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Monday, May 23, 2011

And so he got approved...Sorta.

Finally. I had received the "Pre-Authorization" notice for Bryce to go to Day Treatment Day Camp for the summer. I had practically crawled up his Case Manager's hind end as to know when I was to get the paper work. After several weeks asking about this paperwork to fill out, she FINALLY tells me that Medicaid is "doing things different this year and pre-authing" the clients". Nice! Thanks for telling me after WEEKS of speculation.

So, I get my copy in the mail last week. He got approved alright! For "Mental Health Partial Hospitalization" due to it being "Medically Necessary And Approved as Requested".

Stupid insurance formalities! I am NOT placing my kid in a Psych Ward. He is going to be in a Summer Camp with other kids with problems and disabilities as he too has.

In the Day Treatment Day Camp setting, they not only do fun things like crafts and go to various places. They learn the tools (or are re-taught, if they have "forgotten") to help them have better social and behavioral skills. And they even receive therapy on-site at least once a week. And they learn how to better form and interact in friendships.

Most of these kids don't have any real friends. Why? Because of their "quirks", like being so short tempered, their ability to ramble on about one certain thing, not letting others speak or they get cut off because our kids have yet to master the social cues of when to "talk and when to shut up". Or they have visible tics that scare other kids from interacting with the one affected.

At least at the Day Treatment Day Camp, EVERYONE is equal. There is no shunning. They feel safe and comfortable. And if their "quirks" decide to shine, that's okay. Even the negative ones. But they will get assistance in trying to "deal" with the more negative aspects of the times where being good is just a little bit more hard than most days for them.

But one little hitch is still in the plan. Where in the world is my paperwork to OFFICIALLY place him in to the Summer Camp? I guess I will get to make the lovely call (again!) to ask his ( in new to being one) Case Manager once more about getting the papers to fill out and give permission to be in the Day Treatment setting.

It's only about two weeks away. So they best give me my papers to sign. Or else, if she cannot do her job properly, I will have to report her to Bryce's old CM, who is now in charge of the CM staffing.

And I REALLY hate "tattling" on people, only to get them in to trouble. But by golly! They need to do their job and do it in a TIMELY manner. Yes, there are other kids besides mine that they help and I duly understand this. But I appreciate equal time and concern for my kid as well, along with the other patients.


Missy (& various in Transplant blog) said...


*Calls Child & Family Services office, gets hold of Case Manager, asks about papers to fill/file for Day Treatment*..

Gets, "Funny, I was going to call you *TODAY* about that" from the CM.

Yeah, okay. In other words, that tells me you got caught when it's been almost a week since I got the approval note from insurance.

Seems I am ALWAYS calling at a "funny" time of them about to call me THAT day.

singedwingangel said...

OH how convenient that you called at that time.. stupid government staff. If they walked a mile in our shoes I bet they would do it better..

Mary said...

Hi Missy--Still following your brave story. Love your ability to be real. I also tagged you recently in the Versatile Blogger Award. Head on over to my blog to pick it up.

Pretty Things said...

I'm glad to have found your blog today. I have a son with Asperger's and it's so hard to get the medical community who is supposed to be there to make things BETTER get in line to HELP. I'm so frustrated, feel so alone almost all the time. Thanks for your blog.

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