Re: Re: Therapeutic Riding

[Guest guest]

I have no clue for blue cross and blue shield specifically,myself, but a script for evaluation and then services as reccommended by the hippotherapist ( OT) should be enough if it involves necessary daily living skills- the kicker is that they do not cover things they do not qualify as medically necessary and in their eyes I am not sure any of the things listed are considered medically necessary to them. If the OT evals and proves there is a deficit and he is delayed in certain physical areas like tone, muscle weakness, has desensitization or increased sensory seaking you may have better luck getting services. None of these things can be known until a full evaluation is done. Usually my pediatrician writes a referral or script for a full evaluation and therapy as reccommended/ if needed. We had

hippotherapy and aquatherapy sessions my son had weekly with OTs covered for a year and half so far, but then recently they started denying the aquatherapy with the OT saying it was no longer medically necessary. I think because he made progress and was getting closer the norms for some of the areas. New areas were tesed and goals were canged but basically they said even thought we have 60 sessions a year they are only for when it is medically necessary and they no longer thought the aquatherapy was. So we had to stop the sessions and now wait for regression then we can reapply she said. It sucks because he is way more hyper and tense and stiff without it, he is bouncing off the walls half the time and he is not taking deep breaths as much now, but we got his waiver to pay for swimming lessons weekly so I am hoping in the interem that helps if he can manage it with the other kids and all the noise. Not sure if that helps you at all, but

insurance coverage is tricky and you walk a fine line with trying to get things covered and not losing your insurance, and making sure everything is truthful and not fraud in any way. I have seen some doctors and therapists willing to put anythign down to get stuff covered, so be careful. We are so anxious to get our kids help we do not always inspect the methods as close as we should. It is hard because we do not even always know what they are putting is right or wrong. So just be cautious in your persuit to get him help. Sadly, there are many out they waiting to take advantage of desperate mothers.

From: bridget <beanniferj@...> Sent: Wed, March 23, 2011 7:18:28 PMSubject: ( ) Re: Therapeutic Riding

I believe that sometimes therapeutic riding is done with an OT or PT, in which case that is the service that would be billed by insurance. The riding center you are considering using may be able to give you more details. Good luck - I hear great things about it!Bridget>> Does anyone know what kid of letter my pediatrician would need to write to get blue cross to cover therapeutic riding for a child with aspergers on the autistic spectrum? I am thinking it would be benefitial for social pragmatic speech, core strength, balance, coordination, sequencing, and spacial awareness (understanding personal space). Any info or advice?>