After about two years of medications not working, the psychiatrist has referred my Lvl one teen in for Ketamine and TMS program. There is controversy about its use in minors but it is approved in extreme cases. My son's case is extreme, he has had more self harm and attempts on his life than I can count. I am curious if anyone here has experience with either of these treatments. His occurring diagnosis are MDD, ADHD and RSD.
I thought I would share to help encourage anyone else who feels helpless with the insurance hurdles in this industry.
Headways new requirement for biometric data was the straw that finally broke the camels back for me. Lately, I have also seen pay rate decreases and a failure on their parts to actually refer new clients though they sold me on that to begin with.
First step: I made sure I was credentialed individually with every insurance company I was currently working with through my existing client base on the platforms. If you are not credentialed, this process will take 3 months, maybe more. I had done this when I first became licensed and it did require a lot of follow up, phone calls, etc, but not impossible. It IS confusing but if you allow yourself time to figure out the various details it becomes clearer.
Second step: I gave notice to my clients that I was transitioning to my own billing and collected credit card info for their co-payments.
Third step: I signed up with Square to take those cards which was easy because I already had a business bank account.
Fourth step: I searched through billing companies because I see a lot of Anthem and Aetna clients and Availity is hell on earth. Inovalon ended up winning for me so I signed on with them. What followed was approximately two months of onboarding and of testing claims through Inovalon while also having access to the VC platforms while I waited to see if this would work. Inovalon has a whole team to setup your billing and EFT enrollments. Some of the claims went through, some got denied. When they got denied I had access to the insurance companies billing department which was a lot easier to work with than I imagined.
Fifth step: CANCEL MEMBERSHIPS WITH VC PLATFORMS AND FREEDOM!!!!!
All in all I devoted probably a good 25-30 hours for all of this including the original work to get credentialed. The longest part was waiting on responses for claims, it is not a process that gets up and running in a month, you need a few months and patience but it is absolutely worth it to stick it to the capitalists in my opinion. I hope this helps encourage any of you who thinks you can't do this without these VC companies.
Hello, I am a therapist and a parent to a LVL 1/ADHD teen boy and I guess I am just reaching out for some validation.
Our family (except me) see his behaviors (school avoidance, social avoidance, self-harm, self-medication, anxiety med seeking) as him being a flunkie and I even catch myself wondering what is the autism and what is not. He masks well but when he comes home he is incredibly depressed, has S/I and as a part of his meltdowns, he self harms.
I don't sleep well and I feel chronically in a state of fight/flight but worst of all, I can't figure out how to save him. He has been working with all of the professionals, a therapist and a psychiatrist who specialize in autism for the last 18 months. He is at a small private school with all of the accommodations needed being provided EXCEPT making him feel socially accepted when he is unable to see that the other kids like him. He shakes when it is time to go to school and so I tell him it is okay and he can switch to online school. But he says he wants to fit in and try. Every time he tries to go attend class and fails, he gets more and more depressed.
I am looking for the opinions of other parents of ASD kids because I feel overwhelmed and lost. Should I tell him that's it, no more of this school and I cannot let him continue to walk into the wall like this? Or do you think that would just make him feel less seen and understood by me since he is saying he wants to keep trying?