Insurance help

[Guest guest]

My two sons recently began at Thoughtful House in Austin with Dr.

Jepson. After submitting the visits to our insurance company

(Golden Rule), they were denied, along with the prescription

medications he prescribed. Their letter stated that

" Most knowledgeable doctors consider treatment of PDD with

nutritional supplements (e.g., megavitamins, high-dose pyridoxine

and magnesium, dimethylglycine, and others) and antibiotics to be

experimental and investigational because the peer-reviewed medical

literature does not support the use of these procedures and services

in the assessment and treatment of autism and other pervasive

developmental disorders. "

I am obviously going to fight this, and was wondering if any of you

have any supporting evidence that would help my case. Are there any

peer-reviewed studies I could cite? Any help would be greatly

appreciated, as these are very expensive visits!

BTW, the state of Texas just passed legislation that would mandate

insurance companies to cover treatment for ASD for children ages 2-5

to include:

(1) evaluation and assessment services;

(2) applied behavior analysis;

(3) behavior training and behavior management;

(4) speech therapy;

(5) occupational therapy;

(6) physical therapy; or

(7) medications or nutritional supplements used to address symptoms

of autism spectrum disorder.

As long as our governor doesn't veto the bill (he isn't expected

to), I think this would go into effect 1/1/08 (not positive,

though). In the meantime, it's me against the insurance company -

and I plan to win!

Thanks for your help--

Yerly

Austin, TX