Insurance

June 20, 2000

Blue Cross Valuecare of Utah let me do the antibiotic IV three times, and

then they refused to approve it after that. The last one I did was in July

of 1997. They are still trying to decide if they want to process the bill

and pay the Home Health for it.

Good luck...

Larene

Re: rheumatic insurance

> Just wanted to throw this in if it might help. I have Blue Cross/ Blue

> Shield and they have paid all of my iv home treatment costs . They pay all

> dr.'s visits (except for 20.00 co-pay) and all but the co-pay for my

minocin

> scrip(10.00). I'll be happy to fax you the paid bills so you can show your

> insurance co. if you need them. T.

>

> aewinchell@... wrote:

>

> > I have Kaiser, an HMO, as insurance and on their home page when I

> > looked up minocycline under uses for it RA was listed. So if you

> > have Kaiser this could help you, and even if you have an other HMO

> > you can refer to this. I didn't look up other antibiotics yet.

> > Kaiser is very big in USA, it is in most states.

> > I hope this helps somebody,

> > Agmes

> >

> > ------------------------------------------------------------------------

> > Find long lost high school friends:

> > 1/5535/0/_/532797/_/961525478/

> > ------------------------------------------------------------------------

> >

> > To unsubscribe, email: rheumatic-unsubscribeegroups

>

> ------------------------------------------------------------------------

> Looking for Airfare deals?

> Visit Expedia.com for limited time offers

> 1/5205/0/_/532797/_/961548166/

> ------------------------------------------------------------------------

>

> To unsubscribe, email: rheumatic-unsubscribeegroups

>

June 20, 2000

Just wanted to throw this in if it might help. I have Blue Cross/ Blue

Shield and they have paid all of my iv home treatment costs . They pay all

dr.'s visits (except for 20.00 co-pay) and all but the co-pay for my minocin

scrip(10.00). I'll be happy to fax you the paid bills so you can show your

insurance co. if you need them. T.

aewinchell@... wrote:

> I have Kaiser, an HMO, as insurance and on their home page when I

> looked up minocycline under uses for it RA was listed. So if you

> have Kaiser this could help you, and even if you have an other HMO

> you can refer to this. I didn't look up other antibiotics yet.

> Kaiser is very big in USA, it is in most states.

> I hope this helps somebody,

> Agmes

>

> ------------------------------------------------------------------------

> Find long lost high school friends:

> 1/5535/0/_/532797/_/961525478/

> ------------------------------------------------------------------------

>

> To unsubscribe, email: rheumatic-unsubscribeegroups

October 9, 2002

HI,

From the home page click on files and then click on help folder then

click on insurance help. Also check out these web pages:

http://www.cranialtech.com/ParentsArea/library.html

http://www.plagiocephaly.org

http://www.cappskids.org/PlagioInsuranceHelp.htm

I'm sure on one of those pages you'll find what your looking for.

Good luck and welcome to the group!

> I am getting ready to do a 1st appeal to my insurance company.

They

> told me on 3 occasions it would be covered. They went as far as to

> call the place where she would have it put on and had the initial

> deposit waived. They said it would be covered 100! About 4 days

> letter I received a letter in the mail saying it wasn't covered.

>

> Where can I find more facts on the necessity of treatment. I have

> found things from other parents which is extremely helpful to me

but

> won't be acceptable to the insurace. Isn't there any articles out

> there from Dr's. My daughter will be getting the starband helmet.

October 9, 2002

Hi " tiredmom " and welcome to our group!

Sooo sorry to hear of the runaround your ins. company has given you.

What ins. company do you have?

Check out the great links replied to you for more help. You

can also look in our " files " section, " help folder "

then " insurance " . Below, I've copied & pasted a sample letter of

med. necessity a former member put in our files section. Hope

that'll help.

How old is your daughter? Has she been casted for the band yet?

Good luck - welcome again, and please be sure to keep us updated.

Debbie Abby's mom DOCGrad

MI

>>>>Letter of Medical Necessity

Re: Luck

To Whom It May Concern:

I am writing on behalf of the above named patient for whom we are

requesting orthotic correction of his cranial malformation of non-

synostotic origin. is a child with a skull deformity as a

result of a number of complicating factors. These have included that

is one of twin who suffered twin-to-twin syndrome, requiring

C-section because of tachycardia, prematurity at 29 weeks, postpartum

requiring intubation and NICU care for six weeks for management of

airway, hydronephrosis, anemia and hypertension. Because of early

birth and supine positioning throughout this care this has resulted

in deformational forces on a prematurely developed calvarial vault.

Moreover, this has been compounded by right side torticollis and

appropriate positioning to avoid sudden infant death as recommended

by the American Academy of Pediatricians. These factors have

resulted in an obvious cranial vault asymmetrical deformity

characterized as a parallelogram with right occipital flattening,

right frontal prominence and anterior positioning of the right ear.

Attempts to positionally correct this without more aggressive

intervention has been limited. Because of this, is a

candidate for non-surgical molding therapy. While there are some

centers that may correct this type of positional deformity with

surgery, the surgery is not without significant risks and associated

costs. The medical literature currently supports the use of a non-

operative, non-invasive correction of this condition through use of

dynamic orthodic cranioplasty. This involves correction of the

abnormal head shape with external forces. We feel that in 's

case the deformity is significant enough and that he is an

appropriate age for head molding to help improve the asymmetric

deformity. The results of dynamic orthodic cranioplasty typically

show good improvement and there are certainly many children who have

near complete improvement. The success correlates with the age at

the beginning of treatment and with the severity of the deformity.

It is important that the treatment be started early enough in

development to take advantage of the flexibility of the infant's

skull. Beyond a certain age, external molding will not be possible

and surgery is the only alternative if the deformity remains

significant.

It makes the most sense, from and economic and risk standpoint, to

correct these problems when they are easily corrected non-invasively

rather than to either leave them uncorrected and suffer natural

consequences or to offer a surgical solution that adds expense and

risk. It is on this basis that a treatment approach which involves

dynamic cranioplasty is medically indicated in cases like these.

We will continue to follow throughout the course of his

treatment. If further information is needed, please contact us

directly.

Sincerely,

Pravin K. Patel, M.D.

Attending Plastic and Reconstructive Surgeon

Director, Cleft-Craniofacial Team

October 10, 2002

tons and tons of articles check out these links and more in the files link look under insurance help and another folder for information. Let me know fiyou have difficulty accessing any of them and if we can do anything else to help. We are glad tyou are here and would love to know more about you.

Beck

files

DOC look on their site for info and articles

STATEINSDEPT

Click here: Plagiocephaly Information Web

Click here: Insurance Issues

Click here: Research Links

Click here: Pediatrics -- and Clarren 105 (2): e26 as a parent take this article with a grain of salt but it is good for appeals'

Click here: CranialTherapies.com Articles: Gentle Force, Headband help correct head shape: Green Bay oPress Gazette

Click here: Plagiocephaly Resources

Click here: Other online resources

October 10, 2002

My daughter was casted a week ago. She is suppose to get the starband on the 17th. We have BcBs. I am just so angry that we as parents have to go through things like fighting the insurance co. to help our children.

Re: insurance

Hi "tiredmom" and welcome to our group!Sooo sorry to hear of the runaround your ins. company has given you. What ins. company do you have?Check out the great links replied to you for more help. You can also look in our "files" section, "help folder" then "insurance". Below, I've copied & pasted a sample letter of med. necessity a former member put in our files section. Hope that'll help.How old is your daughter? Has she been casted for the band yet?Good luck - welcome again, and please be sure to keep us updated.Debbie Abby's mom DOCGradMI>>>>Letter of Medical NecessityRe: LuckTo Whom It May Concern:I am writing on behalf of the above named patient for whom we are requesting orthotic correction of his cranial malformation of non-synostotic origin. is a child with a skull deformity as a result of a number of complicating factors. These have included that is one of twin who suffered twin-to-twin syndrome, requiring C-section because of tachycardia, prematurity at 29 weeks, postpartum requiring intubation and NICU care for six weeks for management of airway, hydronephrosis, anemia and hypertension. Because of early birth and supine positioning throughout this care this has resulted in deformational forces on a prematurely developed calvarial vault. Moreover, this has been compounded by right side torticollis and appropriate positioning to avoid sudden infant death as recommended by the American Academy of Pediatricians. These factors have resulted in an obvious cranial vault asymmetrical deformity characterized as a parallelogram with right occipital flattening, right frontal prominence and anterior positioning of the right ear.Attempts to positionally correct this without more aggressive intervention has been limited. Because of this, is a candidate for non-surgical molding therapy. While there are some centers that may correct this type of positional deformity with surgery, the surgery is not without significant risks and associated costs. The medical literature currently supports the use of a non-operative, non-invasive correction of this condition through use of dynamic orthodic cranioplasty. This involves correction of the abnormal head shape with external forces. We feel that in 's case the deformity is significant enough and that he is an appropriate age for head molding to help improve the asymmetric deformity. The results of dynamic orthodic cranioplasty typically show good improvement and there are certainly many children who have near complete improvement. The success correlates with the age at the beginning of treatment and with the severity of the deformity. It is important that the treatment be started early enough in development to take advantage of the flexibility of the infant's skull. Beyond a certain age, external molding will not be possible and surgery is the only alternative if the deformity remains significant.It makes the most sense, from and economic and risk standpoint, to correct these problems when they are easily corrected non-invasively rather than to either leave them uncorrected and suffer natural consequences or to offer a surgical solution that adds expense and risk. It is on this basis that a treatment approach which involves dynamic cranioplasty is medically indicated in cases like these.We will continue to follow throughout the course of his treatment. If further information is needed, please contact us directly.Sincerely,Pravin K. Patel, M.D.Attending Plastic and Reconstructive SurgeonDirector, Cleft-Craniofacial TeamFor more plagio info

October 10, 2002

Hello and welcome to the group! I'm sorry to be so late in responding so I'm

sure you've already gotten all sorts of great tips and advice. We have files

section that has some great articles in it. We also have a bookmark section that

includes some links to helpful information. I had to battle the insurance

company as well so I know how frustrating this process can be. Be sure to keep

very good notes and a call log as well as copies of absolutely everything. The

denial can be overturned - many parents here have been successful in getting

their denials overturned (I'm one of them!).

We'd love to hear more about your little cutie! I'm glad you have joined us!

Marci (Mom to - helmet grad)

Oklahoma

October 10, 2002

Hi, I saw your post. At the time my son was 9 yrs old and finally correctly

diag. with oral Apraxia. I had to fight the insurance co. as well. I have

Health Net PHS (Guardian) I live in New Jersey and I went through the 2

insurance co. appeals, and then contacted the NJ Health and Senior Service

Department. I filled an appeal in which I enclosed a letter I drafted, all

of the Dr's and spec. paper work. I won, but it was only for 30x a year.

Any questions let me know. Kathy Bence

October 10, 2002

Buffy,

What is the status of the appeal at this point? What is the insurance

company asking that you provide to them? Did you file a claim with the

state insurance commissioner? If so, what is the status of the claim (ie

what do they say is the next step)?

----- Original Message -----

From: " russell " <jesscale@...>

> Hi, I have a son who is 5 yrs. old. I am so frustrated. We have been

fighting our insurance company for 3 years. Their plan requires Apraxia

must be do to illness, injury, or congenital condition. I have 2

neurologists that say it is congenital and results from a congenital brain

anomaly. The neurologist is from the Mayo Clinic. He also states speech

therapy is medically indicated for my son Cale. He is making such great

improvements at the clinic where he is going but it is very expensive. He

receives speech therapy 4x per week as well as one on one educational. The

federal dept of labor has been notified as well as the state insurance

commissioner. I don't understand what the problem is they are paying for

other kids with the same diagnosis and not even as severe as Cale. Where do

I go from here??? I would appreciate any input. Thanks, Buffy (MOM OF

CALE)

October 11, 2002

I am going through the exact same thing with my insurance company (Aetna US

Helthcare). My plan tates theat they will cover speech for illness, disease,

etc. I sent them a letter stating that ASHA defines verbal apraxia as " a

medical condition consistent with the definition of illness and disease...a

disorder of body function. " (Keystater, the official publication of the

Pennsylvania Speech Hearing Laguage Ass'n, Sept, 1992; Source: ASHA, Rockville,

MD).

Good luck!

Ilene, NJ

[ ] Insurance

Hi, I have a son who is 5 yrs. old. I am so frustrated. We have been fighting

our insurance company for 3 years. Their plan requires Apraxia must be do to

illness, injury, or congenital condition. I have 2 neurologists that say it is

congenital and results from a congenital brain anomaly. The neurologist is from

the Mayo Clinic. He also states speech therapy is medically indicated for my

son Cale. He is making such great improvements at the clinic where he is going

but it is very expensive. He receives speech therapy 4x per week as well as one

on one educational. The federal dept of labor has been notified as well as the

state insurance commissioner. I don't understand what the problem is they are

paying for other kids with the same diagnosis and not even as severe as Cale.

Where do I go from here??? I would appreciate any input. Thanks, Buffy (MOM OF

CALE)

October 11, 2002

Hi,

I think the first thing to do is to find out the " diagnosis code " for our kids'

condition.

According to speechville.com, " a great code to use is 781.3 which is " lack of

muscle

coordination/coordination disorder " . Find out with your insuracne company to

see if they cover

for this code and how much they cover. FYI, there is another code 784.5 for

other speech

disturbance, dypraxia..etc. is also good. We have OXFORD insurance (we are in

NY), they don't

cover 781.3 but do cover 784.5. However, these insurance companies have a way

to get around

things. Even though Oxford covers 784.5, but they pay less than $20 for HMO

plan. Then you will

still pay the difference to the SLP.

Does anyone know which insurance companies cover speech therapy? Maybe we can

exchange info adn

possibly change insurance company.

Regards

Agnes

--- Ilene Martire <olsby@...> wrote:

> I am going through the exact same thing with my insurance company (Aetna US

Helthcare). My plan

> tates theat they will cover speech for illness, disease, etc. I sent them a

letter stating that

> ASHA defines verbal apraxia as " a medical condition consistent with the

definition of illness

> and disease...a disorder of body function. " (Keystater, the official

publication of the

> Pennsylvania Speech Hearing Laguage Ass'n, Sept, 1992; Source: ASHA,

Rockville, MD).

>

> Good luck!

>

> Ilene, NJ

> ----- Original Message -----

>

> Hi, I have a son who is 5 yrs. old. I am so frustrated. We have been

fighting our insurance

> company for 3 years. Their plan requires Apraxia must be do to illness,

injury, or congenital

> condition. I have 2 neurologists that say it is congenital and results from a

congenital brain

> anomaly. The neurologist is from the Mayo Clinic. He also states speech

therapy is medically

> indicated for my son Cale. He is making such great improvements at the clinic

where he is going

> but it is very expensive. He receives speech therapy 4x per week as well as

one on one

> educational. The federal dept of labor has been notified as well as the state

insurance

> commissioner. I don't understand what the problem is they are paying for

other kids with the

> same diagnosis and not even as severe as Cale. Where do I go from here??? I

would appreciate

> any input. Thanks, Buffy (MOM OF CALE)

October 28, 2002

Hi Debbie. My husband's company is switching to Aetna come January 1. I

will be watching the replies to your message with anticipation! I've heard

stories from people who have had good luck with them as well as those stories

like your own. It just all depends on what the employer has chosen to have

the insurance company pay for as a part of the policy that the employer

offers to their employee. Good luck to you!

Mom to (4 years old this past Friday) and (2 years)

October 28, 2002

Hi,

I am a very " disgruntled " client insured by Aetna. You can try fighting it

but it probably won't get you far. Aetna's policies are very outlined and

they are very clear. I have tried to fight it and have gotten no where.

They claim since my son's apraxia does not show up on medical tests (MRI's)

that they don't have to pay for developmental problems. That is not part of

their contract. Good luck. I took my 60 days and ran with it. The other

thing you could try is to see if they will switch the OT or PT premium (60

days also) to speech. I know someone who tried that and won so she got 6

months of speech. It is too stressful for us to persue it any further. Good

luck

Janet

October 28, 2002

I remember a few people having this situation and successfully appealing it.

They made the case based on the treatment being " medically necessary " , that

because it was medically necessary that the child receive ongoing speech

therapy, the limitation would not provide for the medical needs of the

child. Others have stretched out the benefit by submitting for different

types of therapy, oral motor speech therapy at one point, speech therapy at

another point, occupational therapy at another point. My sense about it

would be that it would be a hard battle to wage. Have you checked into

lower cost speech therapy through ish Rites, Easter Seals, or a local

university's speech-language clinic?

> I have Aetna insurance. The policy allows for 60 consecutive days of

therapy - that's it. They tell me that's not a yearly max - that's a

lifetime max. Has anyone fought this battle before and won? How would I go

about it?

>

> Thanks,

> Debbie

October 28, 2002

We have Aetna. Each companies' policies are different. Ours policy

said that they would only cover speech if the person lost speech

when they had an accident or illness. Well, my daughter was 6 weeks

old when she was sick.

Our company insurance person changed the wording of the company's

policy to include children.

You may want to talk to your company's insurance rep to see if they

can help you.

By the way, they will not cover my other daughter. We don't have

proof that she has brain damage, and we're not trying to get

coverage for her.

Good luck.

Suzi

> I have Aetna insurance. The policy allows for 60 consecutive days

of therapy - that's it. They tell me that's not a yearly max -

that's a lifetime max. Has anyone fought this battle before and

won? How would I go about it?

>

> Thanks,

> Debbie

>

October 28, 2002

hi, i am new to this apraxia stuff,but have you ever

applied for any type of social security help or

anything? i was just wondering. thanks, stacey

--- timari3@... wrote:

> Hi,

> I am a very " disgruntled " client insured by Aetna.

> You can try fighting it

> but it probably won't get you far. Aetna's policies

> are very outlined and

> they are very clear. I have tried to fight it and

> have gotten no where.

> They claim since my son's apraxia does not show up

> on medical tests (MRI's)

> that they don't have to pay for developmental

> problems. That is not part of

> their contract. Good luck. I took my 60 days and

> ran with it. The other

> thing you could try is to see if they will switch

> the OT or PT premium (60

> days also) to speech. I know someone who tried that

> and won so she got 6

> months of speech. It is too stressful for us to

> persue it any further. Good

> luck

> Janet

October 28, 2002

Along the same lines, I couldn't even get the initial

consultation covered by Blue Cross/Blue Shield. JJ

has his eeg scheduled for this Thursday and his MRI

scheduled for November 21st and to my chagrin our

insurance refuses payment on all of it, and so does

the state. Where does one go from here? Who knows.

Kim,

Disgusted in Michigan

--- Stacey <staceymiller30@...> wrote:

> hi, i am new to this apraxia stuff,but have you

> ever

> applied for any type of social security help or

> anything? i was just wondering. thanks, stacey

>

> --- timari3@... wrote:

> > Hi,

> > I am a very " disgruntled " client insured by Aetna.

>

> > You can try fighting it

> > but it probably won't get you far. Aetna's

> policies

> > are very outlined and

> > they are very clear. I have tried to fight it and

> > have gotten no where.

> > They claim since my son's apraxia does not show up

> > on medical tests (MRI's)

> > that they don't have to pay for developmental

> > problems. That is not part of

> > their contract. Good luck. I took my 60 days and

> > ran with it. The other

> > thing you could try is to see if they will switch

> > the OT or PT premium (60

> > days also) to speech. I know someone who tried

> that

> > and won so she got 6

> > months of speech. It is too stressful for us to

> > persue it any further. Good

> > luck

> > Janet

October 28, 2002

I am in the process of trying to get more speech therapy covered for my son. We

have Aetna US Healthcare. I've had some luck in getting more than 60 days

covered, but they said payment was made in error (?). My plan does not have a

lifetime max, but does have the 60 consecutive day coverage. The last letter

that I had written, explained that Apraxia is an illness (I quoted ASHA) and

should be treated like one, meaning that speech therapy is a medical necessity.

I haven't heard anything, yet. Feel free to contact me privately.

Ilene, NJ

[ ] Insurance

I have Aetna insurance. The policy allows for 60 consecutive days of therapy

- that's it. They tell me that's not a yearly max - that's a lifetime max. Has

anyone fought this battle before and won? How would I go about it?

Thanks,

Debbie

October 28, 2002

Ilene's post reminded me of something... Check your states' regulations

because those regulations can override the insurance policy. For example,

this New Jersey legislation (below) indicates that if a physician states

that speech therapy is medically necessary, and the speech therapy will be

provided by a speech-language pathologist, then the person will not be

denied the benefit. This should enable any child in New Jersey to get

speech therapy as long as the pediatrician states that it's medically

necessary (regardless of 60 day limitations in the contract).

----------------------------------------

http://www.njleg.state.nj.us/cgi-bin/om_isapi.dll?clientID=219452 & Depth=2 & de

pth=2 & expandheadings=on & headingswithhits=on & hitsperheading=on & infobase=statu

tes.nfo & record={69E7} & softpage=Document42

17B:26-2.1p Health insurance policy to cover certain audiology,

speech-language pathology services.

4.Notwithstanding any other provision of chapter 26 of Title 17B of the New

Jersey Statutes, benefits shall not be denied to any eligible individual for

eligible services, as determined by the terms of the policy or as otherwise

required by law, when the services are determined by a physician to be

medically necessary and are performed or rendered to that individual by a

licensed audiologist or speech-language pathologist within the scope of

practice. The practices of audiology and speech-language pathology shall be

deemed to be within the provisions of chapter 26 of Title 17B of the New

Jersey Statutes and duly licensed audiologists and speech-language

pathologists shall have such privileges and benefits in the scope of their

practice under that act as are afforded thereunder to licensed physicians

and surgeons in the scope of their practice.

L.1997,c.419,s.4.

October 29, 2002

I am currently battling this out too! We are under Blue Cross, and my son (has

apraxia) has used all the sessions he is allowed for the year..which is 25

visits. When our therapist sent in the notes, re -eval and so forth, requesting

an additional 25 visits..it was denied. We are now in the process of

appealing-and all therapy visits have ceased until appeal is approved.

My heart just sinks...my son needs this so much. I understand that the

insurance companies have to be cautious in making these kind of

decisions...but.............oh well.

charlotte

----- Original Message -----

I am in the process of trying to get more speech therapy covered for my son. We

have Aetna US Healthcare. I've had some luck in getting more than 60 days

covered, but they said payment was made in error (?). My plan does not have a

lifetime max, but does have the 60 consecutive day coverage. The last letter

that I had written, explained that Apraxia is an illness (I quoted ASHA) and

should be treated like one, meaning that speech therapy is a medical necessity.

I haven't heard anything, yet. Feel free to contact me privately.

Ilene, NJ

October 29, 2002

Hello,

I felt like I needed to speak words of encouragement to all that are in

the appeals process with insurance companies for any form of therapy for

our little angels.

I just went through this process, and we won our 2nd level appeal with

Blue Shield. Both for speech and occupational therapy. Just make sure

to keep your chin up, and work very hard with your doctors to get all

the information needed into the insurance companies. I was originally

told that with a diagnosis of Apraxia both motor/oral, that would not

constitute an approval - but we did win. I think it had to do with a

lot of God and the doctor's documentation also helped some too.

Rowena

-----Original Message-----

I am currently battling this out too! We are under Blue Cross, and my

son (has apraxia) has used all the sessions he is allowed for the

year..which is 25 visits. When our therapist sent in the notes, re

-eval and so forth, requesting an additional 25 visits..it was denied.

We are now in the process of appealing-and all therapy visits have

ceased until appeal is approved.

My heart just sinks...my son needs this so much. I understand that the

insurance companies have to be cautious in making these kind of

decisions...but.............oh well.

charlotte

October 29, 2002

Charlotte: I can definitely respond to this one! I, too, have Blue

Cross/Blue Shield - PPO and they cover only 25 visits per year, and only

80% of those 25 visits. So, if my son goes to speech therapy 2x a week,

then we are all done within 3 months! Oh and by the way, these 25 visits

also includes OT therapy. We will be done with our therapy coverage in 2

months now.

But, I also know that BC/BS does not cover more for a developmental delay,

but needs a medical reason....so I will be in the process of obtaining

that paperwork.....and I will let you know what I come across.

I have to tell you a funny story (not too funny). While I was in the

waiting room during my son's therapy, the receptionist is quite an expert

on insurance and has successfully appealled almost ALL of BC/BS claims.

And I guess the president (?) of Chicago's BC/BS is also an owner of the

Chicago Bears football team (which isn't doing so well!). She actually

had a parent make a video of her son trying to ask for something.......to

show how he can't ask for his basic needs and how they desperately needed

this therapy. They then sent this in to the president to show him what

they denied......and they finally did approve their therapy.

Good luck, and let's keep eachother posted....Kim

October 29, 2002

hi charlotte, have you tried applying for social

security or anything?

--- Charlotte Klimchock <charlotte.klimchock@...>

wrote:

> I am currently battling this out too! We are under

> Blue Cross, and my son (has apraxia) has used all

> the sessions he is allowed for the year..which is 25

> visits. When our therapist sent in the notes, re

> -eval and so forth, requesting an additional 25

> visits..it was denied. We are now in the process of

> appealing-and all therapy visits have ceased until

> appeal is approved.

>

> My heart just sinks...my son needs this so much. I

> understand that the insurance companies have to be

> cautious in making these kind of

> decisions...but.............oh well.

>

> charlotte

October 29, 2002

,

Thank you so much for your information. I had no idea that this existed.

Ilene

Re: [ ] Insurance