From the perspective of Dyan Roosma, Treatment Mom
When money is tight, so is care for your child. We know that struggle well. Before I share my story with you, I’m going to give you some tips on how to deal with your insurance company. We could’ve avoided lots of heartache years ago if we knew more then.
What to Do with Insurance Companies
1) Document EVERYTHING
Document every treatment you have tried, every behavior your child exhibits, every emergency room visit…you get the point.
You’d think the insurance company would have these records, but they conveniently don’t keep track. You should.
2) Appeal everything
Be a squeaky wheel. Make them deny your claim—even to the point where you may have to go before a judge. That’s where all that documentation comes in handy. We didn’t have everything we needed and were denied. We might have won if we had all the documentation.
3) Call your ombudsman
An ombudsman is an independent liaison between government-run insurance companies (Medicaid) and regular people. They can help you understand all the complicated jargon and know your rights.
Check out: http://www.locateombudsman.com to find an ombudsman in your area.
Find out if the therapist or program you prefer can do a “single case agreement” with your insurance company if they don’t already work together. They are more likely to agree if you have already tried their programs with no success.
5) Take good care of yourself
Dealing with insurance companies is almost as exhausting as raising your special needs child. It takes a toll on your emotions and your resources.
Don’t forget to take a break. Share the burden with your significant other. Get a massage…anything that helps you to relax and breath.
We legally lost our son because we couldn’t get him the care he needed. The insurance company wouldn’t pay because our son wouldn’t cooperate with his treatment—a symptom of his mental illness. The judge in our son’s criminal case was beside himself with the irony of it all. He tried to help.
The judge tried to order the insurance company to pay for our son’s care. Unfortunately, the insurance company wasn’t required to listen to a small town judge. So they didn’t.
In the end, the judge concluded we weren’t able to care for our son financially or legally. It was heart wrenching.
I wish I had known then what I know now about how to deal with insurance companies. We might still have our son.
It’s not fun to deal with insurance companies. Our story has a sad ending but yours doesn’t have to end that way. You can keep your head up knowing you have done all you can to navigate these scary waters successfully.
Image courtesy of Stuart Miles / FreeDigitalPhotos.net
Are you dealing with problems with insurance? Please share them below. Maybe I can give suggestions.