Jump to content
RemedySpot.com

Help with Ins denial

Rate this topic


Guest guest

Recommended Posts

Guest guest

HELP!! My son (almost 4) has been approved by ChoiceCare for 1 visit

a week until the end of the year. According to our therapist, this

is nothing short of amazing. We recently added a second visit every

other week which was just denied. He's made so much progress I want

to keep it going - additionally, unless there's an underlying

condition (and apraxia doesn't count) the company denies ins claims

on speech therapy after the age of 5!!! Basically, I want to get him

as much therapy as possible until we can't get it anymore... At

$125/hour I'm not sure we can afford it after that - and we are

considered upper-middle class!! I'm sure they're expecting the

schools to pick up the therapy, but I'm just not comfortable with

that (please don't write me irate - I know there are LOTS of good

therapy situations out there - just not here...).

SO! What I need is compelling information about the clinical

benefits of receiving more than one visit per week and it's

definitive benefits. Anyone know of a study?

Anyone have any other suggestions? We've made an appt with a dev ped

(which won't happen for another 2 mos) and that might help. Also,

she might find an " underlying condition " which would help in

general...

Thanks so much for the info - I know this is the very best place to

come - to the experts!

Marina

Link to comment
Share on other sites

Guest guest

We just got insurance approved for our daughter. The only way it

was approved was by my husband's company rep told our insurance

company to make an exception.

My point is that you may want to talk to your company about the

problem also.

--- In @y..., " marina3029 " <philipmary@z...>

wrote:

> HELP!! My son (almost 4) has been approved by ChoiceCare for 1

visit

> a week until the end of the year. According to our therapist,

this

> is nothing short of amazing. We recently added a second visit

every

> other week which was just denied. He's made so much progress I

want

> to keep it going - additionally, unless there's an underlying

> condition (and apraxia doesn't count) the company denies ins

claims

> on speech therapy after the age of 5!!! Basically, I want to get

him

> as much therapy as possible until we can't get it anymore... At

> $125/hour I'm not sure we can afford it after that - and we are

> considered upper-middle class!! I'm sure they're expecting the

> schools to pick up the therapy, but I'm just not comfortable with

> that (please don't write me irate - I know there are LOTS of good

> therapy situations out there - just not here...).

Link to comment
Share on other sites

Guest guest

My husband already talked to the company rep and found out that they

gave fiduciary responsibility to the ins co - we were quite

dismayed! She said she'd help us, but couldn't twist their arms...

Thanks for your input!

Marina

> > HELP!! My son (almost 4) has been approved by ChoiceCare for 1

> visit

> > a week until the end of the year. According to our therapist,

> this

> > is nothing short of amazing. We recently added a second visit

> every

> > other week which was just denied. He's made so much progress I

> want

> > to keep it going - additionally, unless there's an underlying

> > condition (and apraxia doesn't count) the company denies ins

> claims

> > on speech therapy after the age of 5!!! Basically, I want to get

> him

> > as much therapy as possible until we can't get it anymore... At

> > $125/hour I'm not sure we can afford it after that - and we are

> > considered upper-middle class!! I'm sure they're expecting the

> > schools to pick up the therapy, but I'm just not comfortable with

> > that (please don't write me irate - I know there are LOTS of good

> > therapy situations out there - just not here...).

Link to comment
Share on other sites

Guest guest

Our insurance company also said that we could ask for a doctor to

doctor consult. If you have a doctor on your side, you may want to

ask if he would speak to the medical director.

--- In @y..., " marina3029 " <philipmary@z...>

wrote:

> My husband already talked to the company rep and found out that

they

> gave fiduciary responsibility to the ins co - we were quite

> dismayed! She said she'd help us, but couldn't twist their arms...

>

> Thanks for your input!

> Marina

Link to comment
Share on other sites

Join the conversation

You are posting as a guest. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.

Guest
Reply to this topic...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.

Loading...
×
×
  • Create New...