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‘Not the way our health care system should work’: Orange County physician takes to Twitter to secure special formula for premature baby

An Orange County pediatrician is making waves online after taking to Twitter to help save a baby’s life.

Dr. Eric Ball has been caring for a premature baby for more than a month.

The child has now been released from the hospital but is now in need of a “special kind of formula that’s very rare and extremely expensive,” Ball said.

It’s called Monogen, and it can cost the family $80 to $100 per can. The family’s insurance company, Anthem Blue Cross Blue Shield, initially denied the claim and has not responded to KTLA’s request for comment.

“This was out of the range for this family to be able to afford this expensive formula, and this was literally the only formula this baby can have,” he said.

But with doctor authorization, the family can the medication. Since Tuesday, Ball has tried to get an insurance representative on the phone.

“I have patients to see, so this was taking hours and hours of my time, and hours and hours of this family’s time, and we were just done with it,” he said.

On Thursday, Ball took to Twitter.

“Hi, @AnthemBCBS: I have a preemie baby who can’t get his life-saving medication because you won’t cover it without me speaking to someone about pre-authorization. For 3 days I’ve been leaving messages and getting lost in phone trees. Can someone please DM me? We need to talk,” he wrote.

More than 500 retweets and 23,000 likes later, Ball was contacted by a higher-up at the insurance company, and the baby will get the formula.

“I didn’t mean to start like a firestorm or to shame them. I just wanted to reach one person because I probably talked to about a dozen, maybe 20 people, by that time,” he explained.

Despite the happy ending in this case, Ball believes it illustrates a glaring problem within health care, one that can be solved by cutting red tape.

“I had dozens or hundreds of physicians reaching out to me, basically saying, ‘Yeah, we are dealing with the same thing. Isn’t it the worst part of our job? I can’t believe we’re dealing with this,’” he said.

Ball said it’s “ridiculous” that so much effort had to be expended to secure life-saving formula for the child, and he worries about the implications of this struggle.

“That’s not the way our health care system should work … I’m glad it worked out in this case, but there are probably thousands of people who are suffering or paying a lot of money out of pocket unnecessarily or not getting their medicines because of the way this works,” he said.



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