-health-care","tag-health","tag-health-care","tag-healthcare"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/posts\/883764","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/comments?post=883764"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/posts\/883764\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/media\/883765"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/media?parent=883764"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/categories?post=883764"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/tags?post=883764"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}