Unbelievable - Insurance Co.

This beats all. My daughter will in a long term hospital was seen by a nuropschologist. He asked if she had ever had any head trauma which she had. He wanted to run some tests. The ins co. said it was not covered. I told the dr. I would pay for it & he was only going to charge me 1/2 of his normal fee. The insurance co. said I could not pay for it. That there was to be an all inclusive price for her stay at this hospital. Even when they were told that this was not a normal test. They said no. I just don't believe it. The dr. thinks a majority of her problem may be due to her injury to her frontal lobe and this would tell us. I'm at a loss. I'm trying to find anything to help and they are saying NO! Unbelievable. Sorry to rant.

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Me:mom - Tired
difficult child: 16 year old daughter - severe depression, ODD, testing for AD/HD
Current medications: Tegratol, Seroquel

 

There are ways to fight insurance companies. This is utterly ridiculous and I share your bewilderment. Call the insurance company and start by asking for the manager of the claims department. If you don't get any satisfaction, ask them how to get a mediation hearing scheduled.

I wish you much luck with this. It's terrible that they won't support your efforts to help your child.

Suz

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Married 21+ yrs to husband. 1 son age 16, adopted at age 4. Diagnosed ADHD combined type (severe), ODD,Learning Disability (LD),Disthymic Disorder (chronic depression), possible Reactive Attachment Disorder (RAD)

 

Dear PB,

Afraid I can't help much with the insurance company, but I'd say get the testing any way you can.

The dr. told us the same thing about our son. He had suffered a head injury as a toddler. We had him tested and found out that his frontal lobes functioned at a significantly
lower level than the rest of his brain.

The new information called for a change in medications. Since then life has been much better. There are still good days and bad, but the violent rages have decreased and the good times are becoming more prevalent. We even went to a theme park and actually had a good time with no arguing.

We are currently working on alternative therapies that may help him to gain more control over his emotions. We just started on Monday, so I don't know how things will turn out. But it's amazing how much more empowered we feel knowing that we are fighting something physical that may one day be controlled even if not cured.

Hang in there. Fight for your rights as her parent. Even if you find no brain damage, at least you know that you tried and that another possible cause has been ruled out.

Talk to anyone that will listen. Ask if there is an appeals process for the insurance company....keep pestering and calling and asking for the next level of managers. Hopefully, you will find someone who can help.

Good Luck!!!!
exegk

 

Call or tell the insurance company you are going to call The State Insurance Commissioner. Itf The state gets too many complaints the hospital can not get insurance payments. The insurance companies are known to have a different attitude onece the State insurance Commissioner is even mentioned! Good luck!

Here is the link that will tell you how your state rates:
https://web.archive.org/web/20111221225924/http://www.npaf.org/content/state-state

Ps. Can anyone put these sites in the archives? These sites give all the state's Insurance Commissioners.

Nana

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Nana - RN working full time, on Paxil, Guardian and Grandmom to 13 yr.old difficult child

husband 25 yrs sobriety, Post Coronary bypass, Drug and alcohol counselor,
Guardian and Grandpa to difficult child.

difficult child- 13 yr old ADHD/ODD-Explosive Mood Disorder, possible emerging Bipolar, Possible PTSS Takes Depakote 1000 mg 2 x a day and Seroguel 100 mg in am and 300 mg at bedtime

 

I will call the ins. co. tomorrow. Exegk you give me hope. My daughter accident was 3 years ago. She was rollerblading without a helmet. She went head/face first into the pavement. She was unconcious for 10-15 min. and then in & out for the next 24 hrs. She did have a concussion. The nuropsy said the frontal lobes control impulse & executive thinking I am happy to hear that things are better fot you. I am hoping for the same.

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Me:mom - Tired
difficult child: 16 year old daughter - severe depression, ODD, testing for AD/HD
Current medications: Tegratol, Seroquel