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Questions... pulling my hair out.
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<blockquote data-quote="Andy" data-source="post: 331831" data-attributes="member: 5096"><p>Insurances need procedure codes to know how something will be billed and you would need to get that from the offices your are going to. Once they accept your child as a patient, the first step will be a consultation. The office should be able to tell you the correct terminology and procedure code they bill this as so you can contact the insurance company. </p><p> </p><p>I just went through something similar for the neuropsychologist evaluation my difficult child had. The insurance company asked me for specific terminology of why this was being done. If I used English, it would have been denied because the medical world has their own definition of every day words. I had to give them the terms and codes the neurology office gave to me.</p><p> </p><p>After your first visit, the doctor can then provide a treatment plan with different codes and terminology to pass by your insurance to see what will be covered. Sometimes the insurance company can tell you with the consult info what further items would be covered. I was told that if the neuropysch testing was to only diagnosis a specific learning disability, insurance would not cover since they believe schools can test even though schools will drag their feet for years and years until the child outgrows that school and it will never get done unless there is a severe case the SCHOOL wants tested (Schools can care less what parents or doctors ask for).</p><p> </p><p>We definetly need more specialists in every field. The waiting list is forever for everyone and like you said, even a few months is a large chunk of time lost in a child's life. The needs out there are just so great. So many kids looking for help. I would talk to the doctor giving the referral about your specific concerns and see if his office can't speed up that time line. Usually an urgency from another professional is taken more seriously than an urgency from a parent even those who are as well informed as you are in the development of your child.</p><p> </p><p>I hate that they say they don't "THINK" they are the right place. How do they know until they have that consultation? They need to go through the steps of gathering and reviewing what they need before making that decision. I would keep pushing that card, "My child's doctor believes that you MIGHT be able to help us. Referrals are not handed out unless there is an inkling that that would be the correct route."</p></blockquote><p></p>
[QUOTE="Andy, post: 331831, member: 5096"] Insurances need procedure codes to know how something will be billed and you would need to get that from the offices your are going to. Once they accept your child as a patient, the first step will be a consultation. The office should be able to tell you the correct terminology and procedure code they bill this as so you can contact the insurance company. I just went through something similar for the neuropsychologist evaluation my difficult child had. The insurance company asked me for specific terminology of why this was being done. If I used English, it would have been denied because the medical world has their own definition of every day words. I had to give them the terms and codes the neurology office gave to me. After your first visit, the doctor can then provide a treatment plan with different codes and terminology to pass by your insurance to see what will be covered. Sometimes the insurance company can tell you with the consult info what further items would be covered. I was told that if the neuropysch testing was to only diagnosis a specific learning disability, insurance would not cover since they believe schools can test even though schools will drag their feet for years and years until the child outgrows that school and it will never get done unless there is a severe case the SCHOOL wants tested (Schools can care less what parents or doctors ask for). We definetly need more specialists in every field. The waiting list is forever for everyone and like you said, even a few months is a large chunk of time lost in a child's life. The needs out there are just so great. So many kids looking for help. I would talk to the doctor giving the referral about your specific concerns and see if his office can't speed up that time line. Usually an urgency from another professional is taken more seriously than an urgency from a parent even those who are as well informed as you are in the development of your child. I hate that they say they don't "THINK" they are the right place. How do they know until they have that consultation? They need to go through the steps of gathering and reviewing what they need before making that decision. I would keep pushing that card, "My child's doctor believes that you MIGHT be able to help us. Referrals are not handed out unless there is an inkling that that would be the correct route." [/QUOTE]
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