Jump to content

Menu

Which is easier...to get an evaluation or walk/swim to China?


Janeway
 Share

Recommended Posts

What do you think..is it easier (and quicker) to walk and swim to China from Texas, or, get your child evaluated for LD and maybe ASD?

 

So I started the calls again today. I have not made calls in a couple months. Trying to find any place to get my son on a wait list for an evaluation. He has been on wait lists in the past and then for whatever reason (usually, insurance) ended up off the lists.

 

So far today, I have called several places. The whole thing raises my blood pressure and gets me no where. I just want to scream!!!! To top it off, even if I get him on waiting lists, the moment our insurance changes, he will get dumped again and I will have to start this whole process over. And if we get stuck with United Healthcare again, no one will take the insurance and UHC does not work well with others so they do not find anyone for an appointment.

 

Edited to add: this whole trying to get an evaluation has gone on for 3-4 yrs now.

Edited by Janeway
Link to comment
Share on other sites

Ugh, UHC. I feel your pain! At least they will theoretically cover a NP eval whereas Kaiser flat-out refused, even when the NP eval was related to the medical disabilities of hearing loss and autism. Kaiser only covers a NP eval when the child has suffered a traumatic brain injury or stroke. :cursing:

 

I have found with getting on waiting lists, it's easier when the pediatric neurologist writes a referral than when I self-refer. We were on the OT waiting list for ages but when the neurologist sent over a referral, that apparently bumped us up in priority.

Link to comment
Share on other sites

Can you get a list from your doctor of places that accept your insurance?

 

Can you get a referral through your doctor's office?

 

Those are helpful things with our insurance.

 

I don't know anything more specific to your insurance or location :(

Edited by Lecka
Link to comment
Share on other sites

Ugh, UHC. I feel your pain! At least they will theoretically cover a NP eval whereas Kaiser flat-out refused, even when the NP eval was related to the medical disabilities of hearing loss and autism. Kaiser only covers a NP eval when the child has suffered a traumatic brain injury or stroke. :cursing:

 

I have found with getting on waiting lists, it's easier when the pediatric neurologist writes a referral than when I self-refer. We were on the OT waiting list for ages but when the neurologist sent over a referral, that apparently bumped us up in priority.

We went the neuro route previously. But now, the health insurance we were on has no child neurologists. They only had pediatricians and nothing else really. None of the children's hospitals or their doctors were on the insurance. Now we are on medicaid and I am hoping to avoid the whole, start with a new doctor and spend months waiting to go through the string ...pediatrician to neuro to psych. Especially since it would involve a brand new pediatrician and frankly, I do not want to face the whole "oh, you home school, just put him in public school" answer. ugh! In the past, we did use the children's hospitals, but that was years ago. And that was just the eval. We did services for one child, but the wait list was almost 5 yrs for services. He actually aged out from their autism services just a few months after he got in. We don't do any sort of ASD specific services anymore as a result.

Link to comment
Share on other sites

Separate the two processes. Do the autism evaluation first (which will have clearer insurance coverage), and then the LD one.

I did have the processes separate. I always assumed there would never be an LD eval. But, the insurance claimed to cover ASD eval, but then dropped everyone who did the eval. THEN, when working with them in some special division to find someone to do the eval, they would talk to me and then refer me to someone else to talk with me. And then that person would tell me she would call me back with a list. Six weeks or so later, she would call and leave a message with a list (can never call her, only she calls us). The list always included no more than 3 random people and so far, none of those did ASD evals, and often, they did not even take children. At one point, they did get us in with a psychiatrist. That psychiatrist was so bad, he should not be in practice. He left the children in the waiting room, by themselves, without me. Fine, whatever. The oldest was old enough to watch the youngers I guess. Then, without meeting the kids or really asking me much about them, he prescribed medications like Risperdal. When I told him they were not diagnosed with mood disorders, he said kids with ASD always end up needing it. And that was it. I never filled the prescriptions. Never went back. To top it off, that guy was an hour away. We did get in with a neuro for the older kids. The neuro agreed that the kids should not have had those medications. The neuro actually did meet my children. But my 12 yr old, the one I need a new eval for, did not go to the neuro.

 

I have been told UHC is just really bad. Medicaid is already turning out to be better. But, still have to deal with wait lists and I am thinking we will not be on medicaid by the time it is our turn on the wait lists.

Link to comment
Share on other sites

ASD eval can easily be done by a developmental pediatrician. It is a sub specially if pediatrics and part of their main focus of practice. But there is a vast shortage of them in the US, some states having only one. Look for a children's teaching hospital for your best bet.

 

Neuropsych can be difficult, but it shouldn't matter if your insurance changes or not. Call and make an appt (for 2-8 months in the future). If they ask for insurance info then give it. If it changes then so what? It was going to be self pay anyway.

 

Good luck!

Link to comment
Share on other sites

ASD eval can easily be done by a developmental pediatrician. It is a sub specially if pediatrics and part of their main focus of practice. But there is a vast shortage of them in the US, some states having only one. Look for a children's teaching hospital for your best bet.

 

Neuropsych can be difficult, but it shouldn't matter if your insurance changes or not. Call and make an appt (for 2-8 months in the future). If they ask for insurance info then give it. If it changes then so what? It was going to be self pay anyway.

 

Good luck!

the children's hospital's require insurance up front. If they don't take your insurance, they will not put you on the waiting list. They knocked him off the waiting list when they stopped taking our insurance.

Link to comment
Share on other sites

I think it'd be easier to swim to China. 

 

Just to give you big hugs.  And to say that United HC sucks. I've had it.  I've had several providers tell me that.   We have Blue Cross Blue Shield now and they are much better.  But maybe with Medicaid this is better for you, now. I hope so. 

 

And also, in case it makes you feel any better...I've taken what I call "expert breaks."   You know, I bet, experts that don't know as much as you, aren't helpful, even harmful maybe.  And a waste of time and money.  So sometimes you want to clear your mind and calendar of said unhelpful, expensive experts and just enjoy your awesome, cute, lovable, amazing kiddo for awhile. 'Cause our kids are awesome and lovable, to say the least. 

 

 

Link to comment
Share on other sites

You might be luckier at this point trying for a small psych, someone who works solo, rather than going for a big name children's hospital. Around here, I can find a clinical psych on the Hoagies Gifted list who can diagnose ASD just fine and discriminate SLDs. That clinical psych's price? Around $800 for an eval. A private neuropsych eval will be 3X that, and an eval at the children's hospital is radically, radically more.

 

You might ask in your community where other people have gone. Have you contacted a local autism support group?

I've even talked with people who got their diagnosis through the pediatrician, boom done. I don't think that's common, but it *is* accepted by the ps as the starting point for IEP purposes. So maybe aim lower and make SOMETHING happen.

  • Like 2
Link to comment
Share on other sites

I've had crummy, hasty, out and out incorrect evals by big name popular psychs in big cities, and I've had really thorough, patient, detail-oriented, attentive evals by small name psychs in small towns nobody ever heard of. 

 

I think it really matters if the place is so busy they use a lot of assistants. Some hospitals are teaching schools, so your testing is done by students. Seriously. You could wait all that time and get a STUDENT. My dc has a very complex presentation, and you're going to use a NOVICE??  Really???

Edited by OhElizabeth
Link to comment
Share on other sites

Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.

Guest
Reply to this topic...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.

 Share

×
×
  • Create New...