Re: CARE CLINICS post

January 8, 2009

,

I thought that your original post was very clear that you were NOT criticizing Thoughtful House, and you brought up some valid points about paying out of pocket, so I personally do not feel "attacke" in any way. By the way, I think the confusion between CARE Clinics and Thoughtful House arises because (1) they are one the same street in Austin and (2) Thoughtful House uses CARD as their "sister" therapy center. I made the mistake of confusing CARD for CARE already.

I am currently using Thoughtful House and just had a phone appointment with Lucas , NP on Monday. Although I am happy with the progress made so far, it is extremely expensive and is taking longer than I'd like. The bill for a one and a half hour phone call with the nurse (not doctor) was $459.50. I will submit this to Aetna and seriously doubt that I will receive one dime back, since they have been just awful about paying for anything. (We also attended a session with Dr. Volpe in Houston while waiting for TH appts and Aetna paid nothing of a $870 bill, nor do they cover speech therapy.) I have also had an phone appointment with the nutritionist Barnhill at TH; no appointment scheduled with the doctor(s) yet. As I said, the staff is great and I have every confidence in their abilities but it is expensive out-of-pocket, I have not seen anyone in person there yet, and am not sure when my son will

see the doctor. Sounds exactly like what you said in your post...

Thanks,

Sandy H.

All-Please accept my sincere apology if you felt attacked by my post. I am most concerned with the fact that this CARE Clinics complaint letter has been widely circulated by folks with some negative intros on this and other boards. None of us really know the facts, and I am certain there will be an investigation on both sides. If you aren't aware, there is a huge pot of fire simmering between Aetna and autism treatment centers (not just CARE clinics). Read the posts on autism insurance information yahoo group. I am not sure what the outcome will be, but I am fearful that biomedical treatment will not be covered for us. If anyone can attend any of the IACC meetings either in person in Washington DC or via webinar, please contact me. Insurance coverage for biomedical treatments will be a discussed topic, and we need more parents to voice their stories.By the way, I have read Dr. Jepson's

book, and listened to him present in person and think very highly of him. However, when I called to get an appointment last year at Thoughtful House, I was told that he is not taking any new patients. I was told I could see a nurse. It would be great if they would hire more physicians in the future because there are not enough doctors to see all of our kids. I have honestly called every DAN! doctor in the southwest, and this is true everywhere.Respectfully,>> Dear ,> > My son is a patient of Dr. Jepson at Thoughtful House. They don't take > insurance but we file the claims and get reimbursed ...no big deal. I see > nothing IMMORAL about it, As a matter of fact, it is a way

of cutting costs > to the facility. Do you realize how much money and personnel it takes to > file insurance for the patients? Who do you think is footing the bill? the > insurance company?> > I would rather the money is spent on research, for example..> > Phone consultations are not re-imbrued, but this is nothing unique to > Thoughtful House. However, it is convenient for us so we don't have to > travel every time. Furthermore, Any time I have a question or need to > contact the Dr. or any of the nurses outside our appointments, they are > approachable at no cost.> > Unfortunately, my son has not made the progress that yours have, but I don't > think that has any thing to do with the quality of care that we get from > Thoughtful House. I doubt that it will be different if we used the CARE >

Clinics.> > It really bothers me when parents split into camps. If you are happy with > CARE clinics, that's great, but there is no reason for you to attack another > parent who has a different experience from yours.> > > > I [Texas-Autism- Advocacy] CARE CLINICS SAVED MY SON> > > > Friends,> >> > We have taken our son to CARE Clinics since last fall after I listened> > to their medical director speak at the USAAA conference. In a few> > short months, he is speaking in 5 word sentences, keeping great eye> > contact, and

making sudden and rapid progress across multiple skill> > areas. Our treatments have been billed appropriately to our> > insurance, I have checked every statement. We would NEVER be able to> > afford chelation, minerals and other treatments without insurance> > reimbursement. I honestly have shuddered when parents at other places> > tell me they are thousands in debt from autism treatment centers who> > do not accept insurance. Further, these facilities are not helping> > the crusade to have autism treatment covered by insurance because they> > are leaving parents ALONE to fight this battle. This is so ethically> > wrong, I cannot even begin to rationalize this business strategy.> > Burdening families with such financial strain to add to their current> > emotional and family burden???? Is this for real? Only

making> > effective autism treatment available to the upper class?> >> >> > While I have heard positive and negative stories about Thoughtful> > House, I am very concerned that the root of this string of emails on> > this board and others is from TH parents against CARE clinics. If you> > are not a patient at CARE, and have no experience, please do not> > circulate such negative propaganda. This is completely inappropriate.> > CARE Clinics is addressing the defamatory letter that was posted in> > the winter issue of Spectrum magazine, and they take pride in treating> > thousands of patients successfully over the past several years. Their> > executive board of physicians are experts in autism, and their> > treatment protocol is one of the best in the country if not the best.> > I have

investigated almost every facility in the United States from a> > medical perspective and from parent testimonials. That is what led me> > to CARE Clinics...two years of research and interviewing every doctor> > and facility. I have much data collected.> >> > In case you are not aware, CPT codes are set by AMA and federally> > regulated. Insurance companies reimburse providers for a determined> > amount for each procedure. CARE Clinics bills for these treatments,> > and accepts reimbursement following all practices. This industry is> > tightly regulated, and insurance fraud with laboratory testing is very> > closely regulated after some large scandals in national reference labs> > in the past couple of years. My background is laboratory medicine, so> > I know much about test codes and reimbursement

and how this works.> > Further, laboratory tests are burdened with the expense of the> > equipment, certified degreed technologists who are running the test,> > administrative costs, etc. It is not the laboratory 'inflating' this> > costs. In fact, most laboratories across the country are just recently> > becoming profit centers thanks to higher reimbursements than cost> > centers.> >> > I would really appreciate if everyone would be respectful of treatment> > centers that are helping to recover our children. My son's progress> > is nothing short of a miracle. I will take my story nationally if> > necessary to fight the battle with insurance companies and protect the> > reputable institutions such as CARE Clinics that are dedicated to> > saving our children according to a research based,

scientifically> > grounded protocol and provided affordable treatment to families.> >> > Respectfully,> >> > Hunter Ryden> >> >> >> >> > ------------ --------- --------- ------> >> > Texas Autism Advocacy> > www.TexasAutismAdvo cacy.org> >> > Texas Disability Network> > Calendar of Events> > www.TexasAutismAdvo cacy.org

January 8, 2009

Don't want to sound like I am siding with TH or Care Clinic's.

Just something interesting that DR Jepson just adopted a boy who has autism

this summer. And I have read many places about DR Jepson giving a one day conference in various places around the country.

Just wonder if he realizes how many parents are

trying to get their child into his office.

Also FYI~ There is a DR Rao in Plano see's our kids and does a variety of bio medicaltreatments.

DR Rao has more than enough patients but I think he must hate turning anyone away. He is open to try many things, and does offer a list of treatments.

I know his office takes BCBS, and most likely other

Insurances but cannot remember them all.

And there is DR Hamel in Arlington - they take Aetna, United Healthcare,

Cigna, TX True Choice, and Humana

AllieNew year...new news. Be the first to know what is making headlines.

January 8, 2009

Hi Sandy,

I have had some luck getting reimbursement from Thoughtful House. I had a case manager assigned to my little one. That in itself was a life saver. It was only after many many phone calls that some kind person heard the desperation in my voice. Be persistant!!!! I also really pushed the new defintion of autism. Not a behavioral diagnosis, but a complex medical diagnosis. Thoughtful House is worth the dollars. Hang in there!!!