Back to Square One

We're back to right where we started with Speech Therapy and our insurance. The ST can not bill our insurance using an Early Intervention code because they are a private practice and not affiliated with EI. We, again, have no coverage for ST.

I called our insurance for the umptheenth time about this and was told that unless it's coded under EI, it will not be covered. The rep kept calling it a developmental delay and at the third time, I lost it. I yelled at her that it was a neurological disorder and NOT a developmental delay. I told her that he was officially and clinically diagnosed as having Autistic Disorder which qualifies him as having a disorder. I told her not to call autism a developmental delay again with me on the phone and that she needs further educating on this. I'm sure I was out of line, but I've had it with being told "No".

There is that law called a parity law that states they need to treat autism like any other disability, but there might be a loophole there. They only cover OT, ST, and PT if there was an injury that caused the speech delay. So they might not cover any disability with OT, PT, or ST. That's something we need to look into. We're also pursuing an appeal process with our insurance company to get him covered for these services outside of EI. I've filed a grievance and we plan on filing one with our States insurance and health department. We're leaving no stone unturned.

Right now, we will be paying for ST out of pocket because Wes needs this and I won't wait 3-4 months for EI to get him to the top of the list and find someone to work with him. He needs it now, not later. We will figure it out and keep all receipts in case we win the appeal and can have them paid for later.

I'm already feeling beat by this. What we do for our children..