Limited Liability

While there are dozens of organizations to help families struggling with health concerns, what happens when you have to navigate the health insurance maze should a crisis hit? That’s when you reach out to Mrs. Shuli Berger, a proactive liaison between insurance companies and health-care providers. And while she doesn’t have one neat solution to the mess insurance has become, she can help make sure the system works for you

The doctor’s face was grave.

“Neuroblastoma is a terribly aggressive form of cancer,” he told the terrified young parents. “You must transfer your baby to a specialized hospital as soon as possible. The care he needs is not available here in New Jersey.” He recommended a well-known out-of-state children’s hospital. “Our case manager will work on getting approval for the transfer.”

A while later, a hospital social worker approached the tiny patient’s bedside. “I’m so sorry,” she said. “The specialized hospital is refusing to accept your child without an authorization, and your insurance company is denying it.”

The parents turned back to the doctor. Could they keep their child in his care until the approval came through? “No, we need to move him out as soon as possible. It’s a question of hours and minutes,” he asserted, explaining that neuroblastoma is a tumor that affects juvenile nervous systems. It can spread quickly, and delaying higher-level care for even one day can have a serious negative impact on the prognosis.

The parents frantically called Chai Lifeline. “What are we supposed to do?” they asked, and the response was immediate, one that is becoming increasingly common in situations of insurance-related medical crises.