Re: fighting insurance about CAS

[Guest guest]

You would have to get the dr. treating him or that diagnosed him to write a

letter of medical necessity to the insurance co. They will file an appeal after

denying you and then after you're persistence and follow-up, they will approve.

Or at least, that is how my situation worked when my son was diagnosed almost 6

y.o. ago.

From:

[mailto: ] On Behalf Of astruhs99

Sent: Thursday, August 12, 2010 2:19 PM

Subject: [ ] fighting insurance about CAS

Hello.. My son who is 3 has been recently diagnosed w/ CAS. Our insurance,

Altius, is currently denying speech therapy for him. Their reason is that CAS is

a developmental delay, and they do not cover developmental delays. I am looking

for a professional that will write a letter to Altius on my son, Dylan's behalf,

basically stating what Apraxia is and what it is not (developmental delay). If

you would be willing to this, I would really apreciate it.

Thanks so much!

Struhs

This transmission may contain information that is privileged,

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applicable, for any loss or damage arising in any way from its use.

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contact the sender and destroy the material in its entirety,

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[Guest guest]

Check out the asha.org site for the Michigan Insurance 2004 apraxia ruling

against BCBS. Basically, it states that it's not developmental. The site also

has great resources for challenging your insurance.

From: astruhs99@...

Date: Thu, 12 Aug 2010 18:18:34 +0000

Subject: [ ] fighting insurance about CAS

Hello.. My son who is 3 has been recently diagnosed w/ CAS. Our insurance,

Altius, is currently denying speech therapy for him. Their reason is that CAS is

a developmental delay, and they do not cover developmental delays. I am looking

for a professional that will write a letter to Altius on my son, Dylan's behalf,

basically stating what Apraxia is and what it is not (developmental delay). If

you would be willing to this, I would really apreciate it.

Thanks so much!

Struhs

[Guest guest]

just a thought -I would not use the word developmental or childhood apraxia of

speech or DAS or CAS and just call it apraxia -just like nobody calls it

childhood autism of speech they just call it autism. That is in the late talker

book too. jmo Jeanne

Here is an archive from

[Guest guest]

unfortunately it doesnt always work like that I have been fighting for years to

cover certain things and I have not seen anything yet even with getting a drs

notice. Even with the laws they passed in nj not enough is being done here .

Most of our costs are out of pocket for three children it makes me very upset .

what will happen to these kids if things do not improve. NJ has had big cuts I

am not sure about other states but its really tuff here

Tim

http://www.thenutritiongenius.com

________________________________

From: Myra Bauza <myra.bauza@...>

" " < >

Sent: Thu, August 12, 2010 3:59:57 PM

Subject: RE: [ ] fighting insurance about CAS

 

You would have to get the dr. treating him or that diagnosed him to write a

letter of medical necessity to the insurance co. They will file an appeal after

denying you and then after you're persistence and follow-up, they will approve.

Or at least, that is how my situation worked when my son was diagnosed almost 6

y.o. ago.

From:

[mailto: ] On Behalf Of astruhs99

Sent: Thursday, August 12, 2010 2:19 PM

Subject: [ ] fighting insurance about CAS

Hello.. My son who is 3 has been recently diagnosed w/ CAS. Our insurance,

Altius, is currently denying speech therapy for him. Their reason is that CAS is

a developmental delay, and they do not cover developmental delays. I am looking

for a professional that will write a letter to Altius on my son, Dylan's behalf,

basically stating what Apraxia is and what it is not (developmental delay). If

you would be willing to this, I would really apreciate it.

Thanks so much!

Struhs

This transmission may contain information that is privileged,

confidential, legally privileged, and/or exempt from disclosure

under applicable law. If you are not the intended recipient, you

are hereby notified that any disclosure, copying, distribution, or

use of the information contained herein (including any reliance

thereon) is STRICTLY PROHIBITED. Although this transmission and

any attachments are believed to be free of any virus or other

defect that might affect any computer system into which it is

received and opened, it is the responsibility of the recipient to

ensure that it is virus free and no responsibility is accepted by

JP Chase & Co., its subsidiaries and affiliates, as

applicable, for any loss or damage arising in any way from its use.

If you received this transmission in error, please immediately

contact the sender and destroy the material in its entirety,

whether in electronic or hard copy format. Thank you.

[Guest guest]

Have you been to the apraxia kids website? It has TONS of info on dealing with

insurance companies, I think you can even find them on facebook.  Also,

speechville.com has info as well you might want to read.  We have had problems

with our insurance too (Cigna) and have hit a dead end.  They told us we had to

prove medically neccesary, we got a note from the doctor and neurologist sent to

them and then they said " while it is medically neccessary, your plan does not

cover speech therapy that is not rehabilitative. " It is my husband's company

that has chose this policy and they won't change it yet.  It is very

frustrating, I know!! But, read up on these sites, talk to your kids slps, get

notes from your doctors, try everything cause you never know! What state do you

live in? Is there a college where your kids could receive therapy from graduate

students at a reduced cost? I have 2 boys also in therapy, it does get expensive

and we had to cut down on the

amount we take them and are considering taking them to graduate students and

From: Nutrition Genius <thenutritiongenius@...>

Subject: Re: [ ] fighting insurance about CAS

Date: Thursday, August 12, 2010, 6:58 PM

 

unfortunately it doesnt always work like that I have been fighting for years to

cover certain things and I have not seen anything yet even with getting a drs

notice. Even with the laws they passed in nj not enough is being done here .

Most of our costs are out of pocket for three children it makes me very upset .

what will happen to these kids if things do not improve. NJ has had big cuts I

am not sure about other states but its really tuff here

Tim

http://www.thenutritiongenius.com

From: Myra Bauza <myra.bauza@...>

" " < >

Sent: Thu, August 12, 2010 3:59:57 PM

Subject: RE: [ ] fighting insurance about CAS

 

You would have to get the dr. treating him or that diagnosed him to write a

letter of medical necessity to the insurance co. They will file an appeal after

denying you and then after you're persistence and follow-up, they will approve.

Or at least, that is how my situation worked when my son was diagnosed almost 6

y.o. ago.

From:

[mailto: ] On Behalf Of astruhs99

Sent: Thursday, August 12, 2010 2:19 PM

Subject: [ ] fighting insurance about CAS

Hello.. My son who is 3 has been recently diagnosed w/ CAS. Our insurance,

Altius, is currently denying speech therapy for him. Their reason is that CAS is

a developmental delay, and they do not cover developmental delays. I am looking

for a professional that will write a letter to Altius on my son, Dylan's behalf,

basically stating what Apraxia is and what it is not (developmental delay). If

you would be willing to this, I would really apreciate it.

Thanks so much!

Struhs

This transmission may contain information that is privileged,

confidential, legally privileged, and/or exempt from disclosure

under applicable law. If you are not the intended recipient, you

are hereby notified that any disclosure, copying, distribution, or

use of the information contained herein (including any reliance

thereon) is STRICTLY PROHIBITED. Although this transmission and

any attachments are believed to be free of any virus or other

defect that might affect any computer system into which it is

received and opened, it is the responsibility of the recipient to

ensure that it is virus free and no responsibility is accepted by

JP Chase & Co., its subsidiaries and affiliates, as

applicable, for any loss or damage arising in any way from its use.

If you received this transmission in error, please immediately

contact the sender and destroy the material in its entirety,

whether in electronic or hard copy format. Thank you.

[Guest guest]

We used the late talker book to help get therapy covered by insurance. I

brought the book with me to the doctor's office to show him which codes to use

and it worked for us. Kate

>

> just a thought -I would not use the word developmental or childhood apraxia of

speech or DAS or CAS and just call it apraxia -just like nobody calls it

childhood autism of speech they just call it autism. That is in the late talker

book too. jmo Jeanne

>

> Here is an archive from