Tuesday, October 12, 2010

Sept Updates and Insurance news....

Dominic had a good month at Alpine verbally in September. Here're the charts - its the daily average across all the days he was there this month. Free operants are verbal attempts. I did just clarify that a phrase of more than one word is considered only 1 FOP (the rule is 3 seconds), so the 3-4 word sentences we're working so hard on are actually considered a single FOP.

Mands are requests. "I Want Apple" is a single Mand.

Tacting is labeling. This is his vocabulary and being able to identify things.

So very happy numbers. One more good jump on the tacting and we'll have to switch the chart increments of 10 which is going to be interesting.

So talking is going well.

But the big news today is....

About 2 weeks ago, I was in the Alpine office to pay our October charges, and happened to find out that as of October 1, they are an in network (gasp) provider for our health insurance. Previously, Anthem had declined to cover anything because their requirement is for the provider to be both "licensed and certified". ABA therapists do not have any sort of national licensure, so that basically meant Anthems policy ended up meaning they didn't pay anything. Well 9 months later, they changed their policy because they realized it was completely asinine. And Colorado passed the law mandating insurance coverage, and Alpine went and got themselves made a provider.

The limits of the plan my employer pays for, however, are that they'll cover 60 visits of ABA per year. A visit is one day. Thats roughly 3 months, depending on holidays / sick days etc. We'll still have a $15 copay per day. The coverage (as of this benefit year, and we presume next because as hot button as this kind of issue is, we don't expect any sort of reduction) is good through age 6, which means until the day before his 7th birthday. So we'll get 3 months this year (Oct-Dec), 3 months next year (which we'll be doing over the summer so we get full days), and if we're still at Alpine in 2012, Jan 1 - Feb 10 of that year.

We had loosely put an end date on our time at Alpine of Aug 1 2011, because we were going to be completely out of money at that point. This insurance coverage means that if my math is right, and we decide to do it, we could add another year (putting the same amount aside each paycheck as we are right now) without having to hit the 401K's. (I also budgeted in 2 more rounds of HBOT since that seems to have made a HUGE difference) It remains to be seen if we choose to add another year, I think it'll depend on his progress and our comfort level with the school district (and to be honest, how strained we are continuing to live on a shoestring - while I can stretch a dollar until it begs for mercy, there are things piling up on our "needs to be done" list)

The insurance girl called today to let me know she was sending a formal authorization letter out. So I won't have to fight these people. What an amazing concept.


Anonymous said...

So happy for you!
And the insurance part of it especially rocks. Happy thoughts/magic thinking/positive energy works. Wow!

Biffy said...

That is great news! I am so happy for you Joy. It's amazing what can be done when people put their minds to it (meaning the big wigs)

Anonymous said...

Yay! Not having to fight the system is wonderful.

I'm happy to see Dominic doing so well.