Insurance

The ISPT and The Next Six Months

Writer’s note: This story is the continuation of Dr J. And The Next Six Months, and continues to chronical the process we go through every 6 months to justify the treatment our son recieves. I have decided to document our current renewal to show you how we go about getting our Medical Assistance Behavioral Health Management Organization (yes, they make HMO’s for behavioral health too) to authorize and pay for Behavioral Health Rehabilitation...

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Dr J. And The Next Six Months

Writer’s note: The story below is about our last visit with PT’s Psychologist whom I refer to as Dr J. or sometimes Dr P. I have decided to document our current renewal to show you how we go about getting our Medical Assistance Behavioral Health Management Organization (yes, they make HMO’s for behavioral health too) to authorize and pay for Behavioral Health Rehabilitation Services, which is just a fancy phrase for therapy and...

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Where have we been??

Wow, I just realized that I haven’t updated this site since April. That is quite a long time. A lot has happened these past few months, and almost all of it good. First, the insurance company approved PT’s Therapy Support Assistant for the part of the summer he is at daycare. Yeah, surprised?? After all our luck with the insurance company, I was quite surprised too. Once the agency got the packet in, it wasn’t any problem at...

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Delays, Delays and More Delays

After the last post which was happy and nice, its time to get back to the griping. We have recently gone through a change in behavioral consultants. JZ is no longer with us. She got a better job with a steady paycheck, and actual medical benefits. So we are happy for her. We got a new behavioral consultant which we will call MH for now. We like MH and so does PT. Now, on to the problems. The agency MH works for, made a little screw up. They...

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How We Pay for Autism Services

So I met some people who either know someone who is struggling with autism spectrum disorder or is knowns someone who is. The question I get asked often is how do you pay for the behavioral services PT gets. First is it important to note that we live in Pennsylvania, and things vary from state to state. Here in PA, we do have an autism insurance law. In a nut shell (and please note I am not a legal expert), it requires business that offer...

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Changing the System

I know there are many out there that would say the “system is broken”. There are lots of problems with the system, ranging from how children are identified, to money available for support and treatment of children with Autism and Aspergers. We have recently been slapped in the face by one example of how the system is broken. As we have gone through PT’s treatment and planning for his future needs, we have been told by all...

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