Services Denied!!! Advice?....UPDATE!!!
Hello ladies! Ive posted more than several times about my struggles with Ryan. He will be 3yr in a few weeks. He's very aggressive. He has been diagnosed with Autism, ADHD, Disruptive Behavior Disorder, and a TIc Disorder. So I have all of his Drs aggreeing on the diagnosis, school and in-home services. They all have mentioned meds but I don't want that just yet. Id like the training before I resort to that. I got him into a special-ed preschool and his first day is Oct 28th. So I found a wonderful organization that fit exactly what I wanted for Ryan and the family as far as help and training within the home. I submitted to the health insurance. Yeah it was denied. They denied it because they said my husbands work has to add ABA therapy on, right now the company doesn't allow it to be coverred so I have to submit a form to my husbands HR dpt which will be handed in on monday. The insurance company said they cover all out-patiendt behavioral health unlimitied amount but not ABA or anything under Autism. So has anyone experienced this and found a way to get the services. I feel lost and beyond stressed trying to fight for something this family clearly needs. Any suggestions and or advice would be greatly appreciated. Hugs!
UPDATE: First Id like to thank you all for your support and replies. It means more to me than you ladies will every know. So the update is Im fighting the fight with insurance company. I submitted the form to my husbands HR dpt and the HR dpt is contacting the insurance to see what they can do to help us since Ryan has several dianosis maybe they can get it covered under somthing else, differenct diagnosis or procedure code. Ryan's pediatrician is also calling the insurance company to let them know how severe Ryan is and that we need these services. So with all that going on and stressing me out the organziation that I want to provide the in-home ABA is awesome. They had a staff meeting and training and Ryan and I got brought up and several staff memebers want to help us for free! For how long I don't know but hey it buys me some time while I fight the fight to get this approved and Ryan isn't left without services. So this gives me some peace. I just wanted to share a little bit of good news since I don't feel like I have that much good to share most days. Thanks again ladies!!!