Some mojo and prayers please for Greenbean

[gatorsmom]

Our insurance is not sure they want to continue to pay for Greenbean's OT therapy. They've required extensive testing on Greenbean to decide if he qualities. Until this year our coverage was excellent but has now suddenly changed.

I feel he could really benefit from it. So does his OT therapist. I think this will particularly true as he heads into full- day Kindergarten next year. But we don't decide- the insurance company does. Our state's EI program is pathetic. Only the severely disabled get any kind of services. I can't tell you how many times I've heard, "he's not that bad.". :banghead:

Your p and pt are apprecited.

[Momit]

P&PT coming your way.

[anonomom]

I'm sorry. PT that he gets the help he needs.

[lmh2402]

hugs and p&pts, lisa

[DietCokeLover]

Hope he is able to get the services he needs

[OKKiddo]

Prayers that they provide the services!! I understand completely because it was a total battle for my older son to get OT at first too. Hang in there and keep fighting for him!

[infomama]

I know how it feels to wait for the insurance company to make a life huge decision...I'll be thinking of you guys.

[larig]

Many pts. It makes me so sad that those of us lucky enough to have insurance are at the mercy of insurance providers who don't know anything about our kids.

[WitMom]

That stinks. Hoping they come through for you guys.....I can't imagine how frustrated you must feel right now.

[chlobo]

Our insurance is not sure they want to continue to pay for Greenbean's OT therapy. They've required extensive testing on Greenbean to decide if he qualities. Until this year our coverage was excellent but has now suddenly changed.

I feel he could really benefit from it. So does his OT therapist. I think this will particularly true as he heads into full- day Kindergarten next year. But we don't decide- the insurance company does. Our state's EI program is pathetic. Only the severely disabled get any kind of services. I can't tell you how many times I've heard, "he's not that bad.". :banghead:

Your p and pt are apprecited.

is private pay an option? Our State also is very restrictive but there are many private pay practitioners out there.

[Mopey]

tons & tons of mojo to you Mama! :hug:

[crl]

Prayers and positive thoughts.

Catherine

[niccig]

is private pay an option? Our State also is very restrictive but there are many private pay practitioners out there.

:yeahthat: or an OT schools nearby? DS goes to the Speech Therapy Clinic of nearby college, much cheaper than private pay.

[Tea4two]

P&PT and mojo! Our insurance wouldn't pay for speech therapy for DS. Was so frustrating! We ended up going through EI, which we still had to pay for, but so much cheaper than private ST.

[Sweetum]

I agree with Nicci. Check where most of the private practitioners for OT graduated - most likely they will have a clinic program and will be looking for volunteer kids. This can be helpful in the interim, while you figure out how to get around insurance covering OT. I know that SPD is not covered as any diagnosis, but some of challenges are acknowledged when there is another diagnosis. But I also think that your ped can help by saying that he needs fine and gross motor help. You probably already know this, but thought I'd say it anyway. Also, you might consider getting an evaluation from a reputed place even on your own dime, and then visit them monthly for a check-in while you get the therapy at home or at the university program, hoping there is one.
I just realized that you did not ask for suggestions...oh well...HTH anyway...

P&PT...

[WatchingThemGrow]

If he's old enough for K in the fall (I have one that age too) he should be able to get services through your school district. I know he's in private, but the public school system should be able to at least test him and provide those services for him, as far as I understand. It's kinda like 2 friends I know who homeschool their kids...and still bring them to speech therapy within the school district, at a school site.

[Still-in-Shock]

in work!

[dcmom2b3]

Mojo and prayers headed your way. And this: :hug: x100

[TwinFoxes]

PPT. I agree that paying out of pocket would be worth it. Sometimes private practices will negotiate with you for a lower fee.

[123LuckyMom]

Mojo and P&PT! Everything I've got in my arsenal of helping everything work out, I'm sending that your way!

[kittymom]

I'm so sorry. I have noticed big changes in insurance coverage for my physical therapy patients in adult outpatient ortho. Insurance companies that had great coverage are cracking down big time as well as ones that provided mediocre coverage. As a provider we are noticing they are really cutting PT, OT and ST services but still paying out for big medical procedures etc. It is a shame bc we can provide services that will save them money in the long run but it's all about politics. The medical associations have a lot of power than allied health lobbying. :(

[elektra]

Many pts. It makes me so sad that those of us lucky enough to have insurance are at the mercy of insurance providers who don't know anything about our kids.

:yeahthat:

[MamaMolly]

P&PT on the way and bumping!!

[lizzywednesday]

Thinking of you guys with hope that Greenbean will get everything that he needs ... and sending lots of hugs. :grouphug:

Also, I just found this lovely post online while searching for a patron saint of ASD and/or SPD, which I hope may bring you & Greenbean comfort in the future:

http://asksistermarymartha.blogspot.com/2010/08/flying-high-for-austism.html (So, according to the blog writer, St. Joseph of Cupertino is apparently a wonderful match for folks with ASD and SPD. He certainly suits better than Sts. Bartholomew & Dymphna, IMO.)

[Kindra178]

is private pay an option? Our State also is very restrictive but there are many private pay practitioners out there.

I was thinking this as well. Many providers here will charge a lower rate to their private pay patients.

Also, see if you can pull the actual insurance contract and see what their OT policy is. Ours covers a certain number of visits a year (45 or so) plus a co pay. Beyond that, it would be a losing fight. I believe once you reach the max you are entitled to a lower rate though.

Don't be afraid to appeal any insurance decision. Write letters, etc.