Friday, September 18, 2009

Working the system

For the past 8 months, Drake has been receiving weekly in-home speech therapy through our state's Early Intervention program. However, California's budget crisis caused a new law to be passed that says children in this program now have to use their private insurance for speech therapy. And the Early Intervention program won't bill their services to insurance carriers, so no more home visits. Since we have private insurance, I was given 30 days to find new therapist.

I don't mind using my insurance to pay for speech therapy. I like using my insurance, because hey, I pay for it anyway. And if it means more kids without insurance get services, that is great, too. What I do mind is that we no longer get home visits. My hubby and I both work full time and every appointment out of the house is a logistical nightmare with our work schedules and child care. We already have 3 out of house appointments each week, this would add a fourth.

So I complained and sniffed around and found out that if you can show documentation that you are on a waiting list for speech therapy, EI will extend your home visits/services until you get off the said wait list. So what did I do? I found the longest wait list ever, over a year, at local hospital who provides pediatric speech therapy. I got a note saying we were on the list, sent it off to EI and got my home visits extended 6 months! We will revisit after 6 months and if we are still on the wait list, well, we'll get another 6 months!

Workin' it.


Hopeful Mother said...

Very interesting strategy! I like it!

We are in a similar boat, but probably don't have the waiting list option since our therapist's speech agency takes insurance. We have Al.ex's IFSP meeting in 2 weeks and will have to show that we are pursuing insurance coverage for speech which we currently have funded through EI/Regional Center.

I'm curious what they intend to do about co-pays - ours is $15 per session. That will really add up quickly...

Anyway, good detective work and resourcefulness!

Anonymous said...

Nice! It almost seems like the system is designed to FORCE you to have to be a good detective and find the loop holes. I think they think most people will just give up... guess they don't know Mamas very well :)