neuropsychologist evaluation

Discussion in 'General Parenting' started by Kjs, Sep 30, 2007.

  1. Kjs

    Kjs Guest

    Ok..I have been pulling my hair out with difficult child and school. Somedays I think it is him, others I think it is teachers and sometimes I honestly believe it is not in his control.

    Ever since he was 2 - 3 years old he could be this nicest kid, then in an instant be this screaming, mean scary kid. 4th and 5th grade the worst. He threw books, talked back, flipped over his desk...Then we took him in and he started on Lamictal. Also came the change to middle school. We have not seen that side of him in a very long time.(anger) Blurts out inappropriate remarks that get him kicked out. Other issues at school. So, I am really wondering if he has out grown that part or if it is the Lamictal that is keeping it in check. I am second guessing everything, wondering if he really needs the medication, if it is the wrong medication. So...I called the behavior health portion of my insurance on Friday. The Childrens hospital/medical college is about 30 miles away. The insurance man told me:
    They will approve an intial "intake" visit. I must call him with the name of ONE psychologist. They will not pay for a TEAM.
    After the initial visit the psychologist must send the papers back stating what kind of testing they want to do. Then they will approve a certain number of hours for testing. (not by a team) However, in the end, the insurance payment is decided on the diagnosis. ????
    ADHD..mood covered. Tic disorder is covered, however Tourrettes is not. Autism is covered, aspergers is not.

    So, how can I get an accurate diagnosis, if he cannot be tested by a team and their specialties? He has had some real sensitivities with noise when he was younger. Flicker lights, clock getting stuck and buzzing(at school). fire alarms, french fry buzzer at fast food places. Buzzers at sporting events. He has trouble writing, hence the computer use in his IEP. Has trouble transferring information from board/overhead to paper. Weak visual skills, superior auditory skills. (probably since he has such difficult time writing. says his hands hurt)

    These are all situations that teachers kick him out of class for. It angers me that even when he is quiet he is kicked out of class. That is his strongest learning listen.
    He loses absolutely everything. Any homework he does he forgets to turn it in or loses it. Eventually finds it but loses points. Class supplies are just never there. I buy them, I send them and he has no idea what happens to them. School text books..How can you go to class with a book and then lose it?
    He is very bright. Teachers comment on how even when he looks like he isn't paying attention, he knows the answers. Just has a difficult time writing them down. Talks. He can walk up to a stranger and carry on a conversation like he's known them his entire life. But..people talk to him too.

    I was hoping that with a neuropsychologist evaluation maybe I could get a definate diagnosis..and help him overcome these difficulties. Don't know if I will get an accurate diagnosis if the insurance only pays for limited testing...and THEN it depends on the diagnosis.

    Been thinking of speaking to his psychiatrist about coming off the Lamictal. Scary thought. But maybe he doesn't need that anymore. He doesn't seem to have the anger he once had. Seems sad a lot. Quiet. Is that his age? Or is he depressed? I KNOW he has a lot of anxiety about so many things. Different things.
  2. nvts

    nvts Active Member

    Autism is covered but Aspergers is not? Wow, I'm so impressed that this guy reclassified Aspergers out of the autistic spectrum!

    Total dork - this guy doesn't know his [edited by adm] from his elbow. Call the insurance company back and ask for a supervisor. This doesn't make any sense - I'm so curious as to the rational behind these classifications. I suspect this guy is not up on his coverages. I've had a LOT of luck escalating and being their "best friend" and acting confused. Once they start their double-talk, you catch 'em and they approve it! :wink:

    Go for the intake and explain the double talk as far as coverage. Most of the time, they submit the billing to the insurance company from the facility NOT the individual team members so the insurance company pays based on the testing as opposed to the titles of the team members. Also, you can talk to their billing department. Make sure that you appear to be most concerned that they would be paid right. Once you get them on your side, they will apply the best coding toward the bill. Again, more flies with sugar approach.

    Don't let this one clown prevent you from getting an accurate diagnosis.

    Rooting for you from here!

  3. Kjs

    Kjs Guest

    I called the Insurance company to inform date of appointment and Dr.'s name.

    insurance company man called back shortly to inform me that Childrens Hospital of Wisconsin pulled out of network last month.

    he then gave me two names. One in my town, one about 20 miles away. I called the one in my town. Not accepting new patients.

    Called the next closest and was told they do not do any insurance billing. Must pay upfront and file any insurance myself. Not going to happen. Don't have the upfront cost.

    So, back to square one.
  4. Wiped Out

    Wiped Out Well-Known Member Staff Member

    I'm sorry there is nothing close to you. What about Milwaukee? Madison? I know it's a drive to Madison but there are some very good ones here.
  5. Kjs

    Kjs Guest

    Milwaukee is 30 - 40 miles. Did a search on 30 miles and the only thing that showed up was in Illinois. Except the ONE in my town that isn't accepting new patients.
    Will have to increase the search criteria. you live near Madison? I forget. You are my hometown girl correct? Gee. Maybe a visit is in the future.
  6. Big Bad Kitty

    Big Bad Kitty lolcat

    If you are going as far as Madison, you may as well come out to Chicago.

    Children's Memorial, Loyola, Rush-Presbyterian-St. Luke's, and University of Chicago are all highly accredited hospitals. You could stay at your sister's.
  7. susiestar

    susiestar Roll With It

    Wherever you go, make sure that you make friends with the billing dept. I have a friend who does billing and her docs resend info three or more times to companies, tweaking diagnosis's as needed.

    Talk to your state insurance board. If there is no doctor in your area taking new patients, then the ins co and be forced to pay for another doctor.


  8. tiredmommy

    tiredmommy Well-Known Member

    Hi Kjs,
    I've finally gotten a chance to read this post, and I realized it's in the wrong forum! I'll go ahead and move it to General now.