Tuesday, May 20, 2008

Insurance really sucks sometimes.

Last week, I got a bill from Children's Autism clinic for $212. Wondering what was going on, I made some phone calls. It turns out that our insurance denied the claim because it was billed under "family psychotherapy" which falls under mental health that is applied to our deductible. This particular bill was for the last appointment that Greg and I went to, without Ryan. We were to get the results from all of the testing they did on Ryan to determine whether or not he was on the Autism spectrum and to see where he was developmentally. We met with the psychologist for about an hour to discuss his findings and to discuss our concerns.

So after many phone calls to our insurance company, it was determined that the doctor's office would need to re bill the appointment using a different code. They didn't see any reason why it shouldn't be covered since the doctor only gave us the results on the previous appointments that were covered in full. So I called patient accounts who then told me that it was up to the doctor. It took many calls, over several days, to get to the right person to relay the message onto the doctor. He called me back and explained the situation and said they had run into this a couple of times and he would work on it and see if he could bill it under a different code. He did say it could take a while for it go to through but he or his secretary would be in touch.

He also asked about Ryan and how his progress was coming. It hasn't been good. When we first started speech, we noticed a huge improvement in Ryan and then it was like he hit a brick wall and his tantrums have become more frequent and longer in length. And I am not talking about typical 2 year old tantrums. Those I can deal with. It is the sometimes hour long tantrums that result in Ryan going to his crib, until he calms down. He kicks, bangs his head, sometimes for no apparent reason. Sometimes, it is because we can't seem to figure out what he wants in time before the meltdown. When he starts to get fussy, we ask him what he wants and I still feel like he doesn't always know how to answer that question. We have to go down the list of things....Ryan do you want to eat, play, drink, outside, etc. He won't just come out and tell us what he wants and that is all very frustrating for all of us. One step forward, 2 steps back.

The good news is that Ryan's teacher through MRDD noticed his tantrums and how hard it is to get him back down. She is bringing a behavior therapist with her next month and she will be able to come once a month. I am hoping she can give us some suggestions on how to deal with his tantrums. Right now, we ignore it as much as we can and put him in a safe place (crib) when he is in full on meltdown mode.

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