Dealing with our insurance company is a trip

skittles_123

Kind of interesting, my lovely state has an awesome law that requires all insurance providers to cover therapies related to autism with no limits to how much they have to pay. The problem is, self-insured policies don't have to pay, which is what we are.

Well, we are submitting our claims anyway, as that is what my dh's employer advised us to do and final appeals will be reviewed by the company themself. Which gives us hope, because it is a large, well-known company and they cannot afford bad publicity with this. Plus they told us more than likely they will cover anyway (but we will actually have to see if this holds true, with the economy the way it is).

In the meantime, we just got our first denial for ABA therapy. And the thing is, they are denying us because it is considered experimental. While, most of us ASD mommas know, that isn't the case, and we will of course appeal with lots of research articles and a doctor's letter, I am wondering what they will come back with?

The thing is, with both the speech claims that were recently denied along with the ABA stuff, you would have thought they would have denied based on our policy not covering these services?

As when I called them orginally, before we even started any therapies, this is what they originally told me. I am kind of interested to see how this all pans out. . .