Guest guest Posted July 27, 2003 Report Share Posted July 27, 2003 As I mentioned before if a doctor finds a problem that requires a specialist then for the most part Childrens Special Health Care services WILL cover. Autism is considered a mental disorder and CSHCS only covers physical disorders. However if there is a physical problem present such as stomach problems, ENT's or Neurologist (Due to Seizures, brain tumors ect), they do cover EVERYTHING! You just have to have the right doctor that knows how to write up a letter to CSHCS. They really are a great company that helps alot of kids. We need to remeber that autism is not the only mental disorder out there. If they cover autism then they have to cover Bi-Polar, Scziphrenia, Depression, suicidal tendency's ect. They only have so much money to work with. Yes I agree that autism should be covered however if they take on one, then they have to take on them all. We know thats not going to happen, they dont get that much funding. CSHCS has covered a ton for Abby and saved us thousands of dollers just at the ENT alone. They cover her copays and pay for her presciptions if from a specialist. Pennie Abby's Mom Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 27, 2003 Report Share Posted July 27, 2003 I agree with you that the whole medical system needs to be reformed. What kind of problems does have with his ears? Abbys is just frequent infections, she is on her 3rd set of tubes Pennie Abby's Mom Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 27, 2003 Report Share Posted July 27, 2003 Theresa I am missing something here about the seizures. Abby had one bad seizure and was immediatly covered. All the neurologist has to do was say that she had a seizure and was under her treatment. That was all the letter said. CSHCS paid all. A person that works at CSHCS cannot diagnos over the phone and they shouldnt be telling you that its not covered. All it takes is a neurologist to say that there is something there or that he is being seen to find the cause. I am sorry that things have gotten so bad for you. Pennie Abby's Mom Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 27, 2003 Report Share Posted July 27, 2003 Theresa also WIC will cover formula if you have a medical letter from your doctor. Pennie Abby's Mom Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 27, 2003 Report Share Posted July 27, 2003 I was told a CSHC that my son only having 8 seizures was not considered "chronic" enough for coverage. They also denied him for his gastro and he is on a $90 a 14 oz can formula! He is also blind in one eye and they won't cover him! That is just proof of the injustice in this country!!! I told them the formula would cause us to lose everything and they didn't care! Now we have only until Aug 4 before we are homeless! If they had covered him I could have used the SSI to pay rent. Now we are going to live out of a car that we can't pay for! This country is not the great place everyone thinks it is . Ploveabby@... wrote: As I mentioned before if a doctor finds a problem that requires a specialist then for the most part Childrens Special Health Care services WILL cover. Autism is considered a mental disorder and CSHCS only covers physical disorders. However if there is a physical problem present such as stomach problems, ENT's or Neurologist (Due to Seizures, brain tumors ect), they do cover EVERYTHING! You just have to have the right doctor that knows how to write up a letter to CSHCS. They really are a great company that helps alot of kids. We need to remeber that autism is not the only mental disorder out there. If they cover autism then they have to cover Bi-Polar, Scziphrenia, Depression, suicidal tendency's ect. They only have so much money to work with. Yes I agree that autism should be covered however if they take on one, then they have to take on them all. We know thats not going to happen, they dont get that much funding. CSHCS has covered a ton for Abby and saved us thousands of dollers just at the ENT alone. They cover her copays and pay for her presciptions if from a specialist. Pennie Abby's Mom Support Everyday Miracles by shopping online at IGIVE.COM, where a portion of every purchase is donated to this support network. Proceeds received will be used for a variety of functions, such as educational activities, therapy, famiy outings, etc. http://www.igive.com/EDM Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 27, 2003 Report Share Posted July 27, 2003 You are lucky that you have a dr willing to write this way for you, Pennie, and luckily (Not really LUCKILY) Abby has ear problems which need ENT care. When I have pursued this, most of 's problems are considered secondary to autism, not primary, as in ear problems. Plus, autism is NOT a MENTAL disorder! That is my biggest gripe. It is NOT a condition of the mental state, alleviated by mental health counseling....it is biological, it is medical, neurological, induced by the envt, etc.... In my work in the mental health field, autism is billed as 299.0-- it is not reimbursable under mental health plans, it is considered an Axis II diagnosis, which means it is right there with mental retardation and borderline personality disorders, i.e. things that are permanent conditions, not amenable to treatment (so they say). People treat bipolar, schizophrenia and major depression as Axis I disorders- reimbursable under mental health- even though I personally believe there is a huge biomedical component with these neurological disorders as well. There needs to be HUGE insurance reform, especially in the state of Michigan, before our kids will eb treated fairly, and their conditions taken seriously. Re: CSHCS As I mentioned before if a doctor finds a problem that requires a specialist then for the most part Childrens Special Health Care services WILL cover. Autism is considered a mental disorder and CSHCS only covers physical disorders. However if there is a physical problem present such as stomach problems, ENT's or Neurologist (Due to Seizures, brain tumors ect), they do cover EVERYTHING! You just have to have the right doctor that knows how to write up a letter to CSHCS. They really are a great company that helps alot of kids. We need to remeber that autism is not the only mental disorder out there. If they cover autism then they have to cover Bi-Polar, Scziphrenia, Depression, suicidal tendency's ect. They only have so much money to work with. Yes I agree that autism should be covered however if they take on one, then they have to take on them all. We know thats not going to happen, they dont get that much funding. CSHCS has covered a ton for Abby and saved us thousands of dollers just at the ENT alone. They cover her copays and pay for her presciptions if from a specialist. Pennie Abby's Mom Support Everyday Miracles by shopping online at IGIVE.COM, where a portion of every purchase is donated to this support network. Proceeds received will be used for a variety of functions, such as educational activities, therapy, famiy outings, etc. http://www.igive.com/EDM Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 27, 2003 Report Share Posted July 27, 2003 Let's do something! Let's get a group together and go picket or something-- this isn't right. Autism is a physiological disorder-- let's pull together and do something about this!!!!!!!!!!!! sharlan@... wrote: You are lucky that you have a dr willing to write this way for you, Pennie, and luckily (Not really LUCKILY) Abby has ear problems which need ENT care. When I have pursued this, most of 's problems are considered secondary to autism, not primary, as in ear problems. Plus, autism is NOT a MENTAL disorder! That is my biggest gripe. It is NOT a condition of the mental state, alleviated by mental health counseling....it is biological, it is medical, neurological, induced by the envt, etc.... In my work in the mental health field, autism is billed as 299.0-- it is not reimbursable under mental health plans, it is considered an Axis II diagnosis, which means it is right there with mental retardation and borderline personality disorders, i.e. things that are permanent conditions, not amenable to treatment (so they say). People treat bipolar, schizophrenia and major depression as Axis I disorders- reimbursable under mental health- even though I personally believe there is a huge biomedical component with these neurological disorders as well. There needs to be HUGE insurance reform, especially in the state of Michigan, before our kids will eb treated fairly, and their conditions taken seriously. Re: CSHCS As I mentioned before if a doctor finds a problem that requires a specialist then for the most part Childrens Special Health Care services WILL cover. Autism is considered a mental disorder and CSHCS only covers physical disorders. However if there is a physical problem present such as stomach problems, ENT's or Neurologist (Due to Seizures, brain tumors ect), they do cover EVERYTHING! You just have to have the right doctor that knows how to write up a letter to CSHCS. They really are a great company that helps alot of kids. We need to remeber that autism is not the only mental disorder out there. If they cover autism then they have to cover Bi-Polar, Scziphrenia, Depression, suicidal tendency's ect. They only have so much money to work with. Yes I agree that autism should be covered however if they take on one, then they have to take on them all. We know thats not going to happen, they dont get that much funding. CSHCS has covered a ton for Abby and saved us thousands of dollers just at the ENT alone. They cover her copays and pay for her presciptions if from a specialist. Pennie Abby's Mom Support Everyday Miracles by shopping online at IGIVE.COM, where a portion of every purchase is donated to this support network. Proceeds received will be used for a variety of functions, such as educational activities, therapy, famiy outings, etc. http://www.igive.com/EDM Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 27, 2003 Report Share Posted July 27, 2003 How old is Wyatt? Pennie Abby's Mom Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 27, 2003 Report Share Posted July 27, 2003 Pennie- Per Oakland County CSHC the pt must have a chronic seizure disorder and his did not qualify. Our nerologist filled out all the paperwork. He got us everything else. Diapers starting with his 3 rd b-day (Aug. 26) and a handicapped parking pass. But CSHC wouldn't cover him. I did reaply here in Macomb but it has been months and I haven't heard a thing from them. Ploveabby@... wrote: Theresa I am missing something here about the seizures. Abby had one bad seizure and was immediatly covered. All the neurologist has to do was say that she had a seizure and was under her treatment. That was all the letter said. CSHCS paid all. A person that works at CSHCS cannot diagnos over the phone and they shouldnt be telling you that its not covered. All it takes is a neurologist to say that there is something there or that he is being seen to find the cause. I am sorry that things have gotten so bad for you. Pennie Abby's Mom Support Everyday Miracles by shopping online at IGIVE.COM, where a portion of every purchase is donated to this support network. Proceeds received will be used for a variety of functions, such as educational activities, therapy, famiy outings, etc. http://www.igive.com/EDM Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 27, 2003 Report Share Posted July 27, 2003 Pennie- Wyatt is on EleCare and it is not covered by WIC. They give him pediasure but we can't use it because it contains dairy. Ploveabby@... wrote: Theresa also WIC will cover formula if you have a medical letter from your doctor. Pennie Abby's Mom Support Everyday Miracles by shopping online at IGIVE.COM, where a portion of every purchase is donated to this support network. Proceeds received will be used for a variety of functions, such as educational activities, therapy, famiy outings, etc. http://www.igive.com/EDM Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 27, 2003 Report Share Posted July 27, 2003 He'll be 3 on Aug. 26 Ploveabby@... wrote: How old is Wyatt? Pennie Abby's Mom Support Everyday Miracles by shopping online at IGIVE.COM, where a portion of every purchase is donated to this support network. Proceeds received will be used for a variety of functions, such as educational activities, therapy, famiy outings, etc. http://www.igive.com/EDM Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 27, 2003 Report Share Posted July 27, 2003 Pennie, doesn't have any chronic ear problems-- he just had (the typical) multiple ear infections and rounds of antibiotics as a baby-- never enough to need tubes. He has been diagnosed with leaky gut, malabsorption, zinc deficiency, elevated heavy metals, etc etc-- but none of those medical diagnoses " count " . It's unfortunate that we have to coach our medical professionals on how to " lie " for us...autism is not something to be embarrassed about; we should not have to have all these " tricks " for skirting the system. I'm sick of trying to come up with the right wording and the correct reimbursable code to get things paid...autism is autism... On another note, thanks for the white juice grape box suggestions to those who replied; I will check it out. I'm trying to just get away with having drink out of water bottles but when all the other kids are having juice boxes, he's gotta have one too! --sch Expect a miracle! Re: CSHCS > I agree with you that the whole medical system needs to be > reformed. What > kind of problems does have with his ears? Abbys is just > frequent > infections, she is on her 3rd set of tubes > > Pennie > Abby's Mom > Quote Link to comment Share on other sites More sharing options...
Recommended Posts
Join the conversation
You are posting as a guest. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.