So after I spent 15+ hours on the phone with insurance and preauthorization to get Jonah’s speech therapy appointment covered last week, Jonah finally had his “one 45-minute appointment.”
Pre-authorization basically said “insurance is saying speech therapy isn’t covered for this autism DX code.”
When I talked to insurance, they said, “no, autism IS covered, we did not ever deny coverage. Talk to pre-auth again.”
So, I ended up contacting our primary care physician who rewrote ANOTHER speech therapy referral with a secondary “unspecified” diagnosis, which apparently IS covered (according to pre-auth).
I’m putting odds at 50/50 that insurance will actually cover the claim, and I’m not scheduling another appointment until I know for sure.
We never actually resolved the original problem (that I spent those 15+ hours trying to resolve)
But as for the actual appointment… Jonah spent the time playing with toys and shooting the therapist over and over with a nerf gun, while cackling. (Basically building rapport)
It was fine. But I don’t know if I’d say “it was worth it.”
But apparently, it’s the best we can do.
Our next scheduled available appointment is in 3 months…with a completely different therapist.
Hopefully, we won’t have to do it all again…
…but it wouldn’t surprise me if we did.
After we were done, I took Jonah to get ice cream… Lord knows he earned it…and maybe I wanted a bite or two as well… but the ice cream shop was closed. 😭 (When it rains it pours)
Jojo was briefly sad and laid on the ground covering his ears for a few minutes, but was able to pull it together and had fun playing at the adjacent splash pad for the rest of the afternoon.
It’s been about a week. I’ve needed this long to reflect to finally write about our experience with insurance and our healthcare system.
It has been a ridiculous journey. One nobody should have to take, but far too many do on a daily basis.
Something has got to change.
#specialneeds #specialneedsparent #autism #insurance #fightforcoverage #advocacy #ausome