VACAVILLE, CA - A Vacaville couple whose 14-month-old infant girl was denied surgery said she will be at greater risk if her surgery is moved and delayed.
UPDATE: Vacaville toddler's heart surgery in limbo
When Bridgette and Johan Schilling learned their daughter Aria had a dangerous heart condition back in January, they stayed with the cardiologist who diagnosed it, and who recommended Oakland Children's Hospital to do the delicate surgery.
Aria had already been diagnosed with ventricular tachycardia, which causes her heart to beat too quickly.
In January, a cardiologist they went to for a second opinion diagnosed Aria with stenosis of her pulmonary artery, meaning the artery that serves her lungs is slowly closing.
Aria was scheduled for surgery at Oakland Children's Hospital next week when the couple's health care provider, Western Health Advantage, told them it had to be cancelled and would have to be done later, in-network, at UC Davis Medical Center.
"To get to one week before her scheduled surgery and have the rug pulled out from under your feet has been devastating," Johan Schilling said. "It's traumatic."
A Western Health Advantage spokesman said he could not comment directly on the case for privacy reasons, but said it has a network of more than 3,000 doctors and 14 hospitals, and that they refer out of network when they need to.
The Schillings question why they weren't notified sooner that the surgery could not be done at Children's Hospital.
The Schillings said they were told by Western Health Advantage that they were notified the surgery would have to be at UC Davis back in January, but they said they have found not documentation to back up the insurer's claim.
"We've never once been told that we were out of network. We never once were told that Children's Hospital would not be an avenue for us," Schilling said.
"Our doctor said he would've never taken us on as patients if he would've known that Western Health Advantage would not pay for Children's Hospital Oakland," Schilling added.
The couple said they went to the media with their story hoping the publicity might change their insurer's mind.
The couple now worry that Aria's condition might worsen as they restart the process to prepare for surgery at UC Davis.
"If they could show some compassion and just pay for the surgery next week with these doctors that we have faith in," Bridgette Schilling said.