Sunday, June 29, 2014

I'd Like To Thank My Health Insurance...

Way back in October, the school recommended that Nicholas see an outside therapist.

Take a step back - not time-wise, people. I mean back from the blog content for a second. I've been wondering how to phrase this issue. I've been wondering if I should even speak about this issue. Nick isn't a baby. He is a now 10-year-old boy with his own thoughts and his own life and above all his own right to privacy. I can't be a good parent and be explicit or detailed with his issues here. 

Dealing with these issues, however, is a different matter. And that is where the focus of this post is.

What the heck is she talking about, you wonder?

Well... way back in October, the school recommended that Nicholas see an outside therapist. There were issues, and the teacher, the guidance counselor, and the principal all seemed to think this was a good idea.

After some calling around, some filling out of forms, many voicemails.... do you know how difficult this was? It's the golden triangle of Therapists. 1 - Willing to work with children, 2 - Will take my insurance, 3 - Had appointment times NOT during school hours.

We found someone. Nick started to see her.

She recommended something called neuropsychological testing be done. This is a test to find out how the brain is working. Look it up if you have questions, because I can't explain it now. This began phone calls to the insurance company to see if they'd cover the testing, and to another center who does the actual testing.

Meanwhile, issues at school got a little worse. There were more meetings. More issues. We assured them we were trying.

An appointment was made, weeks in advance. Not for a test, but for an intake. A week before the date I got a phone call saying the therapist had to cancel because she wasn't taking new patients. I explained we didn't want to be a long time patient, just needed this one test done. At which point I was told the therapist just didn't take our insurance. Something I feel should have been noticed when I MADE THE APPOINTMENT.

So I scheduled again. For a month later.

I brought Nick with me to the intake, which apparently is never done. But the nice Therapist #2 seemed OK with it, and recommended that we schedule testing - we scheduled 6 hours of it, over 2 days. Both scheduled weeks ahead.

Only THEN Therapist #2 called us and told us our insurance company wouldn't cover the testing. To pay out of pocket would mean a rate of $200/hr, for a possible 13 total hours. THANK YOU, INSURANCE COMPANY! 

Instead, our insurance company wanted him to have something called a "Comprehensive Diagnostic Evaluation."

When I called to make the appointment for this, the nice lady scheduling the appointment called it the "Medication Evaluation." I know there are those of you out there who think pills solve a lot of problems, but I honestly feel the damn test should be called something else. I don't want him on meds IF HE HASN'T BEEN TESTED FOR EVERYTHING ELSE!

Anyway, Steve and I sat down for yet ANOTHER intake - the get-to-know-your-kid appointment which is an hour of history, which you have to do with each new person they make you see. Therapist #3 seems really nice, is prepared to to this evaluation, and based on her assessment we'll know if we can have / should have the neuropsychological testing.

My feelings? Well, this is the first therapist who asked for a form to be filled out by his teacher. Of course, this meeting took place the FIRST MONDAY OF SUMMER VACATION.

I mean, the TIME it takes. And this is time sensitive, because this crap started back in October. I know no one wants to be rushed, but this is ALL of the third grade, here, that we've been trying to get something actually done, but we've been jumping through hoops. 

A task made more difficult because, oh yeah, we're in the middle of getting divorced and I am working for the first time in a billion years.

Also, I'm a little apprehensive because Therapist #3 - a lovely lady - seems a bit over-ready to slap an ADHD label onto my son. And while I know it's not off the table, I've MET kids with ADHD  - Nick isn't like them. I've also met kids with Asperger's, and Nick isn't like that. While everyone is different, I feel like Nick deserves to be looked at before diagnosed, and I'm not sure that's actually happening with this new round of testing.

I hate it. I hate it. I feel like it's made this difficult because they actually want you to drop out of the race and leave them alone. Then, of anything goes wrong, they can blame you for being a bad parent and not following through. But if you DO try to follow through, they just recommend you see a different therapist, and you have to start all over again, add another month or two to your sentence, fill out another round of paperwork.

Nick starts school in two months. We'll se how much has changed before then.

3 comments:

Anne-E. said...

Ugh. This kind of bureaucracy is so frustrating! It's like a Kafka novel. Their primary goal is to make you feel like you're insane. But Nick is in good hands with you as a parent; he couldn't be luckier. You are going to give him the help and guidance he needs. Love and hugs!!!!

Lindax0x0x0x0x said...

What Anne-E said!

Chad said...

This whole situation really sucks! I'm sorry you have to go through it all. I'll be sending you positive thoughts and hope everything works out for the best for all of you!