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Old 01-08-2013, 07:54 PM   #31
Mickey'snewestfan
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My insurance only pays for "in network" people. DS has had multiple medical issues since birth, and we've never had an MD we wanted to see turned down by this insurance, but this would be a neuropsychologist, and the insurance company is much more picky about who they approve of for psych. things. We ran into this when he was tiny and the ped wanted him seen by a developmental psychologist to see if his medical issues were connected to anything developmental. The insurance initially argued that since it was a "psychologist" he should see a counselor first to see if talk therapy would work. I argued with them that talk therapy has limited utility with people who don't talk (he was 3 months old at the time), and that someone who mostly saw adults wouldn't work, and eventually they let us see an infant specialist.

So, it's possible I could fight them on this. I'll call them tomorrow and see.
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Old 01-08-2013, 07:55 PM   #32
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OP here,

I kept him home today because he didn't sleep much last night. I'm not clear whether that's because he hadn't done anything all day and wasn't tired or because his head hurt or what, but the Dr. said to tell him to call to come home if he was tired, so I figured sending him exhausted was a bad idea.

He woke up around noon and is much more "himself". He says the side of his head (where the impact was) still feels bruised but there's not throbbing in his head. He also asked for Chipotle for lunch and gobbled it down, as opposed to yesterday when he asked for "just salad" for dinner and ate 3 bites.

Here's my next big question. The follow up clinic is apparently to do neuropsych testing to see if there are lingering cognitive effects. They called back today and said my insurance denied them. Without insurance it's $717
per visit and they couldn't tell me how many visits he'd need.

I can come up with $717, but it's a lot of money for us. If he needs it, of course we'll go, but I'm wondering if I could wait and see if I see anything before taking him. They said they usually schedule a few weeks out, so I assume it's not urgent to go right now? I have a call in to the ped's about what they suggest, but I'd love thoughts from here too.

I'll be honest and say without the Natasha Richardson story I would have given him some Motrin, and sent him to school. So to jump from that to 3 days of no school, the ER, $717 in medical bills, etc . . . seems like a lot. Just not sure.
Hi OP. Glad to see your Son is starting to seem more like himself, and is feeling better. If I were in your shoes, I would hold off on further testing. It doesn't seem like he needs it at this point. Now, if he starts to complain or appear to have memory loss, slurred speech, etc...then I would look into additional tests. I am interested to hear what your Ped says about this.

Is this clinic a reputable place? I only ask because it appears (based on what you posted) that they may be trying to take advantage by suggesting these tests that are not covered by insurance, and can't tell you how many testing sessions your Son would need.

I'm all about conservative treatment plans within reason, and this just seems like the clinic is suggesting you jump from point b to point q with the testing recommendations.

Best of luck to you, and I hope your Son continues to feel better!
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Old 01-08-2013, 08:18 PM   #33
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Hi OP. Glad to see your Son is starting to seem more like himself, and is feeling better. If I were in your shoes, I would hold off on further testing. It doesn't seem like he needs it at this point. Now, if he starts to complain or appear to have memory loss, slurred speech, etc...then I would look into additional tests. I am interested to hear what your Ped says about this.

Is this clinic a reputable place? I only ask because it appears (based on what you posted) that they may be trying to take advantage by suggesting these tests that are not covered by insurance, and can't tell you how many testing sessions your Son would need.

I'm all about conservative treatment plans within reason, and this just seems like the clinic is suggesting you jump from point b to point q with the testing recommendations.

Best of luck to you, and I hope your Son continues to feel better!
The clinic is part of one of the top children's hospitals in the nation. He's been seen there by many other specialists (all of whom were covered) and they've generally been good. I don't think they're taking advantage, but with a head injury I think they keep testing until the child is "cleared" meaning they're back to normal. Given that, they can't tell me how long.
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Old 01-08-2013, 08:27 PM   #34
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The clinic is part of one of the top children's hospitals in the nation. He's been seen there by many other specialists (all of whom were covered) and they've generally been good. I don't think they're taking advantage, but with a head injury I think they keep testing until the child is "cleared" meaning they're back to normal. Given that, they can't tell me how long.
Ah, I understand. I must have missed that in one of your previous posts. Sorry about that!

Keep us posted on what your Ped says.
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Old 01-08-2013, 08:44 PM   #35
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Ds had a concussion from playing soccer last January. He said that he blacked out for seconds when he collided with his team mate. DS told no one for 2 weeks that he thought he had trouble. When he told the school trainer, they refered him to a neurologist who ordered an MRI and then did the cognitive neuro tests.

He told DS the same thing to take it easy, get his rest, no soccer, limit computer, homework, tv and any stimulation to rest his brain.

DS went back after about 4 months for a recheck and discussion with the dr. because he wasn't bouncing back as quickly as DS hoped. Dr. told him it could take months-up to a year- to be 100%. So it's been a year and DS seems to have no lingering issues.

It can be scary and you are wise to seek treatment, but I think I would let your DS go to school tomorrow, see if you can get in with a dr. who is in your network and then follow up.

This might be a longshot, but sometimes the athletic departments at high schools now have neuro baseline concussion testing. Do you know anyone in your school's athletic department who might have this technology? They could at least see where your DS stands and if it's crucial to see the dr. based on those results.
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Old 01-08-2013, 08:51 PM   #36
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Ds had a concussion from playing soccer last January. He said that he blacked out for seconds when he collided with his team mate. DS told no one for 2 weeks that he thought he had trouble. When he told the school trainer, they refered him to a neurologist who ordered an MRI and then did the cognitive neuro tests.

He told DS the same thing to take it easy, get his rest, no soccer, limit computer, homework, tv and any stimulation to rest his brain.

DS went back after about 4 months for a recheck and discussion with the dr. because he wasn't bouncing back as quickly as DS hoped. Dr. told him it could take months-up to a year- to be 100%. So it's been a year and DS seems to have no lingering issues.

It can be scary and you are wise to seek treatment, but I think I would let your DS go to school tomorrow, see if you can get in with a dr. who is in your network and then follow up.

This might be a longshot, but sometimes the athletic departments at high schools now have neuro baseline concussion testing. Do you know anyone in your school's athletic department who might have this technology? They could at least see where your DS stands and if it's crucial to see the dr. based on those results.
This is actually the clinic that does the neuro baseline for our high school. We'll see them this summer before he starts high school because he's a football player. Since he played youth football, I actually thought about asking if he could come in last summer instead, but I didn't. Now I'm regretting that.

I asked if he could see a neurologist instead of a neuropsychologist, because there are plenty of neurologists in network. The reply I got is that the neurologist would only look at the physical symptoms, but maybe I'll ask the ped. the same question.
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Old 01-08-2013, 09:00 PM   #37
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This is actually the clinic that does the neuro baseline for our high school. We'll see them this summer before he starts high school because he's a football player. Since he played youth football, I actually thought about asking if he could come in last summer instead, but I didn't. Now I'm regretting that.

I asked if he could see a neurologist instead of a neuropsychologist, because there are plenty of neurologists in network. The reply I got is that the neurologist would only look at the physical symptoms, but maybe I'll ask the ped. the same question.
Ahh. While we didn't have the baseline for DS last year either before his concussion, he did take the test to see where he was as far as reaction times, memory, etc. after he had his concussion. This was really helpful for the dr. to say "Yea, there is a problem" because DS did so poorly on the test.

It's not easy, is it, when there's a possible head injury. So much easier to see a broken bone and understand what's going on. I'll keep sending you and your DS good thoughts and continue to follow your progress.
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Old 01-08-2013, 09:10 PM   #38
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Based on what you said, I would probably watch him. I know it's scary, but in DD's case they didn't send her for any further examination, and she was kicked square in the forehead by a 1200 lb. horse with aluminum shoes on. As I said before, she did lose consciousness and saw stars beforehand.

I would make sure that he did very little for a few days and just monitored him very closely, but that's JMHO.
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Old 01-08-2013, 09:14 PM   #39
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If you wouldn't get the testing, would you ask for accommodations at school? Midterms begin on Friday. I already emailed his counselor asking if his Friday test could be pushed back so he's had 3 more days to recover and to review the stuff he missed. Does that make sense?
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Old 01-08-2013, 09:17 PM   #40
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Originally Posted by Mickey'snewestfan View Post
This is actually the clinic that does the neuro baseline for our high school. We'll see them this summer before he starts high school because he's a football player. Since he played youth football, I actually thought about asking if he could come in last summer instead, but I didn't. Now I'm regretting that.

I asked if he could see a neurologist instead of a neuropsychologist, because there are plenty of neurologists in network. The reply I got is that the neurologist would only look at the physical symptoms, but maybe I'll ask the ped. the same question.
Are neuropsychologists not covered by your insurance plan or was the particular place not in your network? Are any neuropsychologists in your network?
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Old 01-08-2013, 09:23 PM   #41
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Will you send your DS to school tomorrow? If it were me, (and I am usually the "rub some dirt on it" and keep going kind of mom) I think I'd see how he did at school tomorrow--if it makes him overly tired, or brings on headaches, etc. and then decide about taking or postponing midterms.

I do think I'd alert his teachers and the nurse and ask for notification if he seems "off" in any way while at school.
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Old 01-08-2013, 09:29 PM   #42
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Are neuropsychologists not covered by your insurance plan or was the particular place not in your network? Are any neuropsychologists in your network?
I don't think that neuropsychologists are covered at the same rate or in the same way, since they are considered "behavioral" issues rather than "medical". But I'm calling the insurance company tomorrow to be certain.
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Old 01-08-2013, 09:36 PM   #43
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I don't think that neuropsychologists are covered at the same rate or in the same way, since they are considered "behavioral" issues rather than "medical". But I'm calling the insurance company tomorrow to be certain.
That's a good idea to call and ask. It could be that the particular one your son was being sent to isn't in your network. My insurance has a network too, which includes specialists. If the specialist isn't in the network, it's covered at 60% instead of 80% and there is no out-of-pocket maximum. Same with hospitals being in or out of the network.

If your insurance company has a website, you might be able to access the information there. You might also be able to see if there is a list of neuropsycologists in your network using the physician or facility search for whatever network you are in. With my insurance, I can do a physician and specialist search online.

It's also possible that behavioral is only covered at 50%. i'm not sure how my insurance company would classify that type of service. Calling is a good idea.
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Old 01-08-2013, 09:45 PM   #44
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I'm far from an expert on this, but I will say that the two people I know who had issues following head injuries had very obvious signs so it was clear that they needed help.

My nephew was thrown from one of those huge farm tractors. He had headaches, dizziness, and slurred speech from the first day.

My SIL (his mom) was thrown from a horse. About a week after, she was saying weird, off the wall comments and her writing was illegible.

Based on those two experiences, it seems to me like you would notice if your son needed further testing. I'm pretty sure if it was my kid, I'd just keep a very close eye on him for a few weeks and see if anything seems off. Go with what feels right to you.
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Old 01-08-2013, 10:03 PM   #45
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Quote:
Originally Posted by Mickey'snewestfan View Post
The clinic is part of one of the top children's hospitals in the nation. He's been seen there by many other specialists (all of whom were covered) and they've generally been good. I don't think they're taking advantage, but with a head injury I think they keep testing until the child is "cleared" meaning they're back to normal. Given that, they can't tell me how long.
I work in a hospital that has an outpatient concussion clinic.
I don't work directly with the clinic, but have seen presentations they have done and the son of a friend has gone to a conclusion clinic.
They continue to do follow up visits until the person gets to a particular point in recovery.
How people recover is very variable, so it is really hard to tell how long the follow up will need to be.
Quote:
Originally Posted by Mickey'snewestfan View Post
This is actually the clinic that does the neuro baseline for our high school. We'll see them this summer before he starts high school because he's a football player. Since he played youth football, I actually thought about asking if he could come in last summer instead, but I didn't. Now I'm regretting that.

I asked if he could see a neurologist instead of a neuropsychologist, because there are plenty of neurologists in network. The reply I got is that the neurologist would only look at the physical symptoms, but maybe I'll ask the ped. the same question.
The reply you got about neurologists and neuropsychologists is correct.
Neurologists look at physical symptoms and physical damage.
Neuropsychologists are experts at measurement of the function of the brain - things like cognitive testing, that Neurologists don't do.
Neurologists and Neuropsychologists work together in many clinics.
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