OMG! Megan's OT/ST bill

coasterqueen wrote: O M G is about all I can say right now.

I just opened Megan's occupational therapy and speech therapy bill and it was $938! This was for one session of each. I was told insurance will more than likely not cover it, but I'm still waiting to hear from them. OMG guys, they are wanting her to go every week! I can't afford this. This just stinks!

Course I'm very upset at myself because I was supposed to check w/the insurance company before going for the eval, but I got too lazy then her appointment got here and I just decided to take her instead of checking on the insurance. So Dh is a little annoyed w/me at the moment.

gr33n3y3z replied: my sister inlaw had the same problem
She found a program though the state that works with him at school even tho he wasnt school age

Kaitlin'smom replied: medical bills just astound me, like the scan DH had on his neck not to long ago, 1200 for a lousy 15 minutes and it told us NOTHING, sure insurance covered part of it but still, so I feel your pain.

coasterqueen replied: Yeah, I'm half way between tears and rage right now. We were there for TWO hours, that's it. Not only that but they told me EVERYTHING I already knew. Both docs even said to me, "you've already done so much research and are so intune with what Megan is going through that we aren't sure what to tell you in this evaluation. Most times we have to explain all this to the parents and you already know." So I am going to have to pay them for almost a grand for telling me something I already knew?!? At least I could have gotten tips and help on dealing with her situation for my $1000!!!!! But know, that's what the weekly appointments will be for. What a crock!

Lisa - we had hoped not to have to rely on the government to pay for her treatments, but if the hospital is going to charge me this much weekly I guess I'm going to have to swallow my pride and let the government pay.

boyohboyohboy replied: Karen we use something called early intervention. Its a free program here in pa, I am not sure where you live, but it was something the ped told us about, and its not a "welfare" type program, although honestly even if it was we would be using it. I think when it comes to kids, and I am sure you are the same way, there is nothing we wouldnt do for them.

this is a state sponsered program that is paid by how much it is used, like government grants..

I can see if there is a web site if you are interested..

boyohboyohboy replied: oops i forgot to mention that they pay for everything and also will go back and pay for medical bills related to the diagnosis, if the dr says thats what it was for. like your dgts case. they paid for feeding clinic and the ot that comes to the house once a week.

coasterqueen replied: Stacy,

Yeah that is the program we have here too. I know it's not a welfare program, but it's still a state funded program and Dh and I have always been ones that really don't want to rely on others for help. I guess we'll find some way to pay for it. Looks like I won't be getting my tile floor. But you are right, when it comes to our kids we'll do what we have to, and I guess that will mean no floor.

Dh and I will talk about it more tonight, who knows maybe he will go for the EI. I'm still holding out hoping the insurance company will pay something for it. We may also look into private therapy, it HAS to be cheaper than what the hospital just billed me. There's no way a private therapist charges $938 an hour.

ETA: Our insurance covered all feeding team visits. Also, I don't what what I said to sound like I'm bad mouthing anyone who does use the program. It's a great program, I know many who have their children in it, it's just our stubborn pride and the way we were raised that keep us from doing it, I guess.

boyohboyohboy replied: early intervention also allows you to use your private insurance as the "first billed" and then does cover the rest also..the insurance co would pay EI

mckayleesmom replied: holy moly.......Did they teach her to spin gold while she was there or something? That is outrageous.

First...I would call the office and ask if that is the standard weekly fee. Some places have an initial consultation fee too.

gr33n3y3z replied:
hun it has nothing to do with pride when it comes to the kids and what insurance wont pay call them up and say hey she really needs this maybe just maybe they will pay for some of it.
I see what your saying and the thing that burns me is this
If your child was in grade K they would do it through the school at no charge and use the child study teams workers.

ZandersMama replied: That SUCKS. I am so happy I live in Canada, I often wonder what Zaviers medicals bill would have added up to if I lived somewhere else. 2 months in intensive care, blood transfusion, ivs, all the tests and procedures he had.........would have added up quick. When it comes to kids, I think it all should be covered.

coasterqueen replied: Update:

I called the insurance company and they are paying for $400 of it. So we still owe $538. Our deductible is $300, and we still had $170 left to pay on it in 2006, so we owe that for sure. The rest ($320) is for the speech visit and the insurance isn't covering any of it because of coding the hospital put on. SO....I have a call into the hospital and waiting to hear from them. I'm trying to appeal the code and have it changed and if so then that should be covered. Then we'll only owe $170. Whew!!!! But as far as future visits who knows.

gr33n3y3z replied:
Thats Great News Karen!!!
Keep us posted

amberlynnie replied: How old is megan? and what state are you in? In NY what i had to do with braden is this... when he was 3 I went into the local elementary school and enrolled him for Kindegarten. I was told I had to do this to establish his "school assignment" even though he would not be attending school for 2 years. I then called that school and asked them to come do an evaluation on my son. They came to our house, and did an evaluation, and determined that he would require ST, OT, and PT. Because this was the SCHOOL'S determination, It became thier burden to provide these services free of charge due to the fact that he would need them in school eventually anyway. He was placed in a special education preschool where he received all three services FREE OF CHARGE. If she has been evaluated and you know she will need these services, move fast so you can get these things going.
Call your local board of education. Ask them about Early Intervention.
EI only goes to age 3, So do it soon.
If I were you I would do this call first before you take her to any other appointments that will cost you that kind of money.
If you have any questions, feel free to ask me, I have dealt with this kind of thing for years, braden is going to be 7 next month.
Goodluck!

Kirstenmumof3 replied: I'm so sorry you are going through this! We had to send Spencer for Occupational Therapy, but it was all covered. I hope that your insurance company will be able to cover some portion of the bill!

MommyToAshley replied: Welcome to our world of self-pay. Doctor bills just plain suck! However, if you call their accounting department and tell them that it is not covered by your insurance, they may reduce the bill if you pay the full amount within 30 days. Most places will reduce it by at least 20%.

We took Ashley to the emergency room when she was 2 years old and it ended up costing us $1200. So, if there was a state funded program available that covered our visit, I would have taken advantage of it. There's no shame in going through a state funded program, that is what they are there for and why you pay taxes to support the programs. It's frustrating to me that we pay taxes for everyone else's insurance, and yet we can't afford full coverage insurance and we don't qualify for any programs and can barely afford the medical costs ourselves. Life just isn't fair sometimes.

MommyToAshley replied: Ooops, just saw your update. Glad things are looking up and you will owe much less now.

mummy2girls replied: OMG Karen!!!!!! im not sure what to say!

Jenna went to speech and occupational therapy and it was all covered by our health system. She goes to that special school every day and its government funded. Makes me sit backa nd thank heavens im in Canada! WOW!

mummy2girls replied:
i know what you mean.. Jordan was in the NICU for 7 days, then the Peds ward for 2 days and then the PICU for 4 days... and then blood etsts, biaposies, and operations and catscans... UGH!!!!!!!

DansMom replied: What a shock! I'm glad you got some of it reduced.

alice&arik replied: Arik goes to speech every week, but our insurance pays for it. I still get a statement saying what it cost and it's $55 for each visit. Here's the kicker---he only goes for a half hour at a time! Sometimes all he does is play the whole time. I am sure glad I don't have to pay it, or else he probably wouldn't be going. I don't know why yours is so expensive, but I know his eval and first visit was like 3x more. Glad you don't have to pay for it all!