Any Recourse??[QUOTE=tzoya]Gotta go up the chain of command. Hopefully, you have your promises in writing. Always remember, if it is not in writing it wasn't said.[/QUOTE] I think that's going to be the problem..... Babies Can't Wait of GA is refusing to cover 3 months of Jack's Therapy...I'm placing the letter below which explains it all: Ms. X, I am emailing you in regard to our conversation per 3 weeks ago regarding my son, Jackson , and the mix-up that seems to have occurred between myself and our Service Coordinator at the time. While I have heard back from your secretary concerning the BCW Program assisting us monetarily with Jackson’s Speech and Occupational Therapies at X Regional Medical Center from May 2008-August 18, 2008, I have yet to be contacted regarding the dates in question of February 2008-May 2008. To remind you of the situation: I contacted Babies Can’t Wait in January 2008. My son was evaluated, and during the meeting between myself, Service Coordinator, and the evaluators (via phone) in February 2008, it was stated that my son should continue receiving Speech and Occupational Therapy at his current rate at X Regional Medical Center at the rate of two times per week per session. Service Coordinator went over the percentage share cost of the plan, stating that I would be responsible for 25% and BCW would cover the remaining 75%. I specifically asked “Once my Insurance stops paying, BCW will kick in?” At that time I was filing Jackson’s Therapies under our Family Medical Plan with X Health Care. I was specifically told “Yes” by Service Coordinator. In May 2008, I was alerted to the fact, by X Regional Medical Center, that Jackson did not have an IFSP on file. When I contacted BCW, an IFSP was hurriedly completed over the phone (no additional evaluations were necessary) and faxed to X Regional Medical Center so that Jackson could continue his Therapies. Now, I understand that BCW is tied by paperwork, and that an IFSP was not completed on Jackson until May 2008. However, I continue to maintain that I was under the belief that when Service Coordinator and I parted ways February 2008, that all of Jackson’s paperwork with BCW was completed, and that BCW would be covering his Therapies at the percentage share rate as soon as our Insurance with X Health Care was used completely. I am simply a parent, unused to the procedures and paperwork of your program. That is why I made sure to ask Service Coordinator specifically about the percentage share plan and if BCW would kick in automatically. I am now very distressed to hear that Jackson’s Therapies from February 2008-May 2008 will not be covered due to what I believe was a miscommunication between Service Coordinator and myself. In May 2008, when the IFSP was hurriedly completed by BCW, I was told that Service Coordinator (after being contacted about the situation) had been told by me, at the February 2008 meeting, that our Insurance Company, X Health Care, would be covering Jackson’s Therapies until he was 3 years old. Due to the fact that Jackson was attending 8 sessions of Speech and 8 sessions of Occupational Therapy per month, and X Health Care only covers 40 sessions of each per year, it is absolutely impossible that I would have stated such to Service Coordinator…which leads me to further believe that this entire situation was a matter of miscommunication. Therefore, I would like to request that Jackson’s Therapies at X Regional Medical Center from February 2008-May 2008 be covered under the percentage share plan that Service Coordinator outlined to me at the February 2008 meeting. While I understand that paperwork is a problem in this scenario, I feel that this situation was one of miscommunication wherein I believed that my son was covered under the BCW percentage share plan from February 2008 onward. Thank You, Each state has different rules for Early Intervention. YOu might do better with advice if you put your state in the title of the thread. It is fine for states to charge for EI. FREE starts at age 3.Valuable lesson learned. Keep a paper trail going. This will apply until your child finishes HS. I've tried SEVERAL systems over the years and none really worked for me until I resorted to an old-fashioned 3-ring binder, punched every official paper, kept it (going back two years -- older papers archived in the attic) in reverse chronological order and NEVER allow those originals to leave the house -- I use my printer to make copies and/or I make extra copies of documents that I need to present frequently (like signed med OKs) at Staples. If you don't have documentation, I doubt you'll get anywhere. Maybe you'll have to ask to do the evals over again. Get help from your local EI.I'll try that. I guess my letter doesn't explain succinctly enough....I'm not asking for FREE services. Jack has been getting ST/OT since August 07. In Feb 08, I completed everything with BCW and was told that they would pay for Jacks therapies at 75% AFTER my Insurance was used up (40 visits each). Then in May I am told by the Hospital that BCW never sent over an IFSP for Jack...that's the form that authorized the facility to provide services, and BCW will pay 75%. The BCW Services Coordinator then states that I never asked for BCW to cover Jack's thereapy when Insurance kicked out...instead saying that I said not to worry about it, my Insurance would pay for all (which is niuts in itself...I WISH we had that kind of Insurance!! This Coordinator soon left BCW after our Feb 2008 appt....and I sincerely feel that we got lost in the mix. Honestly, I feel as though she comletely dropped the ball on us. I am only asking that BCW pay the agreed upon % from Feb 08 forward, not May 08 forward (when the IFSP was hurriedly completed over the phone when we realized what had happenmed). Basically, BCW is 'getting out of' 3 months of services (about 3k worth) because of this. And as I'm paying on the other 5k from August 08-Feb 08....I'm pursuing this. I could understand some things....but I was completely led to believe that we were all set when we left the Feb 08 meeting. |
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