"When one door of happiness closes, another opens;
but often we look so long at the closed door that we do not see the one which has opened for us."
Helen Keller

Monday, November 1, 2010

Insurance and their control

I never in a million years guessed it would be this hard to start Brycen's speech and OT again after moving! I knew we had to complete a new evaluation here, but I guess I figured we could start immediately and he would be out of therapy two weeks at the most since we are transferring to the exact same services here.
Guess I was wrong! It's amazing how much insurance can rule your life in these instances. Yes, we have Medicaid as a back up for speech and OT, but the hospital won't act on that until it has been run through our primary insurance first. We are one of the lucky ones in that our private insurance covers a decent chunk of the first 20 appointments of the year for both types of therapy, and then Medicaid sees both therapies as a necessary treatment for Autism so they will then pick up the rest of the tab. There is no way we could afford to pay $125+ per hour of therapy that he needs out of pocket.
Anyway, so for the last three weeks, we have had to just sit back and wait for BCBS to "pre-authorize" a service that he was already receiving before at a different hospital. Transitioning Brycen to a new therapy place with new people is hard enough as it is (hence the interesting evaulation we had earlier in October where he gave the therapists a clear picture of the not-so-good days), but then to keep him out of it for over a month is just outrageous! If it wasn't for the fact he was in school right now and for us actually knowing how to encourage ways for him to get out his energy through a partial sensory diet or how to encourage sign language and choices, he could have definitely regressed in these areas in a month's time. This is just another reason why it is so important for parents to be actively involved in their child's therapy because you just never know who or what will have control over that time and how long it can be on hiatus.
So, the good news is the pre-auth came in the mail over the weekend and the new clinic called me today to set up his first OT and speech with them on Thursday. The bad news...starting a new routine with him and transitioning him to this is probably not going to be easy:(

1 comment:

  1. Melissa-
    You are such a good mom and advocate for Brycen! Thank you for your updates!
    Laura Zeckser

    ReplyDelete

Autism and Our Family

"Autism"----It's one word that can change the life of a child and family in so many ways. Autism Spectrum Disorders are being diagnosed at a rate of 1 in 68 children currently. If you do not already know someone that has been diagnosed, the statistics say it won't be long before you do.

Our son developed typically until around the time he turned 2 years old. We heard words...we saw him play with other kids...we watched as he played with his toys appropriately...we made eye contact with him...overall we understood his wants and needs. In a matter of a few months, that was all taken away from him. He began lining up toys, lost all of his words and signs except for one word "ball", ignored other kids, could not sleep through the night, lost eye contact and the ability to follow directions, and he had no way of letting us know what he wanted or how he felt. It was heartbreaking to see something happening to our child that we couldn't stop!

Brycen began receiving home therapy 1-2 times per month for about 6 months before we realized it wasn't just developmental delays. We knew it was Autism...we just didn't want to say it outloud to anyone. He was officially diagnosed with Autism (classic form and regressive), as well as Mental Retardation in August 2009 by the University of Iowa Hospitals and Clinics.

We continue to learn as we make our way through this journey with Brycen and we will continue to share this journey with you on this blog! The blog has been a great therapy for us to be able to vent our frustrations and struggles with accepting that we have a child with special needs, while sharing how blessed we are to have a child teach us what life truly means. It has also been a great way to inform others of his progress and changes over the last couple of years.

Thank you for your support of Brycen and our family! We hope you are able to learn something through this blog no matter if you are a parent of a child with special needs or a neurotypical child, a teacher or therapist, a family member, or just someone that is interested in the journey that a family goes on as they learn their child is battling a life-long disorder.