GEORGETOWN, Texas — UPDATE: David Stippick told KVUE on March 20 that following this report and pressure from other sources, Blue Cross Blue Shield reversed its decision and approved coverage for his son's medical care and transportation. The Stippick family will be arriving at Dell Children's Medical Center in Austin on March 21.
ORIGINAL STORY:
A father is worried and frustrated after an insurance company denied his request to transport his family from New York City to Austin.
To celebrate Riker Stippick's 10th birthday, his family went on a trip to New York. That was where he suffered what his father called the "worst headache" his son has ever had.
"His arteries in his veins and his head are kind of mingled together," David Stippick said. "There was a rupture inside of that ... that caused a brain bleed and that's what caused that pain. Since then, he has been in the pediatric ICU."
Riker Stippick has been in a hospital room in New York while Blue Cross Blue Shield of Texas covers his care. But his family has had issues getting him transported and having his medical care covered at home in Texas.
"We've been told is that it's not medically necessary to move him," David Stippick said. "They consider it a medically lateral move ... Comparable or higher level of care at the [New York] hospital than he would be coming to ... in Austin."
KVUE contacted Blue Cross Blue Shield of Texas, but we were told the company does not comment on member cases. The family claims the insurance company is not considering the support network Austin can provide.
"That's going to be a negative impact to our family," David Stippick said. "It's already a negative impact to our girls to have mom and dad ... gone unexpectedly for so long."
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Patient advocate Belynda Montgomery said the situation does not surprise her.
"So, insurance is not very well regulated as far as what the client might want versus what the insurance might want," Montgomery said. "So, automatically, things are denied the first time they come through. Keep appealing. You can appeal multiple times. It does take a really long time, unfortunately."
Meanwhile, the Stippicks are starting their third appeal with Blue Cross Blue Shield of Texas, hoping to bring their son closer to home while he recovers.
"There is more than just mom and dad and an unfamiliar hospital room ... Things like that, that there is some level of comfort that's brought back to him during his recovery," David Stippick said.
For those needing patient advocacy services in Central Texas, you can visit Advocate ATX, BBM Advocate, Stoneworks Healthcare Advocates or Compassionate Healthcare Advocacy of Texas.