In the midst of our IEP preparations, William is preparing for something else too.....to go bald once again to support research towards childhood cancers.
See his blog HERE.
See what he looked like last year in my blog post HERE.
28 February 2012
12 February 2012
An Insurance Victory!
We just received a check from insurance for, among other things, Ria's individual speech therapy for 2/17/11 and 2/24/11, and her *dyad* speech therapy for 2/17/11 and 2/24/11.
VICTORY!!!
I sent these in in July.
They were denied. The dyad sessions were denied "because we don't cover group speech codes", and the individual was denied "because it occured on the same date as those other speech sessions".
My insurance saviour at Google sent them back in January saying "pay them".
Jan 24: the 2/24 dates are denied "because this person doesn't have insurance with XXXX, send it to your real carrier".
Jan 31: the 2/17 dates are denied "because they are duplicates and we already finalized this one"
Feb 2: The 2/24 dates are denied for the original reasons "we don't do dyads" and "this was on the same date as another speech code, so its not covered".
Feb 3: ALL 4 SESSIONS, both the 2/17 and 2/24 dates, are denied AGAIN, because the claims are duplicates.
[Right about here we get the letter from 1/24 saying Ria has no insurance with XXX, and we fax the amusement on to our insurance saviour at Google.]
Feb 4: ALL 4 SESSIONS, are now magically approved. paid in full. ;-)
Today, we got the check.
Heh. You take THAT [unnamed insurance company]!!!
VICTORY!!!
I sent these in in July.
They were denied. The dyad sessions were denied "because we don't cover group speech codes", and the individual was denied "because it occured on the same date as those other speech sessions".
My insurance saviour at Google sent them back in January saying "pay them".
Jan 24: the 2/24 dates are denied "because this person doesn't have insurance with XXXX, send it to your real carrier".
Jan 31: the 2/17 dates are denied "because they are duplicates and we already finalized this one"
Feb 2: The 2/24 dates are denied for the original reasons "we don't do dyads" and "this was on the same date as another speech code, so its not covered".
Feb 3: ALL 4 SESSIONS, both the 2/17 and 2/24 dates, are denied AGAIN, because the claims are duplicates.
[Right about here we get the letter from 1/24 saying Ria has no insurance with XXX, and we fax the amusement on to our insurance saviour at Google.]
Feb 4: ALL 4 SESSIONS, are now magically approved. paid in full. ;-)
Today, we got the check.
Heh. You take THAT [unnamed insurance company]!!!
11 February 2012
Did you miss me? and IEPs.
So, it must be easy to tell when our life is crazy, as I don't post anything, eh?
I keep thinking, "surely at least one of these areas will come to some sort of neat conclusion soon, and I'll post about it then!", but then nothing comes to conclusion. And my progress on pictures is, erm, non-progressing.
Have a picture! this is from our spring 2011 visit to New Hampshire, while William was still mostly bald-ish. Ria had a bad haircut. She HATED being mistaken for a boy.
One of the areas of our current saga is starting to work with the local school district to determine what services they might provide for Ria next year when she enters Kindergarten. "Services" = "special education services", which is now called an IEP, or Individualized Education Plan. We started the process to get Ria evaluated to determine if she qualifies for an IEP late last year, and since then we've been getting reports from all our therapy providers to give to the school district to guide them, and the district has been doing a bunch of testing/evaluations of Ria on their own, to determine how her "challenges" (how do you like THAT euphemism!? Get used to it.) might impact her ability to learn in a school setting. Filter this all through the "California schools have no money since the state keeps stealing the school money" issue, and it's clear that there is a conflict between the needs of the kids, and the money available to meet those needs.
You've made it through another paragraph! Have a picture! This is from the same trip out east last spring, from our visit with Mormor and Grandpa Henry.
The testing process for Ria's IEP is done, now it's just a 3 week wait until the official meeting on 2/29.
It's been a bit of an emotional roller-coaster process. The 1st date of school testing, back in January, seemed to test 100% to Ria's strengths. She performed fabulously on the tests, so much so that the school psychologist was using careful words to prepare me for Ria not qualifying for an IEP. The 2nd date of testing the speech therapist pulled the test that she expected would be the most likely to make Ria "fail" (i.e., qualify for an IEP), and we thought she had failed it, but when the test was scored, she squeaked past, so no qualification based on speech skills (I guess 2 3/4 years of speech therapy has been helping!!). Then there were various parent questionnaires, and 2 observations of Ria at her school, one by someone from the Autism group and one by the school psychologist. Both of the observations seemed to run "short", by mine and the teacher's thoughts. We were all really concerned that they'd not stayed long enough to see Ria have to do something she REALLY struggled at. So, at this point, I'm freaking out that they aren't seeing what we see, that they're going to blow us off, etc., etc., which was in conflict from the very supportive feeling I was getting when I met with them in person. But then, luckily, someone had told me I should request to receive the reports/test results prior to the actual IEP meeting. I did that, and though I won't get some of them until a few days before the meeting, the school psychologist passed her draft on to me to review for factual errors. I reviewed it yesterday and was just thrilled....the things she noticed and noted down from the school observation were just spot on. She described Ria to a "T". Even though she only saw Ria performing less stressful/hard academic tasks, she still saw clearly how Ria responds. Basically, even though she left earlier than we had expected, she had seen all she needed to see ;-).
So, as of yesterday, my stress level and concerns have plummeted, and I feel relatively positive again about the IEP meeting coming up.
I'm still going to get what is called an advocate, someone who is specialized in special education law to be your personal expert. I've re-realized that I function best if I have maximum data, maximum information, maximum expertise...otherwise I collapse in a puddle of stressed out goo. Hopefully we'll never need to bring the advocate to an IEP meeting, I'd like to avoid the conflict approach. However, I need someone to help me understand if my expectations are reasonable, where is the line between what the school is supposed to help with and what we do with medical insurance. I just don't know the lay of the land in this area, and it's stressing me to death. So, we'll hire an expert, to help in the sanity area.
The reports we got from OUR providers to support the IEP process were great. The speech one was especially interesting. Since Ria had crossed over the 5 years old boundary, new tests were available for her. Based on her progress on the old testing we had been thinking we might be able to graduate her from individual speech therapy this year, but the new testing showed some fabulously interesting discrepancies in Ria's skills. Some tests she performed at the 83rd %ile, age equivalency of 9 yrs 11 months, others she was less then the 1st %ile. It's redirected her speech therapy into focusing on different skills. We'll be continuing with them for another few years ;-).
Oh, I could go on and on about the IEP stuff, but I'll stop there.
Here, have a picture!! This is from Julia, Will, Duncan & Toby's visit in July....a short escape from the earthquake insanity that is their home in Christchurch, NZ.
In addition to the many many many (many many) layers of the Ria saga, I've been trying to reclaim my body from the abyss it seems to have fallen into in the last few years of chaos. There's, of course, the requisite 5 MORE pounds that have shown up since I turned 40 a few years ago. In addition, however, my hips have returned to their post-childbirth chaos, and I have this vertebra that went AWOL during our visit to England over the summer, and which I can't seem to regain control of.
Have a picture for making it this far! This is from our visit to England last summer. Grandmother, us, and Alastair, Bev, and Rowan spent most of a week in the Lake District.
I can sometimes put my own hip back in place with my old physio exercises, but it's not reliable enough that I can give up the chiropractor visits. The one vertebra in my back is being tricky too. I've had to up my commitment to my physio exercises....I do them 6-7 days a week, 30-45 minutes a day. I've had to add in the core strengthening exercises. That plus trying to actually do cardio/fat burning exercise. The weight isn't coming off, but at least the joints are doing better ;-). It just takes so much TIME. I don't get to spend my evenings doing little projects on the couch (like blogging!), I spend them doing therapy. It's frustrating, but I guess that's what I get for ignoring my body for 2 years.
Insurance is making progress, very very slow progress, but that's whole other rant/story.
I keep thinking, "surely at least one of these areas will come to some sort of neat conclusion soon, and I'll post about it then!", but then nothing comes to conclusion. And my progress on pictures is, erm, non-progressing.
Have a picture! this is from our spring 2011 visit to New Hampshire, while William was still mostly bald-ish. Ria had a bad haircut. She HATED being mistaken for a boy.
One of the areas of our current saga is starting to work with the local school district to determine what services they might provide for Ria next year when she enters Kindergarten. "Services" = "special education services", which is now called an IEP, or Individualized Education Plan. We started the process to get Ria evaluated to determine if she qualifies for an IEP late last year, and since then we've been getting reports from all our therapy providers to give to the school district to guide them, and the district has been doing a bunch of testing/evaluations of Ria on their own, to determine how her "challenges" (how do you like THAT euphemism!? Get used to it.) might impact her ability to learn in a school setting. Filter this all through the "California schools have no money since the state keeps stealing the school money" issue, and it's clear that there is a conflict between the needs of the kids, and the money available to meet those needs.
You've made it through another paragraph! Have a picture! This is from the same trip out east last spring, from our visit with Mormor and Grandpa Henry.
The testing process for Ria's IEP is done, now it's just a 3 week wait until the official meeting on 2/29.
It's been a bit of an emotional roller-coaster process. The 1st date of school testing, back in January, seemed to test 100% to Ria's strengths. She performed fabulously on the tests, so much so that the school psychologist was using careful words to prepare me for Ria not qualifying for an IEP. The 2nd date of testing the speech therapist pulled the test that she expected would be the most likely to make Ria "fail" (i.e., qualify for an IEP), and we thought she had failed it, but when the test was scored, she squeaked past, so no qualification based on speech skills (I guess 2 3/4 years of speech therapy has been helping!!). Then there were various parent questionnaires, and 2 observations of Ria at her school, one by someone from the Autism group and one by the school psychologist. Both of the observations seemed to run "short", by mine and the teacher's thoughts. We were all really concerned that they'd not stayed long enough to see Ria have to do something she REALLY struggled at. So, at this point, I'm freaking out that they aren't seeing what we see, that they're going to blow us off, etc., etc., which was in conflict from the very supportive feeling I was getting when I met with them in person. But then, luckily, someone had told me I should request to receive the reports/test results prior to the actual IEP meeting. I did that, and though I won't get some of them until a few days before the meeting, the school psychologist passed her draft on to me to review for factual errors. I reviewed it yesterday and was just thrilled....the things she noticed and noted down from the school observation were just spot on. She described Ria to a "T". Even though she only saw Ria performing less stressful/hard academic tasks, she still saw clearly how Ria responds. Basically, even though she left earlier than we had expected, she had seen all she needed to see ;-).
So, as of yesterday, my stress level and concerns have plummeted, and I feel relatively positive again about the IEP meeting coming up.
I'm still going to get what is called an advocate, someone who is specialized in special education law to be your personal expert. I've re-realized that I function best if I have maximum data, maximum information, maximum expertise...otherwise I collapse in a puddle of stressed out goo. Hopefully we'll never need to bring the advocate to an IEP meeting, I'd like to avoid the conflict approach. However, I need someone to help me understand if my expectations are reasonable, where is the line between what the school is supposed to help with and what we do with medical insurance. I just don't know the lay of the land in this area, and it's stressing me to death. So, we'll hire an expert, to help in the sanity area.
The reports we got from OUR providers to support the IEP process were great. The speech one was especially interesting. Since Ria had crossed over the 5 years old boundary, new tests were available for her. Based on her progress on the old testing we had been thinking we might be able to graduate her from individual speech therapy this year, but the new testing showed some fabulously interesting discrepancies in Ria's skills. Some tests she performed at the 83rd %ile, age equivalency of 9 yrs 11 months, others she was less then the 1st %ile. It's redirected her speech therapy into focusing on different skills. We'll be continuing with them for another few years ;-).
Oh, I could go on and on about the IEP stuff, but I'll stop there.
Here, have a picture!! This is from Julia, Will, Duncan & Toby's visit in July....a short escape from the earthquake insanity that is their home in Christchurch, NZ.
In addition to the many many many (many many) layers of the Ria saga, I've been trying to reclaim my body from the abyss it seems to have fallen into in the last few years of chaos. There's, of course, the requisite 5 MORE pounds that have shown up since I turned 40 a few years ago. In addition, however, my hips have returned to their post-childbirth chaos, and I have this vertebra that went AWOL during our visit to England over the summer, and which I can't seem to regain control of.
Have a picture for making it this far! This is from our visit to England last summer. Grandmother, us, and Alastair, Bev, and Rowan spent most of a week in the Lake District.
I can sometimes put my own hip back in place with my old physio exercises, but it's not reliable enough that I can give up the chiropractor visits. The one vertebra in my back is being tricky too. I've had to up my commitment to my physio exercises....I do them 6-7 days a week, 30-45 minutes a day. I've had to add in the core strengthening exercises. That plus trying to actually do cardio/fat burning exercise. The weight isn't coming off, but at least the joints are doing better ;-). It just takes so much TIME. I don't get to spend my evenings doing little projects on the couch (like blogging!), I spend them doing therapy. It's frustrating, but I guess that's what I get for ignoring my body for 2 years.
Insurance is making progress, very very slow progress, but that's whole other rant/story.
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