Guest guest Posted April 20, 2006 Report Share Posted April 20, 2006 Insurance companies, if they cover ST, will cover up to a number of day sor dollar amount for DEVELOPMENTAL CPT code. But since apraxia is a Neurological DISORDER the neurologist can write a letter of medical necesaty and then put in the correct CPT codes which are in the 700's (your ST should know exact code) have them put the claim in that way with the letter and many times I have seen them cover and sometimes the members have had to fight and even after the fight have seem the insurance co. cover. Insurance companies try to get around covering all types of therapies because they consider them " developmental " but we all need to go the route of " Disorder " and not use the word " therapy " either. These are all words for denial of service. In the Late Talker book there is a complete section that explains how to work the insurance system-please review-very good info!!!! ---- ckptry <ckptry@...> wrote: Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 24, 2006 Report Share Posted April 24, 2006 Kaiser won't even consider my son's Apraxia because of the type of plan my husband has. Since my husband's employer is in DC we don't have the mandates many states such as land members have to modify when the sessions can be used and how. Kaiser approved Kellen for 90 speech sessions under a rehab benefit (per incident/consecutive days) using his ear trouble as a justification. He has a tube in his right ear and still has a flat tympanogram on the left side. Our approval expires on 7/14 so we will try for an extension if there isn't another ear incident. I WILL be scheduling another ENT visit about two weeks before his approval expires and hopefully this will count as in incident. You would think health insurance should do a little better than this. > > Hi all, > We just found out that our insurance co. won't cover speech > therapy through our local children's hospital for our 15mo dyspraxic > son. They say they won't cover unless it follows a brain injury e.g. > stroke, accident....Has anyone encountered this before, or gotten > around it? I shouldn't be surprised, but I still can't believe it. > thanks > Carolyn > Quote Link to comment Share on other sites More sharing options...
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