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no. just no. I dont believe it

Posted by on Feb. 5, 2014 at 5:13 PM
  • 31 Replies
Before I get started, this is based off my personal experience,so if you have had a different outcome please share how you did it because I cant imagine that the majority of people have paid out pocket up front.

Ok on to my post. I tried to schedule an appt by referal to have an evaluation done for educational testing for my son 8 to confirm the schools evaulation of a cognitive delay in addition to his dx of speech apraxia (done by children's hospital) I was informed that children's no longer does these evaluations for educational and behavior problems unless they are being seen for neurological reasons or were premature at birth or at had complications at birth. My son does not have any of these issues.

I was given some advice to see if he can be reevaluated for speech which they still do evals. And insurance covers. This is just to see where he stands and where to go from here. Also, I was given places to contact behavioral physcologist for the behavioral and educational purposes. Holy crap 1500 dollars for one test and 675-975 for the other! Out of pocket, just eval and not follow-up.

Im sorry by for those people with all these disorders like odd or spd or what have you, who dx your kids with that? Did you really pay 1500plus out of pocket? I just dont see it unless your are really well off.

I guess I will be sticking with the speech eval and the schools dx. Which I no longer will scoff at. Im glad the schools can get funding and have to the ability to make an iep for him. I thought it would be beneficial to have it medically documented or see if there were other underlining issues, or the see if they agreed or disagreed with what they school had to say.

I guess my real issues is, im just floored at how expensive behavioral and educational intervention cost and how much people spend to get that dx. So, either someone along the lines is suggesting it and people are just running with it, or they were able to differently. Ps. I dont know I'd this includes autism cases or not. Also, im on mobile with auto correct, so if you see an error, sorry.
by on Feb. 5, 2014 at 5:13 PM
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Replies (1-10):
caustinb
by Ruby Member on Feb. 5, 2014 at 5:20 PM
When my son was referred for physical therapy, I had to pay the deductible, plus 20%. So it was about $600 for the Ortho consult, $150 a month co insurance for 2 sessions a month, and about $800 for corrective braces. It adds up fast. =(
EmilyG10
by on Feb. 5, 2014 at 5:26 PM
My son is in speech therapy 3 days a week for apraxia of speech we pay $900 for are premium and co pays when we had my husband work insurance when our son was in occupational therapy as well we paid $1300 sometimes more a month
Lennyloves
by Silver Member on Feb. 5, 2014 at 5:27 PM
This not an issue of my insurance not covering. These places simply only do this out of pocket.

Quoting caustinb: When my son was referred for physical therapy, I had to pay the deductible, plus 20%. So it was about $600 for the Ortho consult, $150 a month co insurance for 2 sessions a month, and about $800 for corrective braces. It adds up fast. =(
Lennyloves
by Silver Member on Feb. 5, 2014 at 5:30 PM
I should add his speech therapy and eval was/ are covered. Plus he recieved services in school. But the educational and behavioral evals do not use insurance for payment. It is all privatized.

Quoting EmilyG10: My son is in speech therapy 3 days a week for apraxia of speech we pay $900 for are premium and co pays when we had my husband work insurance when our son was in occupational therapy as well we paid $1300 sometimes more a month
Fulgent.Drinker
by on Feb. 5, 2014 at 5:34 PM

 You can only do what you feel is best and you can financially afford.  Just do your best Mama, that's all anyone can ask.

With good jobs, investments, planning and some luck, we have always had excellent insurance, and if it's not covered I can afford to pay what ever they require.

Anonymous
by Anonymous 1 on Feb. 5, 2014 at 5:36 PM

I'm a licensed educational psychologist and former school psychologist. I previously only worked through the school system but since having my child went into private practice. Depending on what evaluations I am doing I charge around $2500 for private evaluation which generally involves 20 hours of work. If I do more involving a functional analysis or behavioral analysis I can make up to $5-7k. It's never covered by insurance. But I am often paid by lawyers who are then reimbursed by either insurance carriers or school districts.

Lennyloves
by Silver Member on Feb. 5, 2014 at 5:43 PM
But not is not the insurance I have issue with.

For example your child is struggling to read. Your suspicious of dyslexia, but the school may not agree with you. You ask your doctor about what can be done. They give a referal to see a child physcologist. But they dont do evals. They send you into the the community that is all privatized and says testing for educational delays is 1500.

You have to pay that out of pocket just so you are to go back to the school and say here its documented, please write up an appropriate I.E.P.

If you dont have it, or think it is fair for them to charge you that, then you are just left with accepting whatever answer you can get and never really knowing if that is the correct dx. This is just one example off the top of my head.

Quoting Fulgent.Drinker:

 You can only do what you feel is best and you can financially afford.  Just do your best Mama, that's all anyone can ask.


With good jobs, investments, planning and some luck, we have always had excellent insurance, and if it's not covered I can afford to pay what ever they require.

Lennyloves
by Silver Member on Feb. 5, 2014 at 5:46 PM
May I ask why insurance doesnt pay for these services or recognize these issues?

Quoting Anonymous:

I'm a licensed educational psychologist and former school psychologist. I previously only worked through the school system but since having my child went into private practice. Depending on what evaluations I am doing I charge around $2500 for private evaluation which generally involves 20 hours of work. If I do more involving a functional analysis or behavioral analysis I can make up to $5-7k. It's never covered by insurance. But I am often paid by lawyers who are then reimbursed by either insurance carriers or school districts.

sillytroll
by Teehee on Feb. 5, 2014 at 5:53 PM

My Ds has down syndrome, he's 14 now. When he was born things were a little different than they are now. We had him start in early intervention at 6-8weeks old. From what I remember, it was pretty expensive but insurance covered a lot of things back then. He's had a lot of med problems. By the time he started school, we just went with the schools therapists because it was so expensive outside of the schools system. I've gotten heat before for that from other moms that thought I should seek out other therapist. Honestly though, I knew the therapist at school were doing a good job and outside therapist wouldn't be doing that many things differently. He was in a special needs school until he started kindergarten. Once he started K In the school he's been in a special needs program w/them. The diagnosis part wasn't difficult for him bc of the downs syndrome, but yes, it was expensive. I'd have to pull out his med file to tell you exactly how much it was then, but I remember it being a lot.

Fulgent.Drinker
by on Feb. 5, 2014 at 5:57 PM

 I'm sorry, but as someone who went to school for a psychology degree and then transferred to law, it irks me that you don't understand that that education cost a small fortune to obtain and they are in fact being very fair with their prices. In fact 1500 is damn cheap.

UGH. I'm sorry Mama, but life isn't free, nor is anyone entitled to take advantage of some one who is educated and a professional in the field your child needs to be seen by because you can't afford it.

Keep searching, and don't stop till you get a diagnoses for your child. That's all I can advise you to do.

Good luck.

Quoting Lennyloves: But not is not the insurance I have issue with.

For example your child is struggling to read. Your suspicious of dyslexia, but the school may not agree with you. You ask your doctor about what can be done. They give a referal to see a child physcologist. But they dont do evals. They send you into the the community that is all privatized and says testing for educational delays is 1500.

You have to pay that out of pocket just so you are to go back to the school and say here its documented, please write up an appropriate I.E.P.

If you dont have it, or think it is fair for them to charge you that, then you are just left with accepting whatever answer you can get and never really knowing if that is the correct dx. This is just one example off the top of my head.

Quoting Fulgent.Drinker:

 You can only do what you feel is best and you can financially afford.  Just do your best Mama, that's all anyone can ask.


With good jobs, investments, planning and some luck, we have always had excellent insurance, and if it's not covered I can afford to pay what ever they require.

 

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