Reply Hey Mom! Learn more about the Gerber Life Insurance Grow-Up Plan!
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Old 02-02-2013, 05:26 PM   #21
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Originally Posted by EvaL View Post
But, if your boy has a diagnosis of 'failure to thrive' or the like, I can't see how any insurance company can reject the claims. I am not familiar with the agency you talk about... I don't have that in our state or any state I have lived in but wouldn't the heart doctor be able to write a letter to this agency explaining the issue with feeding and that it is medically necessary to treat?! Children are supposed to be growing so anything termed 'maintenance' in regard to a child's eating is simply wrong. Call the heart doctors!
I agree about the maintenance is frustrating. The problem (?) is that he isn't failing to thrive, thanks to much diligence on our part he is maintaining his weight just fine. I've said over and over that if I stopped doing what I do to get him to eat every day, he would certainly start failing to thrive...but as a mom, I just can't make my son suffer just to prove a point to insurance (and some doctors, even). Its hard.

Anyhow, Owen's cardiologist and therapists ARE working to provide proper documentation to get his therapy covered. Since I last posted, we did get approval for 20 visits, but at twice per week that will run out quick...hopefully that will buy us enough time to get the paperwork pushed through though. Fingers crossed!


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Old 02-04-2013, 11:36 AM   #22
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Re: Well, it's official...

Crossing my fingers for you, Alex!
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Old 02-14-2013, 10:36 PM   #23
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Re: Well, it's official...

Just another thought....when DS needed sppech therapy our insurance wouldn't cover it cause it wasn't due to a medical condition....I contacted DH's company (which our insurance was though) and appealed to them. They got got insurance to cover therapy for I think 6 months....doesn't hurt to try...I did have to go through a couple "levels" of management though.

Now our insurance covers speech (a hefty co-pay) and they too originally said just 20 sessions....but the therapy place said that is usually not a problem they just have re-submit after they use those up.
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