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Parent Support Forums
Substance Abuse
update on son: found hospital/Residential Treatment Center (RTC) but there's a hitch...
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<blockquote data-quote="recovering doormat" data-source="post: 225645" data-attributes="member: 5941"><p>Last time I posted our son had agreed to try a wilderness program in the Adirondacks, but my ex and I after much thought have decided that we should stick with our first choice, a hospital diagnostic program that steps down to an Residential Treatment Center (RTC). The judge knew and approved of it, and three kids in our district are currently placed there.</p><p></p><p>Our son has been accepted into the program but there's a problem, a big one: the facility requires that the insurance carrier precertify the child's stay, and the carrier won't precertify until we show up on their doorstep and they examine our child, then call the carrier's Care Advocate to see if they will precertify on medical necessity.</p><p></p><p>I'm just sick about this. Today we finally nailed down the school district to take responsibility for the $200/day educational costs that we would otherwise pay out of our own pocket, and now we might not get him in.</p><p></p><p>Or, we just bite the bullet and sign a responsibility contract and pay for the bulk of it ourselves.</p><p></p><p>I'm sure my ex is going to hesitate about that part. He is also already fretting that our son won't let us get him in the car to take him to PA when a bed is available (he has told us he won't go and since it's out of our state, the juvenile court can't help us with transport).</p><p></p><p>I was so happy that we were going to get this resolved, and now it looks like it's unraveling.</p><p></p><p>Have you ever heard of an insurance company not precertifying ahead of time, with a kids' physician?</p></blockquote><p></p>
[QUOTE="recovering doormat, post: 225645, member: 5941"] Last time I posted our son had agreed to try a wilderness program in the Adirondacks, but my ex and I after much thought have decided that we should stick with our first choice, a hospital diagnostic program that steps down to an Residential Treatment Center (RTC). The judge knew and approved of it, and three kids in our district are currently placed there. Our son has been accepted into the program but there's a problem, a big one: the facility requires that the insurance carrier precertify the child's stay, and the carrier won't precertify until we show up on their doorstep and they examine our child, then call the carrier's Care Advocate to see if they will precertify on medical necessity. I'm just sick about this. Today we finally nailed down the school district to take responsibility for the $200/day educational costs that we would otherwise pay out of our own pocket, and now we might not get him in. Or, we just bite the bullet and sign a responsibility contract and pay for the bulk of it ourselves. I'm sure my ex is going to hesitate about that part. He is also already fretting that our son won't let us get him in the car to take him to PA when a bed is available (he has told us he won't go and since it's out of our state, the juvenile court can't help us with transport). I was so happy that we were going to get this resolved, and now it looks like it's unraveling. Have you ever heard of an insurance company not precertifying ahead of time, with a kids' physician? [/QUOTE]
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update on son: found hospital/Residential Treatment Center (RTC) but there's a hitch...
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