ely@jpl-devvax.JPL.NASA.GOV (Ely Feinerman) (10/19/90)
Index Number: 11193 I have a 3 Year old Autistic Son. He has been receiving Intense Behaivor Modification Theraphy in my home from a staff of specialists. After an initial fight with the insurance company they agrrred to pay for the services. Now they are turning the tables on the payment. They were having this case handled by a speacial case management team and paying the Doctor and his staff, by the way the Doctor is very well known in the field of Autism. Now they want us to just submit the bills and see if we get paid or not. They are also saying that there might be no coverage, even though they have paid the bills for 6 months. I need help. Please give me any leads you may have. I can be reached in the following manner. You can reply by email to me.( look at my sending path) you can call me at 818-354-1479 - daytime you can call me at 213-675-0165 - nighttime you can mail me stuff ( you know snail mail) E. H. feinerman 14622 Fonthill Ave. Hawthorne, Ca. 90250 P.S. Please help this 3 year old child. The theraphy has improved him so much. He now responds, can match items and is slowly getting speech. This comes from a parent with a broken heart. They are changing the rules next week. Thanks.
wtm@bunker.uucp (Bill McGarry) (10/19/90)
Index Number: 11194 Ely Feinerman (ely@jpl-devvax.JPL.NASA.GOV) writes: >I have a 3 Year old Autistic Son. He has been receiving Intense >Behaivor Modification Theraphy in my home from a staff of >specialists. After an initial fight with the insurance company >they agrrred to pay for the services. Now they are turning the >tables on the payment. . . . Just a couple thoughts -- First, the disclaimer: I'm not a lawyer but between me with my pain problems and my son Alexander with all sorts of medical problems, I've had more than my share of fights with insurance companies. Now some suggestions: Is this insurance through the company that you work for? If so, your first step would be to talk to your Human Relations department. The contact person in your company will generally be in frequent contact with the insurance company at the supervisor level. If this is company insurance, then I believe that you are entitled by Federal Law to receive a copy of the actual policy, not just the brochure that is handed out to the employess. I cannot recall what the law is called but the company (your company, not the insurance company) has 30 days to get you a copy (this is the stage that I'm at with my latest fight). Then you ask the insurance company to point out in the policy where it says that they will not pay for these services or you can search for some loophole. Every insurance company also has some method whereby you can officially appeal when they reject your claim. This should be listed in your insurance information or in the policy. I would think that the fact that they have paid for six months would make it harder for them to now deny future claims. Many (all?) states have an Insurance inspector or commissioner whose job is to see that insurance companies do what they're supposed to. Contact them. What is the city's special education department doing with your son? They must provide him with an "appropriate" education. (Anyone with a special ed child soon learns that the magic legal word "appropriate" covers a enormous range of services.) If you are not satisfied with the "appropriate" education that he is receiving, you can request a re-evaluation of your son. I've been through this route as well so if you want, I can expound further, but you should be able to get the information on requesting a new PPT meeting, appeals, etc from your special education department. Last alternative, I guess, would be to hire a lawyer. Good luck and please keep us advised as to what happens. Bill McGarry (203) 337-1518 UUCP: {oliveb, philabs, decvax, yale}!bunker!wtm INTERNET: l-hcap@vm1.nodak.edu BITNET: l-hcap@ndsuvm1.bitnet FIDONET: The Handicap News BBS (141/420) 1-203-337-1607 (300/1200/2400 baud, 24 hours) Compuserve: 73170,1064
Jeff.Best@f71.n135.z1.fidonet.org (Jeff Best) (10/27/90)
Index Number: 11351
The only thing I can suggest is HRS if your child is multi-handicapped your
chances are even better of reciveing help the name of the program is
=============CHILD AT RISK==========
DON'T let them tell you that it doesn't exist it does and there is
a lot of funding there it has nothing to do with your income DON'T
-DON'T-DON'T TAKE NO FOR AN ANSWER . I am a single parent of a 5
year old boy who has a PROFOUND HEARING LOSS and is ataxic HRS paid
for equiptment that is not provided by the school system such as
the IBM SPEECHVIEWER and a TACTAID PLUS both out of my reach
financially but recommended by his theryphist and doctor just don't
take no for an answer God Bless and good luck .
CHOW FOR NOW !
-*=JEFF=*-
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Uucp: ..!{decvax,oliveb}!bunker!hcap!hnews!135!71!Jeff.Best
Internet: Jeff.Best@f71.n135.z1.fidonet.orgRonnie.Toth@f71.n135.z1.fidonet.org (Ronnie Toth) (11/06/90)
Index Number: 11557
The original message came in to SOX! via netmail and Jeff
responded in the private area. I am not familiar with
'uucp' (uunet?) and am forwarding his response here. Hope
it reaches you. Ronnie
=======================================================
* Forwarded from "Private Messages"
* Originally from Jeff Best
* Originally dated 11-02-90 22:43
JUST CONTACT YOUR LOCAL OFFICE OF HRS THE Name of the program is "CVHILD AT
RISK" if they say it doesn't exist ask about "CHILD AT RISK
UNDER 5" this is a program that HRS doesnt talk to much
about but is does exist and if a doctor
recommends(prescribes something that will aid in your
child's education and it is not provieded through your
local school system than they will pay for therapy or
equipetment used to help the child learn there is a FEDERAL
LAW THAT STATES THAT ALL CHILDREN ARE INTILTED TO AN EQUAL
EDUCATION AND THATS THE LAW CHECK IF THERE ARE ANY LOCAL
ADVOCATE GROUPS FOR OTHER HANDICAPS IN YOUR AREA THEY WILL
BE MORE THAN GLAD TO HELP POINT YOU IN THE RIGHT DIRECTION.
GOOD LUCK: -*=JEFF=*
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Uucp: ..!{decvax,oliveb}!bunker!hcap!hnews!135!71!Ronnie.Toth
Internet: Ronnie.Toth@f71.n135.z1.fidonet.orgely@jpl-devvax.JPL.NASA.GOV (Ely Feinerman) (11/09/90)
Index Number: 11653 Will spmeone tell me what HRS stands for and a phone number for them in the Los Angeles , California area. thanks.
Jeff.Best@f71.n135.z1.fidonet.org (Jeff Best) (11/16/90)
Index Number: 11751
HRS stands for ( The Department Of Health And Rehabilitative
Service ) to the best of my knowledge there one in every state
good luck .
KEEP THE FAITH YOUR CHILD'S FUTURE DEPENDS ON IT !
-*=JEFF=*-
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Uucp: ..!{decvax,oliveb}!bunker!hcap!hnews!135!71!Jeff.Best
Internet: Jeff.Best@f71.n135.z1.fidonet.orgJoe.Chamberlain@f140.n150.z1.fidonet.org (Joe Chamberlain) (11/17/90)
Index Number: 11759
JB> HRS stands for ( The Department Of Health And Rehabilitative Service )
JB> to the best of my knowledge there one in every state good luck .
Every state does have such a program, but many states
have different names for it. Some name could be vocational
rehabilatation, social services, human services, and other such
names.
Hope this helps.
-=joe=-
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Uucp: ..!{decvax,oliveb}!bunker!hcap!hnews!150!140!Joe.Chamberlain
Internet: Joe.Chamberlain@f140.n150.z1.fidonet.org