April 19, 2011 - Our insurance company denied us coverage on Jackson's very special severe-food-allergy formula due to "lack of legislation in Oklahoma".
So, one of my summer projects was to convince our insurance company that they needed to pay for it.
July 21, 2011 - Insurance company received 16 pages of my packet (I mailed 21 pages.)
July 30, 2011 - "All 16 pages" were uploaded and imaged. Representative told me to call on Monday, August 8 and said that I would most certainly be denied but customer service could help me with my appeal.
August 8, 2011 - My "appeal hasn't been processed yet". The representative was going to "send a note over". She sent my receipts to claims and my letters to preauthorization. She said I "would be denied" because I "wasn't preauthorized". But she encouraged me to "always do a verbal appeal" and to call this Friday for the decision.
August 12, 2011 - My "appeal is not yet finalized". But my "request for authorization has been sent in."
August 17, 2011 - Our family goes on an outing to the Oklahoma State Capitol. I am reminded about the summer of 1991 when I went to Girls State in Texas. I recognize the fact that I live in a capitol city. A crazy idea forms in my head.
August 22, 2011 - I'm in the "processing phase...should be finished by the end of the week." And I get a DCN!! A Document Control Number!! So I can reference this at each call so customer service can be caught up to speed quickly.
August 26, 2011 - "Claim is in the ready status." What??? "Yes! We are cutting you a check for $235.50." Oh. What would that be for? Are you just paying a portion of each can of formula? "Hold please." Wait 9 minutes. "It seems to be that we are missing some receipts." I fax over missing receipts.
August 29, 2011 - 8:26am Insurance company received fax. They should be uploaded and imaged by August 30. Brenda the representative says "we will retroactively reimburse you and pay for formula going forward!!!" (Not just the $235.50 - which was one receipt but ALL receipts!!)Success! Elation!! Thrilled!!! Thoughts of Disney World pass through my head...
2:13pm Joe calls. "We have made a mistake." "Your claim is pending." "Formula is not covered." "Going forward we will not cover." "You have the right to appeal." "We will send you a denial letter." Tears. Sadness.
August 31, 2011 - Claim was officially denied. No longer pending. I have 30 days to appeal. If denied again I can take it to the "2nd level appeal". "Denial letter going out today."
September 9, 2011 - Have not received denial letter. Call insurance company. Tom gets Pharmacy Management on the phone. She says, "product service not covered." Why? I ask. "Well, we don't cover over-the-counter medicines." It's not over-the-counter. I have to have a RX. "I'm sorry. We don't pay for medically necessary food." Why? "Well, if a feeding tube is needed, then we would." Insurance company will pay for the surgery to get the feeding tube, the tube and the formula and any other necessary equipment. "There is no legislation in your state enforcing coverage."
September 10, 2011 - Begin appeal procedure.
September 12, 2011 - Hands are sweaty. Stomach is queasy. Feeling light headed. Scared out of my mind. Make a call to Senator Clark Jolley and Representative Randy Grau. Leave a message with both.
September 14, 2011 - Representative Randy Grau calls back and leaves cell phone number with Matt!!! I call Representative Grau back and leave rambling-horribly-scattered message on his voice mail....I'm not even sure I said, "Hi. This is Alyssa McCook." Oh yes...it was bad.
September 15, 2001 - Representative Randy Grau calls to see if Monday, September 26 would be a good time to meet. We have a pleasant chit chat on the phone. I am not at all rambly, horrible or scattered on the phone - what a relief! He goes to Quail Springs Church of Christ. Went to Edmond Sonshine School as a young boy. Went to Pepperdine. Took over representation from Ken Miller and was a page for Ray Vaughn. Loving the connections! Praying for a great meeting! I tell him that I would like to discuss the lack of coverage by insurance companies in Oklahoma for amino-acid based elemental formula.
So, until now....there were VERY FEW people that I talked to about my idea to get some legislation going on this.
And this is what I need from you, my blog friends:
1. Prayers - because really...I don't know what I'm doing.
2. High-fives. I'm collecting them. I think it will help my confidence.
3. Ears - I need to talk to as many people who will listen to my presentation (that I have not prepared yet) between now and Monday, September 26.
4. Connections to other food allergy people in Oklahoma. Please send your friends my way. Please send your friend's friends my way.
5. Empty cartons. If you or your family drinks almond milk, soy milk, rice milk, goat milk, etc, I'd like to collect your empty cartons for my visual presentation. Have since decided that this is a bad idea. I would just be taking garbage up to the representative.
I'm sure over the next 11 days I'll make this meeting/event more public. I wanted to start here.
Thank you in advance.
Katie won the Charleston's coloring contest!!
Not just the one where everyone who enters gets a free kids meal.
The one where you win a Charleston's t-shirt.
The manager said to her, "Do you know what a rare item you own?" (talking about the t-shirt). Katie said, "What is it?" He said, "Your new shirt." She said, "No silly. I have lots of shirts. But thank you."
Jackson is ready for the Farm Animals class.
He's got his night-night, his blankie #1, blankie #2, ya-ya (paci) and 2 cars.
Jumping J would not sit still for a picture in his classroom and thought running around the rocking chair would be way more fun.
Mrs. Chiara finally captured the boy and made him sit so I could get a first day of school picture. Whew!
Katie was super excited that she got to ride the Sonshine School bus from morning kindergarten ALL the way over to Sonshine School. This is her last year :( and she is in the World Explorers class. 
This tooth was hanging on by a teensy bit of a root. It would twist when he talked. I don't pull teeth. It's not in my job description. But our dad, being the son of a dentist, used his great and tender tooth-pulling skills.
Katie is doing her best Rolling Stones impression and "can't wait" until she looses a tooth!!!
This is one cutie patootie!
Yes friends and family...that is my husband. The University where he works has a night where the faculty and staff get on stage to entertain the students. Matt has been a part of this show...one of his very favorite campus events...since 2003, his 2nd year here. 
Some of Matt's adoring fans.
Now scroll back up and look at that hair again. Do you know how long it took me to perfect that Lady Gaga hair?? Thank you Sarah for the Lady Gaga makeup advice. The washable marker was perfect!