The squeaky wheel gets the... policy changed?

Last year, on World Down Syndrome Day, I shared a post about how IBM’s Neurodiversity program helped prepare me for my adventure of a lifetime – becoming a mom to my sweet daughter, Margot, who has Down syndrome.

?It was through seeing how brilliant and talented People with Diverse Abilities(PwDA) are, and how much they have to offer the world and corporations like IBM, that I could see a future for my daughter.

Since my post last year, Margot has embarked on all sorts of new adventures including Physical, Occupational, and Speech Therapies multiple times a week to help her develop the skills that don’t come as easily to her as a typical kid.

We are very fortunate to have these services covered by my insurance through IBM, and even luckier to have found amazing providers that bring out the very best in our girl.

The Challenge?

We ran into a challenge last year with an insurance policy that requires a Medical Necessity Review(MNR) after every forty sessions to validate that progress is being made and determine if services should continue.? This is pretty standard across the insurance industry.

We were finding that this extra step was slowing down payment to our provider and putting us at risk for no longer getting their life-changing services. ?Not to mention, it was an unnecessary process for someone diagnosed with Ds as they typically need these therapies for years considering their genetic disorder is not something that will go away.

After a few months of working through this process, I decided it couldn’t hurt to share feedback about our experience with an IBM Insurance Advocate. I was able to find the right person and sent her an email, which was quickly followed up with a phone call from her to fully understand our experience.

?One month later

A month later, I heard back from the Advocate with mind-blowing news…

“Ms. AuBuchon, I’m happy to share with you that we had the insurance company look into both of our policies and MNRs are no longer required/needed for Down syndrome patients.”

I couldn’t believe it.?There are approximately 250k+ employees in our company.? If you conservatively say only half are parents and with the knowledge that one in every 700 babies is born with Down syndrome… you can estimate that hundreds of IBMers no longer have to submit paperwork on a regular basis for their children to receive therapy services.

How many other companies will adopt this policy change? This could potentially positively impact the lives of thousands. And it’s all because of one email.

Moral of the story?

Take the time to provide feedback.?You'll never know if you don't ask. And if you're lucky, you might just make life easier for one or thousands of others walking the same path as you.

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