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Old 08-19-2010, 03:49 PM - Thread Starter
 
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I'm very frustrated right now & needing some guidance. Basically, my son w/SN (ADHD/LD/SPD) is requiring vision therapy. The cost is very high and not something we can afford. Because we adopted our son from the state, we have state insurance for him. When I asked the eye care place if insurance covers it, they said that typically no & that we are to pay & can hash it out with the ins company. So I called the ins co & they said (politely) that they can't talk with us, that it's the responsibility of the eye care place and that's the protocol. So I called the eye care place back & told them & she said that they were *not* going to call.

I got very frustrated because we're in between a rock & a hard place. I told her we couldn't afford it & that there's a good chance that the vision therapy will be covered due to his SN. She was firm that she would not call, but ins said that it is the duty of the eye care place to call to establish whether it's a covered charge & if the eye care place doesn't, then they don't get paid. I feel like this is a sneaky way that the eye care place ensures that they get their money (from us!).

So I had my husband call, thinking that sometimes a man gets listened to better than a woman. She gave him the same song & dance. But the kicker is, the therapist (who works contractually through this eye care place) left a mssg stating that the reason they don't call insurance is because they only get paid $15 on an $80 bill (BTW, it's $80 per session & my son will need at least 8 session plus there's a program we have to buy, etc, etc) --so it's spendy. I feel like the office lied to me, saying it wasn't covered.

So my questions to you are, is this legal? Does anyone know of a low-cost or DIY program for vision therapy? His diagnosis is "Convergency Insufficiency" which basically means he has difficulty tracking & sustaining his eye/brain to track. I would appreciate any advice because I'm just sitting here crying because I'm so frustrated & feel like I can't get straight answers or having the person do a simple thing as call the insurance company. I can't help it if the ins company only pays them $15

: Jewel~ Mama to 4. Quilting & Sewing WAHM living a natural life.
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Old 08-19-2010, 04:57 PM
 
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That's frustrating. Our eye place would file with insurance but we had to pay what insurance would not cover. That is legal if they aren't a provider for your insurance or if your insurance won't cover a portion related to the therapy (our case). So it was still expensive for us even with insurance covering a bit.

The only thing I can suggest if you really can't afford it is to get the book "Developing Ocular Motor and Visual Perceptual Skills An Activity Workbook by Lane. A lot of our assignments came out of that book and so I bought it myself. But gosh it would be hard at the beginning especially to do it on your own. It's not the activities as much as I would have felt overwhelmed with what to do/where to start and with the difficulty of the assignments. I was overwhelmed with how hard it was for my son and that was with a doctor making the assignments. It was just so incredibly hard and we both hated it but we stuck with it and I'm so glad we did. My son had similar issues as yours I think (convergence and tracking were abysmal). We started with Pencil Pursuits described on page 30 of the book I referenced above. My son had to use something really big to follow at first rather than a pencil though. He was also to jump his eyes from a pencil with a topper on the left to one on the right if I remember right. But mostly we started with following an object that moved slowly left to right with one eye at a time (the other patched). It was so hard and he literally could only follow for seconds and with a relatively large object (not a pencil). Slowly--so slowly--he got better and the objects got smaller and it got easier. But boy was it hard for a long time. He was too severe for them to work with him in office for a long time so I know the significant progress my son made was what I was doing at home (assigned by the dr.).

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Old 08-27-2010, 11:06 PM
 
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You can lodge a complaint with your insurance company against the provider. If they are a contracted provider, they are violating their contract with the insurance company. We get free viosion therapy services through our school district, so you might want to see if that is available.

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Old 08-27-2010, 11:21 PM
 
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Quote:
Originally Posted by anj_rn View Post
You can lodge a complaint with your insurance company against the provider. If they are a contracted provider, they are violating their contract with the insurance company. We get free viosion therapy services through our school district, so you might want to see if that is available.
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Old 08-28-2010, 12:06 AM
 
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Is there another place that will do the vision therapy? I would check around and see. If there is, maybe they'll give you better customer service.

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