Need Advice on Insurance Info! Please!

[Guest guest]

Hello Listmates,

I am trying to find out a way to get my health insurance provider to continue Occupational Therapy for my Autistic daughter age 3. Our insurance is Kaiser and they only approved of 12 visits. Period. This is expensive and her DDD is already used up from AIT. Has anyone been there, done that, with getting their insurance to help pay for therapies? I don't understand, we pay for the insurance coverage, their own doctor's diagnosed my daughter autistic, but only cover 12 visits for therapy. This is a bit ridiculous considering in their terms that Autism is a life long disability!

Needing any information that you may have to help.

Thank you for your time!

Kathleen

"Education is a continuous process ending only when ambition comes to a halt." -- R.I. Rees

[Guest guest]

kathleen why isnt birth to three or school district giving her OT??

Crystal

[ ] Need Advice on Insurance Info! Please!

Hello Listmates,

I am trying to find out a way to get my health insurance provider to continue Occupational Therapy for my Autistic daughter age 3. Our insurance is Kaiser and they only approved of 12 visits. Period. This is expensive and her DDD is already used up from AIT. Has anyone been there, done that, with getting their insurance to help pay for therapies? I don't understand, we pay for the insurance coverage, their own doctor's diagnosed my daughter autistic, but only cover 12 visits for therapy. This is a bit ridiculous considering in their terms that Autism is a life long disability!

Needing any information that you may have to help.

Thank you for your time!

Kathleen

"Education is a continuous process ending only when ambition comes to a halt." -- R.I. Rees

[Guest guest]

Kathleen,

If your daughter is 3 she should receive OT from your school district. Our insurance would only cover physical or occupational therapy that was needed as a result of say a trauma that could be cured within a given period of time. Yours is probably the same. But my daughter has received very good OT and PT from our school district since she was 3 years old and is still happily working with the same therapists now at the age of 7.... she has made enormous gains within this time.

[ ] Need Advice on Insurance Info! Please!

Hello Listmates,

I am trying to find out a way to get my health insurance provider to continue Occupational Therapy for my Autistic daughter age 3. Our insurance is Kaiser and they only approved of 12 visits. Period. This is expensive and her DDD is already used up from AIT. Has anyone been there, done that, with getting their insurance to help pay for therapies? I don't understand, we pay for the insurance coverage, their own doctor's diagnosed my daughter autistic, but only cover 12 visits for therapy. This is a bit ridiculous considering in their terms that Autism is a life long disability!

Needing any information that you may have to help.

Thank you for your time!

Kathleen

"Education is a continuous process ending only when ambition comes to a halt." -- R.I. Rees

[Guest guest]

They are but it is pretty pathetic really, I volunteer at the school and it is a sensory room that they let the kids run around and play in, nothing like how the OT at Synergy is one on one with her.

Thank you all for posting information for me. I really appreciate it!

Kathleen

Re: [ ] Need Advice on Insurance Info! Please!

kathleen why isnt birth to three or school district giving her OT??

Crystal

[Guest guest]

This is exactly the data I have been searching for for our appeal to our

insurance. Would you have the abstracts or journal articles to send?? Also,

anything regarding metals/speech

Thanks to any and all

beth

>From: Nomoremetals@...

>Reply- egroups

> egroups

>Subject: Re: [ ] Need Advice on Insurance Info! Please!

>Date: Sat, 4 Nov 2000 18:24:59 EST

>

>How about having your doctor write a note stating an additional need for

>services due to the problems associated with heavy metals toxicity?

>There's

>alot research linking metals with motor and sensory problems so that

>wouldn't

>be a hard sell. Years ago, our doc wrote a note stating that my son's

>malabsorption had led to physical problems which required OT so they

>covered

>it.

>Gaylen

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[Guest guest]

Kathleen,

Then you need to insist that they provide appropriate OT services for your daughter that will continue on with the program she has had thus far!! Get recommendations from your former O.T. and dig your heels in!

Re: [ ] Need Advice on Insurance Info! Please!

kathleen why isnt birth to three or school district giving her OT??

Crystal

[Guest guest]

In a message dated 11/5/00 4:00:21 PM Central Standard Time,

kimmelclan@... writes:

<< Would you have the abstracts or journal articles to send?? Also, anything

regarding metals/speech >>

Sorry, I don't have them offhand just have read alot. Doing a search online

could probably bring up loads of info. Bernie and Andy probably could direct

you to some good stuff. I wouldn't try to dig up research for the insurance

company. Just use it to convince your doc, if you need to, to write a

letter. A doctor stating that certain problems are related to a diagnosis

seems to carry more weight with them.

Gaylen