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Article #10504

PLEASE HELP A 3 YEAR OLD AUTISTIC CHILD FIGHT INSURANCE COMPANY

#10504
From: Ely Feinerman
Date: Fri, 25 Jan 1991 22:02
34 lines
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*             PLEASE HELP A 3 YEAR OLD AUTISTIC BOY
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My son is 3 1/2 years old and is autistic.  He has been receiving theraphy
at home since March 1990.  Rhe theraphy he recieves is the same type that
is used and taught by the Autism Project at UCLA.  The Psychologist and his
staff were all trained by Dr. Ivaar Loovas at UCLA.  The problem is as follows:

In March 1990 I wrote to my Insurance Plan for pre-approval of the services that
would be rendered to my son.  After they requested the background on the psychologist
and his staff they approved the services.  They continued to preapprove the services
until september 1990.  In Spetember 1990, the end of the month, they informed us that
my son was eligible for school and they no longer should pay since the plane had 
anm exclusion for services that were covered by any government agency.  He did become
available for school, matter of fact he turned 3 in July 1990, so why did they wait.  Well
it has been a cat and mouse game since sept. 1990.  They kept extending his preapporval for
30 hour of in home theraphy through 11/19/90.   Then they said to submit the claims as we went on.  Yesterday we recieved a denial from them for benefits.  They stated that the staff
was not qualified, that their expert( he they refuse to name) states even if the staff
was qualified he would only need 10 hours a week.  That is odd since the UCLA studies state
30 - 40 hours a week.  I am reaching out for help, If YOU KNOW OF A SIMILAR CASES OR
WHERE I CAN TURN FOR HELP>> PLEASE LET ME KNOW>  MY SON DESPERATELY NEEDS HIS
THERAPHY.....!!!!! PLEASE HELP MY SON!!!! WE HAVE CONTACTED A LAWYER AND WILL BE
PURSUING THIS MATTER LEGALLY.



I CAN BE CONTACTED VIA EMAIL AT
ely@jpl-devvax.jpl.nasa.gov
seismo!cit-vax!jpl-devvax!ely


or 213-675-0165 after 6 pm california time m -f or all day weekends.
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From: ely@jpl-devvax.JPL.NASA.GOV (Ely Feinerman)
Newsgroups: misc.kids,misc.legal,ca.general,la.general
Subject: PLEASE HELP A 3 YEAR OLD AUTISTIC CHILD FIGHT INSURANCE COMPANY
Message-ID: <11182@jpl-devvax.JPL.NASA.GOV>
Date: 25 Jan 91 22:02:24 GMT
Reply-To: ely@devvax.JPL.NASA.GOV (Ely Feinerman)
Organization: Jet Propulsion Laboratory, Pasadena, CA
Lines: 34