Autism Evaluation

Many of you have probably already heard but on 6/18 we took Max to see Dr. Hoffman for his autism evaluation. We were referred to him by our regular pediatrician after he failed the short autism evaluation with his 2yr check up. Dr. Hoffman spent almost 2 hrs asking us questions, playing with Max and evaluating him. They really prefer to wait until children are older to diagnose them but if they wait too long they will miss out on alot of early interventions and therapies they need. He diagnosed Max with being on the spectrum. As he gets older we will be able to determine how severe his autism will be. The diagnosis was not a surprise to us. He has been regressing and showing signs of being autistic for the past few months. We feel very blessed that they were able to diagnose him early so that we will be able to get him the early interventions he will need to be successful. We know that we are only at the beginning of what will be a very difficult journey but we know that we will have lots of love and support along the way.

Paradise Park

This free digital scrapbooking design generated with Smilebox

Toothbrush

While doing picture flash cards with Max when I told him he had a "toothbrush" he put the flash card in his mouth like he was going to brush his teeth. How cute is that? Well if he can't say what things are I guess he'll just show me what they are.

Stressed!

Before I start this story you have to know prior to this day I called the insurance company several times to find out if different ped specialist were under our insurance. Most of that time was a waste because most of the peds under our plan were booking many months away. So the story begins....
I was very excited to get the news that the pediatrician was able to get Max in to see a specialist at the end of June. I decided to call the insurance company to make sure they would cover his evaluation. The first lady from the insurance told me the physician he was going to see was not in network therefore I would have to pay the entire bill. I was sure this would be more than just a normal office visit charge since they do a 2-3hr evaluation. I couldn't believe my insurance as an RN covers 0% if you use out of network providers. That led me to call work to talk to someone from human resources. Sure enough our insurance covers 0% if you go to someone out of network. So I then asked her to tell me what specialists he could go see. She tells me that the Dr. he is scheduled with is in network and is unsure why the insurance lady told me he wasn't. That led me to call the insurance comany again. They tell me as long as they bill under the Dr. it will be covered but if they bill under the clinic it may not be. That leads me to try and call the clinic but I guess since its new and the staff travels to different clinics in the area the people are not at that location at the time I call. I spend over and hour trying to get ahold of the actual clinic before I get told they don't charge under the Dr. it will be charged under the clinic. So I call the insurance company back and they can't find that clinic in or out of network so they will need me to call clinic back to get the tax ID #. I then have to leave a message for someone who will have to call me back. Get a call later with tax ID #, call insurance back again. I have to talk to a machine every time I call the insurance company back, put in my account info every time and I get a new person every time I call. Guess what.. the tax ID number they gave me is not covered under our insurance. I finally tell the insurance company that I don't understand that if the Dr. he is going to is in network and the hospital that the clinic is under is in network why it would not be covered. They just "really aren't sure". I then not so sweetly explain to the insurance company they need to call the clinic and figure it out then. I explain to them that my child needs to be evalauted for autism ASAP and that if he can't go to this appt no one else can see him until the end of Sept. After wasting three hours on the phone that day and speaking to everyone at Cigna I get told by the last insurance lady that she "thinks it might be covered and if not I can appeal it". Fabulous! I am so glad I pay taxes and pay monthly to have this great health insurance!

Hand Foot and Mouth Virus

After working Thursday night I got a call Friday morning from my mother telling me Max had been up most of the night not feeling well and running a fever. Luckily our pediatrician has urgent care hours early in the morning so we got to take him to the pediatrician right after I got home from work. He got diagnosed with the hand, foot and mouth virus which is a very common virus in children. He has a few sores on his throat which explains why he has been so cranky. Basically you treat them with Motrin and Tylenol while the virus runs it's course. The good news is when I complained to the nurse practitioner about not being able to get Max in for an autism evaluation until the end of Sept. they agreed to make a few phone calls. Before we even got home I got a call saying he had an appt on June 22nd at a new pediatric specialty clinic that has just opened. I also got a call from Children's Mercy hospital later that day and they are sending out some paperwork for me to fill out to see when they would be able to see him.

First Steps

Today the lady from First Steps came out to sign paper work. First Steps is Missouri's early intervention system for infants and toddlers with special needs. We have been referred to them by our pediatrician and our Parents as Teachers educator. Basically unless you have a medical diagnosis like "autism" (or many other diagnoses) the only way they agree to come out and do services is if your child is functioning 50% below their age. Since Max can't get into a specialist to be evaluated to see if he has autism until Sept. we are "hoping" that on June 17th he is considered to be functioning at a 1yr old level in at least 1 of 5 areas. I know it sounds horrible to say we are "hoping" he is functioning as a 1yr old but we know he really needs the early interventions this program can provide and without a diagnosis that is the only way to get their assistance.