judifilksign: (Default)
[personal profile] judifilksign
 So Sparkle's "pre-approved" speech therapy has been denied by our insurance company.  As soon as the speech therapy's office gets us the paperwork, with all the proper numbers, I shall be having long wait times and conversations with the insurance company regarding this BS.

I keep reading online on how this is an ongoing issue with many autistic spectrum therapies.  On paper, it appears to be approved - until you try to use it.  Then, it's denied until you get on the phone and fight for it.

Cost savings through inconvenience.  I bet there's a bunch of people without my stubbornness who'd give up faced with the hassle and bureaucracy.  If they think I'm one of those sheep, they are SADLY mistaken.

Date: 2009-07-30 03:24 am (UTC)
From: [identity profile] geojlc.livejournal.com
yarg! I would be afraid if I worked for your insurance... :-) I hope you get it straightened out sooner than later!

Date: 2009-07-30 03:48 am (UTC)
billroper: (Default)
From: [personal profile] billroper
Good luck!

Date: 2009-07-30 04:02 am (UTC)
kyrielle: painterly drawing of a white woman with large dark-blue-framed glasses, hazel eyes, brown hair, and a suspicious lack of blemishes (Default)
From: [personal profile] kyrielle
Good luck. I hope it's just a minor paperwork mistake. (I've had other things not-approved in the past because of miscoding on the part of the doctor, for example.) Fingers crossed that the first person you get on the line is helpful, friendly, and fixes it all right away - it does happen sometimes, I hope this is one of those times!

Date: 2009-07-30 01:02 pm (UTC)
From: [identity profile] judifilksign.livejournal.com
*crosses fingers* Thank you.

Date: 2009-07-30 04:09 am (UTC)
danceswithlife: (Default)
From: [personal profile] danceswithlife
Judi, I've been a medical claims examiner for over 25 years. If you need a second opinion on an approach to talking to your insurance company I would be happy to help. Email me at lolamccrary at yahoo

Date: 2009-07-30 01:02 pm (UTC)
From: [identity profile] judifilksign.livejournal.com
Thank you. When I get all the relevent paperwork in front of me, if a simple phone call does not clear things up, I shall do that.

Date: 2009-07-30 04:15 am (UTC)
From: [identity profile] wyld-dandelyon.livejournal.com
Yeah. And they do stuff like this to cancer patients and other people who can barely get the mental and physical energy up to make their own dinners. People whose brains aren't working right due to chemotherapy or other issues.

It makes me mad.

I wish you much stamina and patience for dealing with this.

Date: 2009-07-30 04:54 am (UTC)
From: [identity profile] carmiel.livejournal.com
This sort of thing is why I'm don't accept insurance for massages. I have BIG ethical problems with the way the insurance industry does business.

For example, colleagues I've talked to tell me they charge insurance claims at 20% more than a cash client because they fail to pay about 20% of claims. Doctors, PTs, Chiropractors etc. are treated the same way. So medical providers over charge just to get what they're entitled to, so the insurance compancy justifies denying claims because they get charged more.

Just my opinion, but *this* is why US health care is so screwed up.

Date: 2009-07-30 05:16 am (UTC)
From: [identity profile] admnaismith.livejournal.com
Oh dammit. I almost feel sorry for them, messing with you and not knowing what's about to hit them.

almost.

Well, not really.

When you're kicking their green-bleeding corporate asses, be sure and throw in a couple extra licks for Shiny too, OK?

Date: 2009-07-30 01:05 pm (UTC)
From: [identity profile] judifilksign.livejournal.com
I think what chafes the most is that we set this up this summer *because* it was on a list of "pre-approved" services, for 20 sessions. Just enough to cover Summer.

Date: 2009-07-30 06:07 am (UTC)
From: [identity profile] raishaan.livejournal.com
I don't feel sorry for them at all...:) I agree with carmiel and maybe a little more. The insurance companies business methods are deplorable and IMHO have a lot to do with why the medical care system in this country is so badly broken.

Go get 'em! Show them no quarter! Arrrr! :)

Date: 2009-07-30 06:22 am (UTC)
From: [identity profile] carmiel.livejournal.com
no quarter, NO QUARTER! You damn well earned your fate...

Date: 2009-07-30 01:06 pm (UTC)
From: [identity profile] judifilksign.livejournal.com
Yeah, but their side wants to give "no quarters," or any other kind of change, either.

Date: 2009-07-30 11:34 am (UTC)
From: [identity profile] smoooom.livejournal.com
Sparkle is lucky to have a Mom willing to fight. I am amazed and astounded that the school board your with doesn't have this. Vicky was in a speech program from halfway through JK till grade 2 or 3. Or are schools different south of the boarder as well,

Date: 2009-07-30 01:00 pm (UTC)
From: [identity profile] judifilksign.livejournal.com
She will have school-run speech therapy, but only during the school year. Due to the levy being put down three times in a row, not only do we have no sports, nor any other extracurriculars, but we also have no summer programming, for anyone.

Date: 2009-07-30 01:10 pm (UTC)
From: [identity profile] smoooom.livejournal.com
Ahhhh, Vicky got me during the Summer, with ideas from the Speech therapist, Vicky's problems were easy though. Sparkles (I suspect) are quite a bit more complex.

Date: 2009-07-31 12:05 am (UTC)
From: [identity profile] mewsrissicat.livejournal.com
Hands you nail-bat.

Date: 2009-07-31 01:35 am (UTC)
From: [identity profile] catsittingstill.livejournal.com
Sparkle is lucky to have a mom like you.

And I have great faith in your patience and persistence and generally kindly nature with a fist of steel underneath.

Date: 2009-07-31 01:48 am (UTC)
From: [identity profile] judifilksign.livejournal.com
Now, now. I have soft, gentle hands covered with velveteen gloves, but I know when to put on the mailed gauntlets over them to *make* those fists of steel.

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