Speech Therapist - Houston Area - in-network for UHC - response

[Guest guest]

Hi there -

I have UHC as well, and they are VERY difficult to get to pay claims once a

child is over 3 years old - read your policy carefully! I have found a speech

therapy group in the Galleria area that is in-network for UHC and are very

vigilent about getting claims reimbursed. The way they work it, though, is that

you pay up front for the services, and if they ever get paid from the insurance

company they refund you. They charge you what their contracted rate is with UHC

for the sessions, so a 1-hour assessment is $75 (steal!) and then 30-minute

sessions are $73 (so if 2x a week $146). If anyone is interested, e-mail me and

I will provide the person's contact name. She seemed very familiar with Apraxia

of Speech and the therapist in the group my daughter started with seems

knowledgeable as well. We'll see how it goes. I figure something is better

than nothing at this point. We've been going out-of-network and trying to get

reimbursed and it was a nightmare. This speech practice also told me up front

that what they would do was send in the assessment and see if UHC would approve

further sessions before sending in any claims. She said they usually approve a

date range. Then I had the choice of paying up front and starting in hopes of

being refunded at some point, or waiting until we got approval before starting

sessions - decided the former because my daughter needs it. It hurts

financially, but what to do?

The only way UHC reconsidered and approved some of the claims from this year was

to exhaust our appeals and then ask my husband's HR Dept. to contact them

directly and ask them why they were denying and then they all of a sudden

approved the 1st 30 visits of the year (we have a 30 visit limit - but you can

get more approved if medically necessary - they don't tell you that though.

Just automatically deny it and you have to appeal. Now have to appeal the rest

of the visits again.)

I'm going to keep fighting, and get my husband's HR involved again to get the

rest of the sessions approved that we've already done. It's so hard. Then

hopefully the people I'm working with now will be able to handle it from there.

I got so frustrated, I even started a website -

www.speechot-initiative.web.officelive.com

Hope that helps!

Diane

>

> You really have to get creative to search for therapists. I didn't have any

in network therapists listed online less than about 50 miles away. I even

called UHC to ask about any closer therapists who were in network. Finally, I

thought of the local hospitals and the children's hospital and found that there

were pediatric therapists at both that took our insurance. We had a very short

wait to get Nate in for an eval for speech at the children's hospital. We are

about 45 min away from the children's hospital--yet it was well worth the drive

to get an apraxia diagnosis. I found the young therapist at All Children's to

be much more knwledgeable about apraxia than any private or public school

therapist my son has had. In fact, over the course of our conversation, she

pointed out some things the school therapist was doing in speech that were

counterproductive for a child w/apraxia.

>

> Keep searching--just start making phone calls--

> Colleen

>