Log in to WRAL.com with one click using your favorite social network:
OR
Log in using your WRAL.com account:



Wrong email/password combination.

Forgot password?

Register with WRAL.com using your favorite social network:
OR
Register for a WRAL.com account using our web form.

10:12 a.m. • 5-24-13

Weather Forecast for Raleigh

  • Today: Partly Cloudy.
    • Hi: 72° F
  • Sat: Clear.
    • Hi: 72° F
  • Sun: Partly Cloudy.
    • Hi: 75° F

Other Locations

> 7 Day Forecast

Doppler Image

Published: 2012-06-12 19:12:00
Updated: 2012-06-13 10:26:46

Blue Cross approves Coats girl's treatment after online appeal


Ellen Whittington, family fought Blue Cross for coverage
Ellen Whittington, family fought Blue Cross for coverage
print friendly

After two months of battling for insurance coverage for their 12-year-old daughter's rare condition, a Harnett County family turned to social media recently to ratchet up pressure on Blue Cross Blue Shield of North Carolina.

Faced with the bad publicity of a growing Facebook campaign and the possibility of the state Department of Insurance ordering coverage, Blue Cross agreed Tuesday to pay for Ellen Whittington's treatment, the girl's father said.

About six months ago, Ellen developed auto-immune encephalitis, a rare condition in which the immune system attacks the brain, causing loss of language and motor skills. She can now only stomp her feet and clap her hands.

"This is not what we started out with," said her father, Brian Whittington.

Dr. William Gallentine, a Duke University pediatric neurologist, prescribed an intravenous treatment of immune globulin, or IVIG, that cost nearly $60,000.

Blue Cross denied coverage, arguing that there wasn't enough medical evidence to prove the treatment might help Ellen. Two subsequent appeals of the decision also were turned down.

"I have to believe in my heart that had she had this IVIG treatment when it was originally prescribed, then she may be running around kicking a ball and singing and dancing again," Whittington said.

A Facebook page detailing Ellen's condition and the family's insurance plight sprouted up over the weekend and had 822 "likes" by Tuesday evening.

The family also shifted its appeal to the state Department of Insurance, but Blue Cross offered Tuesday morning to pay for the IVIG treatment on a trial basis if the family withdrew that appeal, Whittington said.

"We were aware of this child's plight and had been working on it," said Dr. Don Bradley, chief medical officer for Blue Cross. "Clearly, the social media kind of brings more light to it, but the process was already in motion."

Blue Cross denies less than 5 percent of claims, and the unusual nature of Ellen's illness made the decision difficult in this case, Bradley said.

"When you look at this on the front line and you get these rare clinical syndromes – and as tragic and tough for the family as they are – we’re going to make sure that the family and the patient aren’t exposed to things that aren’t going to be effective, and frankly, harmful," he said.

Ellen is scheduled to begin her treatments at Duke on Wednesday.

"I didn’t set out to harm Blue Cross Blue Shield in any way with this. I just wanted my daughter to get the treatment she needed," Whittington said. "Not knowing if and when she was going to get treatment (and) not knowing how we were going to pay for it if Blue Cross Blue Shield didn't come through, that was the hard part."

Bradley said the case shows Blue Cross' system works.

"This was an expedited appeal – handled in relatively short fashion – and the patient is now getting the treatment that may or may not help them, but it’s at least the best effort as we in the clinical science know," he said.


136 Comments


WRAL.com welcomes your comments on this story. All comments are moderated prior to publication based on our posting guidelines. Please review them prior to posting and if your message is not approved.

View Comments VIEW ALL 136 COMMENTS

This story is closed for comments.

Latest Comments
For what reason do we pay medical insurance if not to prevent losing everything we've worked for? Also, no one has posted here that state employees do pay premiums out of pocket for dependent care coverage just like anyone else does for insurance offered as a benefit of employment. Unfortunately the rates have gotten so high I've had to switch our dependents over to a plan with less coverage offered by my spouses's employer. All you taxpayers out there who resent my WELL EARNED benefits can now celebrate! Meanwhile I'll keep trying to prevent bankruptcy over medical co-pays/coinsurance left over from hospitalizations/procedures in 2009!

Good for Mr. and Mrs. Whittington! They didn't just sit back and take no for an answer! I applaud you for fighting the big guys and getting what you need for your daughter! Best wishes for success and for healing so that your daughter can live a wonderful life!

I am really not sure what to say to you all who are judging Mr. and Mrs. Whittington and the actions they took to help their child. He has asked that anyone who comments be with dignity and respect so I will only say that in my opinion they did the right thing and got the right outcome. Their daughter is receiving the help she needs and that is what matters.

Well-Well, Were do I begin? I have read all these statements that have been posted and it is sad. First, on the behalf of Mr. & Mrs. Whittington, I'd like to thank WRAL for their coverage for both the Whittington home & BCBS insurance company. Second, I'd like to say/tell everyone that Mr. Whittington is making it a point to tell all of FB/WRAL/BCBS that this was not meant to be grudgeful or slandering, he just wanted the best for him daughter. NOW from me & my comments--How dare some of your say and post what you posted. I'm sorry for the few of you who posted "I didn't receive any help" (let this be a lesson to all), you can receive/get help if you use your GOD giving brain and think/react. And for the ones who said "I'd sell my home, car, boat, my momma, whatever", they tried to pay/set payments up but were rejected because they had health insurance. I'm sorry for the few, who commented and posted so ignorantly, that you wer raised in a home where your parents did not care. (Danny)

Just like ble Cross, more worried about its profit and loss margin and the big salary and bonus for the CEO than the life of a little girl. Time that these insurance companies were regulated again. NOn-profit. CEO's make no more than 150K. NO bonus'!

View Comments VIEW ALL 136 COMMENTS