B
butterflydreams
Guest
Sorry if this is so long. This has been an incredibly stressful week. As you all know difficult child was scheduled for a CT Scan on Thursday (to find out what mass is in his brain). Anyway, no results yet.
However, on Monday at treatment team at the psychiatric hospital where difficult child was, the doctor was reviewing that we were thinking that any day our mental health insurance was going to be exhausted. psychiatrist has been in contact for weeks now with a doctor at the state hospital where the Residential Treatment Center (RTC) is that difficult child is on the waiting list for. Anyway, we knew our benefits would have to run out to be accepted over there in the acute. psychiatrist has felt and I have too that difficult child was in no way ready to be home. Well, I received a call Tuesday that it would be the last covered day. psychiatrist had said that difficult child would have to be home for 1 night before being able to be admitted to the state facility. When the nurse called me on Tuesday, she had left a message for psychiatrist, but didn't know what the plan was yet. We didn't know if there was a bed available or not. I went to visit difficult child Tuesday night and he of course thinks he is ready for home and doesn't need to be there. I told him that psychiatrist feels that he is not ready and what we were trying to do. I didn't just want to spring on him after he was home. He of course cried. He doesn't know he is targeted for Residential Treatment Center (RTC), but he suspects. Anyway, Wednesday, I received the call that psychiatrist was in fact releasing difficult child for home to report to the partial hospitalization program at the psychiatric hospital (even though there was no coverage - just a temporary measure). When I went to drop difficult child off at the partial program he was really playing it up that he was sick and couldn't be there, so I called the nurse that had discharged him, fortunately psychiatrist was right there, she relayed to him and he said to take difficult child immediately over to the state facility.
We went over there and immediately ran into roadblocks. They were like this is not how we operate. You need to provide us proof that your insurance benefits are up. They wanted a letter of denial from insurance company. I called. Problem was that they haven't been billed by psychiatric hospital yet, so they couldn't give me anything. They did have a bed available, but they couldn't/wouldn't admit him until I could prove to them that we had no coverage. This is the only state-run facility in the whole state with only 20 acute beds. The Residential Treatment Center (RTC) unit has 38. Anyway, difficult child was home again Thursday night - same situation only even more so that the previous night. I received a phone call from the evening nursing supervisor wondering why they hadn't received fax from insurance. I told her. She proceeded to tell me that well "if I thought I could keep difficult child safe then lets start over in the morning" Like I had a choice!
Well, we started over yesterday morning, I was on the phone with psychiatrist's office and the psychiatric hospital. We were able to assemble information to show how many days difficult child was there and I printed info off insurance website to show what benefit was. I called state psychiatric hospital and told them I would be there shortly. I was told they would review info and see if it was acceptable. We got there about 1:15pm yesterday. Finally about 3pm they said they were going to admit him! By the time I finished all of the paperwork, it was about 5pm and then I had to go home and pack his clothes.
I am sad that I had no choice in the matter, but I know it is best for difficult child. He is in a unit of 6-12 year olds (he is 12). There are 7 kids total in the unit, with a capacity of 10 in that unit. I will be very curious how things go, and the psychiatrist that will see to his care (his psychiatrist doesn't have privileges).
Now we wait for CT results.
Thank you for listening to me, I needed to get this all out.
Christy
However, on Monday at treatment team at the psychiatric hospital where difficult child was, the doctor was reviewing that we were thinking that any day our mental health insurance was going to be exhausted. psychiatrist has been in contact for weeks now with a doctor at the state hospital where the Residential Treatment Center (RTC) is that difficult child is on the waiting list for. Anyway, we knew our benefits would have to run out to be accepted over there in the acute. psychiatrist has felt and I have too that difficult child was in no way ready to be home. Well, I received a call Tuesday that it would be the last covered day. psychiatrist had said that difficult child would have to be home for 1 night before being able to be admitted to the state facility. When the nurse called me on Tuesday, she had left a message for psychiatrist, but didn't know what the plan was yet. We didn't know if there was a bed available or not. I went to visit difficult child Tuesday night and he of course thinks he is ready for home and doesn't need to be there. I told him that psychiatrist feels that he is not ready and what we were trying to do. I didn't just want to spring on him after he was home. He of course cried. He doesn't know he is targeted for Residential Treatment Center (RTC), but he suspects. Anyway, Wednesday, I received the call that psychiatrist was in fact releasing difficult child for home to report to the partial hospitalization program at the psychiatric hospital (even though there was no coverage - just a temporary measure). When I went to drop difficult child off at the partial program he was really playing it up that he was sick and couldn't be there, so I called the nurse that had discharged him, fortunately psychiatrist was right there, she relayed to him and he said to take difficult child immediately over to the state facility.
We went over there and immediately ran into roadblocks. They were like this is not how we operate. You need to provide us proof that your insurance benefits are up. They wanted a letter of denial from insurance company. I called. Problem was that they haven't been billed by psychiatric hospital yet, so they couldn't give me anything. They did have a bed available, but they couldn't/wouldn't admit him until I could prove to them that we had no coverage. This is the only state-run facility in the whole state with only 20 acute beds. The Residential Treatment Center (RTC) unit has 38. Anyway, difficult child was home again Thursday night - same situation only even more so that the previous night. I received a phone call from the evening nursing supervisor wondering why they hadn't received fax from insurance. I told her. She proceeded to tell me that well "if I thought I could keep difficult child safe then lets start over in the morning" Like I had a choice!
Well, we started over yesterday morning, I was on the phone with psychiatrist's office and the psychiatric hospital. We were able to assemble information to show how many days difficult child was there and I printed info off insurance website to show what benefit was. I called state psychiatric hospital and told them I would be there shortly. I was told they would review info and see if it was acceptable. We got there about 1:15pm yesterday. Finally about 3pm they said they were going to admit him! By the time I finished all of the paperwork, it was about 5pm and then I had to go home and pack his clothes.
I am sad that I had no choice in the matter, but I know it is best for difficult child. He is in a unit of 6-12 year olds (he is 12). There are 7 kids total in the unit, with a capacity of 10 in that unit. I will be very curious how things go, and the psychiatrist that will see to his care (his psychiatrist doesn't have privileges).
Now we wait for CT results.
Thank you for listening to me, I needed to get this all out.
Christy
