Kathy:

First, you need a letter of medical necessity for the services. That would
come from your child's primary care physician. And, you need to get the
denial for coverage for those specific services in writing from your
insurance carrier.

There's key phrases, such as "failure to reach developmental milestones,"
that insurance companies will act on. Work in tandem with your speech
therapy provider to get the approval.

Your insurance company may have a problem with "habilitative" services, as
opposed to "rehabilitative" services. You should contact your State's
Insurance Commissioner (most of them have a consumer help line) and ask them
for assistance. In Maryland I've found them very helpful.

Hope this helps.
Missy in Md.


-----Original Message-----
From: kathybimit [mailto:kathybimit@...]
Sent: Saturday, August 07, 2004 12:24 AM
To: voices_group@yahoogroups.com
Subject: [voices_group] trouble with insurance


we are trying to figure out how to get insurance to pay for our 7
yr. olds speechtherpy! he has been dinosed as aprixia& Dysaprixia&
he has balance problems & etc!!
We have been denied @ times!I dont think the insurance understands
that if he doesnt get treatment he will not get better!He talks on a
3 yrold level!!
HELP!!Thanks,kathy




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