Join the Meeting Place for Moms!
Talk to other moms, share advice, and have fun!

(minimum 6 characters)

this doesn't sound right to me

Posted by on Aug. 5, 2014 at 7:59 PM
  • 11 Replies

So I took my daughter to her phyciatrist yesterday (she is just a nure practiner phyciatrist) and addressed a lot of concerns I have on my daughter.  Well then she started talking about how she wont diagnose my daughter with autism because then her insurance (Iowa medicaid) wouldn't pay for anything but yet they are lableing her as PDD in her notes only but not really giving the full diagnoses.  Does that sound right.  I thought PDD was a form of autism so why would the insurance pay for things with just a PDD diagnoses but yet if you come out and say autism they wont pay.  We have been talking about this for a whole year and she just now tells me this.   How am I supposed to get my daughter help if we can't get a full diagnoses on her?   She did tell me to go get a second, third and even forth appinion and she is even trying to find someone that will take Paiges insurance.  I just didn't think it sounded right that a insurance company will pay for a PDD diagnoses but not a Autism on but yet I just saw 2 weeks ago in the paper were the state is dishing out over a million dollers to send kids with autism to a therapist that specializes just in autism so they can get the help they need to be on their awn as adults.   Its all so confusing to me

baby
baby growth
baby
by on Aug. 5, 2014 at 7:59 PM
Add your quick reply below:
You must be a member to reply to this post.
Replies (1-10):
Momof4AEMW
by Platinum Member on Aug. 5, 2014 at 9:14 PM

I have 3 kids in Iowa on Medicaid with diagnoses of Autism, ADHD, down syndrome,  hearing impairment, developmental delay (all our primary insurance excludes for) and medicaid picks up EVERYTHING!  I'd get that 2nd, 3rd, 4th opinion and get your diagnosis if she has autism.  Two of mine have Autism, they get additional therapies (like ABA) paid for by medicaid because of their diagnosis.  It covers all their OT, PT, Speech, sensory, and feeding therapies as well.

Nicole_2007
by Member on Aug. 5, 2014 at 9:19 PM

TY I didn't think it sounded right to me.  She is having me go to therapy in 2 weeks because she feels like I don't understand anything she tells me.  I really don't like her much

Quoting Momof4AEMW:

I have 3 kids in Iowa on Medicaid with diagnoses of Autism, ADHD, down syndrome,  hearing impairment, developmental delay (all our primary insurance excludes for) and medicaid picks up EVERYTHING!  I'd get that 2nd, 3rd, 4th opinion and get your diagnosis if she has autism.  Two of mine have Autism, they get additional therapies (like ABA) paid for by medicaid because of their diagnosis.  It covers all their OT, PT, Speech, sensory, and feeding therapies as well.


baby
baby growth
baby
Anoronlight
by Bronze Member on Aug. 5, 2014 at 9:21 PM
That's a crock, Medicaid is paying for autism treatments. I suggest getting another opinion. You are right though, PDD is a form, however she has her info backwards. No one will pay for anything related, unless it's an autism diagnoses. Plus under the new DSM, PDD doesn't technically exist any more, even though most still recognize it as such. For insurance reasons, they will all go by the new DSM.
Momof4AEMW
by Platinum Member on Aug. 5, 2014 at 9:22 PM

sounds like time for a new doctor. 

Quoting Nicole_2007:

TY I didn't think it sounded right to me.  She is having me go to therapy in 2 weeks because she feels like I don't understand anything she tells me.  I really don't like her much

Quoting Momof4AEMW:

I have 3 kids in Iowa on Medicaid with diagnoses of Autism, ADHD, down syndrome,  hearing impairment, developmental delay (all our primary insurance excludes for) and medicaid picks up EVERYTHING!  I'd get that 2nd, 3rd, 4th opinion and get your diagnosis if she has autism.  Two of mine have Autism, they get additional therapies (like ABA) paid for by medicaid because of their diagnosis.  It covers all their OT, PT, Speech, sensory, and feeding therapies as well.

 

 

Nicole_2007
by Member on Aug. 5, 2014 at 9:53 PM

See thats what I thought and she told me that medicaid will only go by a PDD diagnoses.  My mom was even there when she told me all of this and she was even confused

Quoting Anoronlight: That's a crock, Medicaid is paying for autism treatments. I suggest getting another opinion. You are right though, PDD is a form, however she has her info backwards. No one will pay for anything related, unless it's an autism diagnoses. Plus under the new DSM, PDD doesn't technically exist any more, even though most still recognize it as such. For insurance reasons, they will all go by the new DSM.


baby
baby growth
baby
Nicole_2007
by Member on Aug. 5, 2014 at 9:56 PM

Yeah thats what I am thinking to.  She even tried to tell me that Iowa City said Paige had PDD and even showed me the paper work but no were in there does it say PDD it said she had a developmental delay and then ADHD/ODD but no were did it say PDD Iowa City even told me Paige couldn't have it because she was sociable to them which she is sociable when its one or two people at a time but if you get more then 2 people in the room she shuts down and gets quite and wants everyone gone.  I just don't know who else to take her to were I live :(

Quoting Momof4AEMW:

sounds like time for a new doctor. 

Quoting Nicole_2007:

TY I didn't think it sounded right to me.  She is having me go to therapy in 2 weeks because she feels like I don't understand anything she tells me.  I really don't like her much

Quoting Momof4AEMW:

I have 3 kids in Iowa on Medicaid with diagnoses of Autism, ADHD, down syndrome,  hearing impairment, developmental delay (all our primary insurance excludes for) and medicaid picks up EVERYTHING!  I'd get that 2nd, 3rd, 4th opinion and get your diagnosis if she has autism.  Two of mine have Autism, they get additional therapies (like ABA) paid for by medicaid because of their diagnosis.  It covers all their OT, PT, Speech, sensory, and feeding therapies as well.


 


baby
baby growth
baby
Charizma77
by Carissa on Aug. 5, 2014 at 10:17 PM

I agree withe other ladies. I would start looking for another dr. Hugs! 

Anoronlight
by Bronze Member on Aug. 5, 2014 at 11:59 PM
I find that hard to believe since the latest info was that Medicaid maybe starting to cover ABA therapy for autistic kids. She hurt your dd, more then helped. Get a second opinion.

Quoting Nicole_2007:

See thats what I thought and she told me that medicaid will only go by a PDD diagnoses.  My mom was even there when she told me all of this and she was even confused

Quoting Anoronlight: That's a crock, Medicaid is paying for autism treatments. I suggest getting another opinion. You are right though, PDD is a form, however she has her info backwards. No one will pay for anything related, unless it's an autism diagnoses. Plus under the new DSM, PDD doesn't technically exist any more, even though most still recognize it as such. For insurance reasons, they will all go by the new DSM.

Kate00
by Member on Aug. 6, 2014 at 7:03 AM

I don't know about Medicaid but in Florida if a company is self-insured, they do not have to provide autism services.  Unfortunately it's usually the biggest companies that are self-insured, so this impacts a lot of people.

Nicole_2007
by Member on Aug. 6, 2014 at 8:57 AM

See all my daughter has is medicaid because her real dad don't provide for her.  But here in Iowa I read that the state was starting to dish out money to help kids get therapy for their autism so thats why I didn't believe what the doctor was telling me

Quoting Kate00:

I don't know about Medicaid but in Florida if a company is self-insured, they do not have to provide autism services.  Unfortunately it's usually the biggest companies that are self-insured, so this impacts a lot of people.


baby
baby growth
baby
Add your quick reply below:
You must be a member to reply to this post.
Join the Meeting Place for Moms!
Talk to other moms, share advice, and have fun!

(minimum 6 characters)