VENT - I Swear it's a Conspiracy!
By Raven7317
@Raven7317 (691)
United States
March 19, 2013 10:14am CST
I'm so frustrated right now! My son needs feeding OT, and has recently been confirmed as having a sensory processing dysregulation, so he needs sensory OT...
There are ONLY TWO places within a 25 mile radius that provide these services...
One provider, doesn't provide both services... the other provider is out of my insurance network! ARGH!!!
So to stay within network, I would have to delay one course of treatment as to get both at the same time would be OT double dipping. I would have to drive 45 minutes there, 45 minutes back, twice a week, after school for several months... and THEN I have to start all over for the other OT sessions...
To get both services at once, I have to fight insurance company!
I swear, it's sickening! This is a little boy who needs services, insurance that I pay for should cover what he needs without bickering about who has what contract!
To be fair, a few years ago, I did request out of network services for him and they were approved, so I am keeping my fingers crossed... But I've also been told the insurance companies are really buckling down... One service providor told me she's NEVER seen my insurance company approve out of network services... (SIGH)
Thanks for listening.
3 responses
@katsmeow1213 (28716)
• United States
19 Mar 13
Sounds like a major pain. I think all these reforms have just made it harder on everyone to get the services they need.. but it was supposed to make it easier?
@Raven7317 (691)
• United States
21 Mar 13
I know, right?? This is one of those times where I can see the benefit of universal care... we all may have to wait a little longer for services, but we would at least know we are going to get them! OK - I wouldn't support it...but it's an angry response to what really frustrates me because not knowing is the worst feeling... esp for moms... Thank you for the response.
BTW - I've been gone a while, but you and I have had nice 'conversations' in the past... I hope you and yours are well.
@katsmeow1213 (28716)
• United States
21 Mar 13
Thanks, same to you.
I'm very much against the idea of universal care. It doesn't work well in Canada and I don't think it would work well here. The thought that worries me the most is that it would be completely government controlled.. and look at everything else controlled by the government and how well that's doing!
@Raven7317 (691)
• United States
21 Mar 13
Yeah, the government needs to back up out of our homes and schools! I don't know alot about the concept of universal care, but I would say where there are some pros, there are more cons... and we'd only be be dancing thru different hoops to get anywhere...
@dorannmwin (36392)
• United States
22 Mar 13
I really feel like when it is a specialized need like your son has that there really shouldn't be network providers. However, I also know that this is not something that is ever going to happen because of the way that insurance works in general.
The only hope that I can have is not something that is going to happen right away, but rather a change that might happen over the next few years and that is that insurance and providers are deregulated.
In the mean time, I wish you the best of luck with getting the therapy for your son that he needs.
@ctryhnny (3460)
• United States
19 Mar 13
That's what we are here for....to give any advice that we can and be a shoulder to cry on. I do it often enough...lol....My daughter had a problem something like yours since she has a daughter who has Downes Syndrome. She had to do a lot of fighting to get the services my granddaughter needed. You really have to be your own advocate for these things. I'm sorry to hear about this and hope things work out for you and your son. My prayers are with you.
@Raven7317 (691)
• United States
21 Mar 13
AWW you're so sweet, thank you! I realized early on that my guy was going to need extra support and thank the Gods someone told me to seek support for ME as his mom/advocate... His first year of K I followed that advice and got an advocate to assist me with the school system, so at least the schools know I'm not a mom to mess around with... I'm not going to let THEM tell ME the best way to handle anything with my son... so my advocate is great, but she can't help with the insurance companies... Thank you so much for your kind words... I'm sure it will all work out because I'm strong and my strength is what my little guy needs.
Warmest wishes.
