tag:blogger.com,1999:blog-401303964563152307.post7647771374639821250..comments2024-03-17T12:02:12.410-04:00Comments on Love That Max : The cost of therapists for kids with special needs: Let's compare!Ellen Seidmanhttp://www.blogger.com/profile/01433429847255621203noreply@blogger.comBlogger42125tag:blogger.com,1999:blog-401303964563152307.post-81210914817073584482016-03-04T08:52:05.507-05:002016-03-04T08:52:05.507-05:00You are right about which staffer views your claim...You are right about which staffer views your claim. Some don't care either way. They are just there to collect a paycheck. A few actually stand up for the person for whom the claim is submitted and argue the tightwads down. Some actually look for reasons to deny a claim. (I'd hate to think I had spent my life doing that to people.). As an RN of 43 yrs. duration, I've pretty much seen/heard everything! This, for obvious reasons, I haven't been able to verify this, but I have heard that some companies financially reward the deniers. So, how many pencil pushing paid-by-the-hour claim reviewers are going to be, at best, objective? Birdacioushttps://www.blogger.com/profile/11820761163611658302noreply@blogger.comtag:blogger.com,1999:blog-401303964563152307.post-39701057997622679242015-10-11T22:00:22.625-04:002015-10-11T22:00:22.625-04:00is 40 hour ABA in NYC? we got 30 in MA and relocat...is 40 hour ABA in NYC? we got 30 in MA and relocating in NY in a month. it seems like i wont get more than 20 hour ABA that is half whats prescribed from doc<br />city girlhttps://www.blogger.com/profile/06695660422355905087noreply@blogger.comtag:blogger.com,1999:blog-401303964563152307.post-83600273396532118402014-04-04T14:23:33.453-04:002014-04-04T14:23:33.453-04:00Vision Therapy? All of the exercises are great for...Vision Therapy? All of the exercises are great for everyone.<br />Is this something you could do just as well at home from a book?<br />Does vision therapy solve the problems?<br />Does a vision therapist have skills and overhead that warrant the cost?<br />Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-401303964563152307.post-48380684743622374662013-02-22T12:17:32.534-05:002013-02-22T12:17:32.534-05:00Hi, we are new to omaha, our 22months baby was tak...Hi, we are new to omaha, our 22months baby was taking 2x per week behaviour theraphy in hongkong. She was diagnosed with risk of autism just 2 months back. We aree due to meet the pediatric doc next week. But before than can anyone tell me as what to look forward and where in omaha. We do have a health insurance but still have to check if BT sessions are covered. Any help is highly appreciatedAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-401303964563152307.post-6755511736080634322012-10-09T00:10:13.173-04:002012-10-09T00:10:13.173-04:00Astrid, not sure how much response you'll get ...Astrid, not sure how much response you'll get since this is an old post but I generally feel the fees we pay for therapists who visit us at home fair. We aren't seeing anyone in a clinical setting right now, so can't comment on that.Ellen Seidmanhttps://www.blogger.com/profile/01433429847255621203noreply@blogger.comtag:blogger.com,1999:blog-401303964563152307.post-82338029940236961902012-10-08T23:16:40.654-04:002012-10-08T23:16:40.654-04:00Hi, I am interested to know what most of you (in t...Hi, I am interested to know what most of you (in the USA) feel is a fair price for private therapy. Considering the ones who travel to the home and those that are in a clinic setting. ThanksAstridhttps://www.blogger.com/profile/03160870412613456578noreply@blogger.comtag:blogger.com,1999:blog-401303964563152307.post-44732645707668465872012-06-22T21:08:57.619-04:002012-06-22T21:08:57.619-04:00I forgot my vision therepy that i used to have it ...I forgot my vision therepy that i used to have it cost 120 a session it helped at first but as i grew it stopped working and it was time for braces the vision therapy was not covered by insuranse because they said she has a hearing loss why does she need vision therapy? hello i have horrible tracking skills last year we were in a fight with the insurance people about covering her therapy as they thought only fat adults could have strokes and they could not happen under anthesia but we won!Kathrynnoreply@blogger.comtag:blogger.com,1999:blog-401303964563152307.post-65168590500379656182012-06-22T17:14:14.104-04:002012-06-22T17:14:14.104-04:00When I had therepay it was either by Early Interve...When I had therepay it was either by Early Intervention or the school so it did not cost much. Now my siter is in OT b/c of a small stroke that afected her wrist it costs a $10 copay every session(3x a week)Kathrynnoreply@blogger.comtag:blogger.com,1999:blog-401303964563152307.post-61173420147676971802011-08-14T11:24:08.605-04:002011-08-14T11:24:08.605-04:00Just to share what has worked for us in the past w...Just to share what has worked for us in the past with my son who has autism. He does now have limited coverage under our private health insurance, but before he did, the OT used developmental coordination disorder and the psychologist used adjustment disorder. Both were approved as medically necessary and then paid at the standard rates for the service/provider.<br /><br />However, I do have friends who were denied from the same insurance company based on the developmental coordination disorder the following year, and their doctor copied the letter my son's pediatrician had sent in to justify the treatment.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-401303964563152307.post-58354489371054590652011-08-02T02:22:08.945-04:002011-08-02T02:22:08.945-04:00Kevin,
I live in Tucson with CP since birth (I&#...Kevin, <br /><br />I live in Tucson with CP since birth (I'm 36 now) and my insurance covers 1 hour therapy sessions once a week for 52 weeks. Although, I had to be on a waiting list for 3 1/2 years. I have APIPA. <br />Also, I'm sure you looked into it, but there is a program in Tucson called TROT that offers Hippotherapy with horses, but here is some info. There are also scholarships if you are financially in need. <br />http://www.trotarizona.org/sitebuildercontent/sitebuilderfiles/infopkt2011.pdf<br />Let me know if you need anything. My email is wildcat2279@gmail.com. <br />http://www.trotarizona.org/id35.html<br />When I was younger I attended a center for the Neurologically Impaired in which my parents paid $700 per month (Monday-Thurs 3-7 pm which included OT, PT, Music, etc.)<br />All you parents are inspiring!Unknownhttps://www.blogger.com/profile/08365667650315668880noreply@blogger.comtag:blogger.com,1999:blog-401303964563152307.post-53438612945207274212011-08-01T16:28:00.342-04:002011-08-01T16:28:00.342-04:00Meghan - Don't know what codes they used, but ...Meghan - Don't know what codes they used, but I will look into that. Thanks!!<br /><br />KevinAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-401303964563152307.post-1982507741489038132011-08-01T08:30:56.550-04:002011-08-01T08:30:56.550-04:00Ellen -
Our state chips in, but the program that...Ellen - <br /><br />Our state chips in, but the program that does it has a crazy paperwork trail to get it set up, and a sliding scale fee for participation. Currently, my son has a medicaid waiver, and being on medicaid makes the program free. The cost of therapy is higher than our $3600 (lump sum) buy-in, so we'll continue it once we lose the waiver...<br /><br />They're the payer of last resort, after you've exhausted all other options, they only cover things related to the specific diagnosis you're signed up for, and there are some recent rules that cut way back on the equipment they pay for, and the travel expenses they'll pay.<br /><br />But....it's better than nothing.kadierahttps://www.blogger.com/profile/03303473037288003918noreply@blogger.comtag:blogger.com,1999:blog-401303964563152307.post-82257784565313038072011-07-31T19:54:56.299-04:002011-07-31T19:54:56.299-04:00Excellent comment, Melissa.
BarbaraExcellent comment, Melissa. <br /><br />BarbaraAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-401303964563152307.post-7573279750359710442011-07-31T10:38:04.260-04:002011-07-31T10:38:04.260-04:00I own a therapy services company. Insurance contra...I own a therapy services company. Insurance contracts require that a provider bill the same, whether to an insurance company or individual. I've seen some providers give a sliding scale based on income, but I'm uncertain if this is technically ok to do. Insurance companies only pay a percentage of the billed rate, but providers aren't allowed to charge different rates for different levels of coverage. In our state, the difference in what's billed and what's paid is at least 30%.<br /><br />My input is that if you are going to private pay for a service and you have options, use a provider group that does not bill insurance, so that they don't charge the inflated rate. Ask about a sliding scale based on income or a reduction for prepayment. <br /><br />Be sure that the therapist you use is training you on home activities/exercises, to make the most of time spent outside of therapy. If you use a sitter or nanny, be sure that they get trained in the exercises too. I've found a lot of college students in elementary ed, special ed, and therapy are eager for extra work. Finding someone to be trained in follow through of a home program can increase the benefit you get and possibly allow you to reduce the frequency of sessions(and you take out the parent/child dynamic that sometimes interferes with parents doing home exercises). It's not a substitute for therapy, but using someone with a greater skill level gives you more benefit. Just my thoughts....Melissahttps://www.blogger.com/profile/04235120634316106561noreply@blogger.comtag:blogger.com,1999:blog-401303964563152307.post-68242772904109277192011-07-30T22:41:08.420-04:002011-07-30T22:41:08.420-04:00We get our therapies at an awesome children's ...We get our therapies at an awesome children's hospital, and they are skilled at manipulating the insurance system and coding stuff in a way that insurance will cover it. So we pay a $15 copay per session. Still, all those $15 sessions add up for us.<br /><br />What bugs me is that if Jack went to public school, some of these therapies might be provided free through school, and on school time. I don't think the public school therapists would be nearly as good as the hospital ones, but they wouldn't suck, either. But he goes to private school so we have to do them on our dime and our time. You'd think for what we pay that school they could throw in a little speech therapy here and there!Amy B.https://www.blogger.com/profile/16978301510902822185noreply@blogger.comtag:blogger.com,1999:blog-401303964563152307.post-2397935096986575082011-07-30T19:10:29.542-04:002011-07-30T19:10:29.542-04:00This post by a mother in Australia might interest ...This post by a mother in Australia might interest readers - although she focuses on the cost of equipment initially, she makes a point about funding all services. <br /><br />http://rollercoasterparenting.blogspot.com/2011/06/stopped-looking.html<br /><br />BarbaraAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-401303964563152307.post-65438126307228204992011-07-30T14:51:58.676-04:002011-07-30T14:51:58.676-04:00So no comment from a "Deep Throat" yet. ...So no comment from a "Deep Throat" yet. Sometimes I think only trusted family members of persons who do medical insurance work know what they do.<br /><br />This is an interesting 'survey' of costs, Ellen. I won't draw conclusions from the comments. Lots of variables....<br /><br />I resist accepting your two statements about having 'no choice' however, Ellen. You may not like either choice, but you are choosing to be employed (no one is forcing you) and you choose to pay because you don't like what the choice of not paying means to your son. <br /><br />Choices are severely reduced when you have few to no licensed therapists - drive further, move cities - tough choices but choices nonetheless. <br /><br />Perhaps I am picking at semantics, but 'cost' of therapy is so much more than the number of $$$$. BarbaraAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-401303964563152307.post-21824698809938065242011-07-30T14:40:56.738-04:002011-07-30T14:40:56.738-04:00We're a military family, so our medical bills ...We're a military family, so our medical bills are nonexistent. Really. Connor racks up about 3,000 dollars a week in medical bills, but the army covers everything, including the little guy's formula and our respite care. The only time we have a co-pay (three dollars) is for his medication, and that's only if we get it off post. Connor to date has racked up over $1,300,000 dollars in medical bills, so this is a very, very good thing.<br /><br />Of course the military comes with it's own big issues, like the one where my husband contributed his own (thankfully paid) 300,000 dollar medical bill after he was injured in Afghanistan. But we're extremely thankful for the military because with the insurance we'd be beyond bankrupt and probably having to make some difficult decisions about what therapies, equipment etc. the little guy would be getting. <br /><br />Good thing Jer likes the army. There's no way he'll be leaving it any time soon.Jesshttps://www.blogger.com/profile/06306757421878995110noreply@blogger.comtag:blogger.com,1999:blog-401303964563152307.post-46712469056715074172011-07-30T10:19:01.713-04:002011-07-30T10:19:01.713-04:00I live in Canada, and in our small town, we deal w...I live in Canada, and in our small town, we deal with the Child Development Centre until O starts school - we get ST, OT, PT & infant development. When he starts school, the Government has the at home program which covers in-school therapy. Great you would think, but we can go weeks without seeing a PT or other therapist, on account of holidays, sickness etc! Unfortunately there are hardly any other private pediatric therapists in our community, or even nearby. Larger cities, they range about $120 for main therapy. We see an accupressuist for $25, and we drive 5 hrs down to the States (Seattle) to see an ABM at $90, fly to California for another ABM at $175, and see a somewhat local feldenkreis practioner for $90. My husbands extended medical coverage pays for 80% of most therapist - we just have trouble finding ones that our close..Karenahttps://www.blogger.com/profile/04425320461040567780noreply@blogger.comtag:blogger.com,1999:blog-401303964563152307.post-67431689992304716612011-07-29T23:40:08.600-04:002011-07-29T23:40:08.600-04:00Kevin-do you know what code is being used for your...Kevin-do you know what code is being used for your child's therapy? I'm an OT (in IL) and we have to make sure we bill for what is being treated rather than the diagnosis itself (i.e., developmental delay rather than CP). Good luck!meghanhttps://www.blogger.com/profile/16262115124253386204noreply@blogger.comtag:blogger.com,1999:blog-401303964563152307.post-69637877765008087022011-07-29T22:55:58.853-04:002011-07-29T22:55:58.853-04:00$168/hour for ABM therapy. And we drive 4 hours to...$168/hour for ABM therapy. And we drive 4 hours to get there.Josephinehttps://www.blogger.com/profile/14833469209505496335noreply@blogger.comtag:blogger.com,1999:blog-401303964563152307.post-29296784321741201262011-07-29T22:35:30.371-04:002011-07-29T22:35:30.371-04:00We pay the copay for aqua therapy $35(1x week) - ...We pay the copay for aqua therapy $35(1x week) - we have an awesome doctor who wrties the aquatherapy script as medically necessary so they haven't faught us too much on it yet.<br /><br />I do hippotherapy with my son myself - obviously not as nice as when he had a true PT doing it with him but it costs me $25 for an hour of having the beginner riding instructor lead the horse aroud while I ride with Rhys and do his stretches (plus the 1 hour round trip to the barn and back) - so much more affordable this way -plus a great excuse for me to ride with him!<br /><br />Once we get his Eye Max up and running we will be paying another friend of mine under the table to help with extra speech and reading help - she is a licensed Speech Therapist with a Master's in Reading - $40 hour (she normally gets $100 hr for that work. Plus she is willing to work around my crazy work schedule.<br /><br />I think we are lucky in that we have great therapists in our area but not the super high prices of a city. We are in upstate NY so we have access to Syracuse and Albany if needed.Bwbellehttps://www.blogger.com/profile/05157743879952039071noreply@blogger.comtag:blogger.com,1999:blog-401303964563152307.post-47688686506773841602011-07-29T20:20:46.646-04:002011-07-29T20:20:46.646-04:00Oh Wow! You guys pay alot for therapy in the Stat...Oh Wow! You guys pay alot for therapy in the States. I'm in New Zealand and things are done very differently. We have a publicly funded health system that includes early intervention programmes. On the down side though we just don't have all the therapies available to us here that it seems you do over there.<br />My son just has one hour per week with his SLT, physio and early intervention teacher all together (NZ focuses on a very holistic approach to education and therapy). So that's one hour per week all up (and only during the school term).<br />So pros and cons to both systems I guess.<br />I do feel very lucky though living in NZ as we do not pay for any of my son's health care and he sure has been a million dollar baby (literally), at least!The Boydshttps://www.blogger.com/profile/17734578890361337666noreply@blogger.comtag:blogger.com,1999:blog-401303964563152307.post-29729733931439460342011-07-29T18:47:16.249-04:002011-07-29T18:47:16.249-04:00As an adult (27) living with CP, my therapy as a c...As an adult (27) living with CP, my therapy as a child was $160 per hour 3x per week. That was under my parents dual insurance. Now, my therapy, once per week is $120 per session, of which my insurance covers $50. I really can't afford $70 per week out of pocket, and even getting my insurance to consistently pay the $50 per week is often a battle. I'm often so inspired by the comments left by parents here...keep up the awesome work!Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-401303964563152307.post-43973431624002636382011-07-29T17:28:09.335-04:002011-07-29T17:28:09.335-04:00Right now between insurance and Early Intervention...Right now between insurance and Early Intervention, everything is covered except for the $200 we paid for a speech/OT camp this summer (3 hours a week for 6 weeks, taught by grad students). If insurance didn't cover us though, it would look something like this:<br /><br />School, 6 hours a week at $300 an hour: $1800 a week<br />Speech, 1 hr a week at about $120 an hour: $120 a week<br />OT, 2 hrs a week at $240 an hour: $480 a week<br />Behavior, 4 hrs a week at I'm guessing $150 an hour: $600 a week<br /><br />That's in the ballpark of $2,550 a week, and that's just my older son. The younger gets an hour of PT, and hour of OT, and soon an hour of early intervention a week. <br /><br />I don't know what we'll do once our older son turns 3 and ages out of Early Intervention. Insurance will pick up some visits but after that I think we'll have to pause therapy, or only do one therapy a time. We're also considering moving out of state (we're in CA).Mayahttps://www.blogger.com/profile/03796619359795526913noreply@blogger.com