[DBlain]

Sort of wondering if I am correct in being upset with my vet and with my pet insurance.

Lola has been very healthy but of course you never know what could come down the pike so I got Pet Plan Health Insurance. At my last visit before taking the insurance my vet gave me every indication that Lola was fine so never in a million years would I have thought that the insurance company would see her as having a "pre existing condition"

I have had full blood work done each year I have owned her and everything has been normal according to her vet. In 2012 her CPK level was 231 and the range is 10-200. The vet said it could be anything like over muscle use, wiggling during a blood draw and since everything else was normal there was no concern. In 2013 everything was normal including the CPK so of course there was no concern about anything. However in 2014 months after the insurance is in place, her blood work indicates a CPK level of 1509 and the range for her age is 59-895. The vet once again talked about a possibility of a muscle strain and not to worry, however I say, "oh but it was high last time". I was going from memory not the dates because last time it was not high, the vet who was not looking at the blood work history goes along with me and says, hmmmm well then it could be something like strain on the heart muscle, I say well she does pant heavy during play time so perhaps it could be her heart. Then she says you could have a heart ultra sound to rule out heart issues. I go to the specialist the next day and they do a heart ultra sound, which thankfully comes back normal and they say her heart is excellent. The specialist also said that 2014 CPK number is not even a concern to her and that it really only indicates heart problems in cats not dogs and with those situations the number would be about 10 times higher than what Lola's was and in fact did not even think I had to have the ultra sound, but I thought I would like to know 100% that she was OK.

So I file the claim for the heart test, it's denied because of they claim in 2012 the CPK value was high and they consider this a pre existing condition and that I needed to have two normal blood tests between the bad one and the good one. However since it was hardly elevated the first time and not at all in 2013 my vet would never have recommended another blood test within less than a year's time. They said I can appeal. When I start to look over the records to do the appeal, I see the first thing my vet had wrote on the chart was it was high last time, which is was not, but she picked it up from my initial comment. The appeal process states if there is a mistake in the records please send in a new record that shows an update with the correction.

I call my vet's office two weeks ago, explained all that in detail, tell her all I need is an update on the medical record stating the results were normal last time and no other tests were required. I then send a follow up email explaining why the claim was denied and suggestions on how to truthfully make a statement in the record so I could get my claim covered. My vet agreed and said in her opinion there was never a pre existing condition because of the 2012 CPK number. I made several follow up calls to the office and even asked them to email me what they were going to put in the records to make sure we were all on the same page. I have been on vacation so I checked in with them yesterday and today I get an email with a letter from the vet that she was sending directly to the insurance company. It is poorly written, sort of confusing and seemed to stress more on the findings on the heart ultra sound, and how I am a good pet owner with pet insurance, and only a brief mention of the slightly elevated CPK level, but throws in could be due to struggling during a draw or secondary to luxating patellas, which Lola does not even have!!!! I am not happy with this letter since this is clearly not what I asked for, I ONLY asked for the mistake to be noted and corrected on the medical record (which could have been simple and to the point), plus the way it was written it sounded like Lola's has a problem with her patellas, which could cause a problem down the road for reimbursements if that bridge had to be crossed. I called the vet to say this is not what I wanted, she gets on the phone and that's when I found out she took it upon herself to call the insurance company to find out why the claim was denied and that the letter was already sent in. I never asked her to do this and I do not think it helped my case a bit. I know she feels strongly that Lola did not have any pre existing conditions and wanted to help, but frankly I am so pissed because I feel she overstepped her bounds, she has cost me hours of needless calls and email writing and after all this I will most likely not get my claim paid because once again on the phone Pet Plan said I still need to start the appeal process and have updated medical records.

Even though Pet Plan denied my claim I am more upset with my vet, because I think the way she wrote the medical records will keep me from getting my claim paid.