As you know, parents of teens with disabilities tend to be anxious about what will happen once high school ends.
Project Independence provides free workshops to help parents who have children with disabilities learn about options for their children once they leave high school. The project also trains youth from ages 14-21 about their options after high school.
A disability should not hamper a person to live their life to the fullest. We share with participants how to obtain employment in the community, assist in applying for college and vocational school, as well as support with life skills. Statistics shows that people with disabilities earn about two-thirds of the median earnings of people without disabilities. They are less likely to attend higher learning, and more likely to live below the poverty line. Project Independence wants to change that.
There will be 2 strands of workshops: One for parents and one for youth. It will be for 5 Thursdays starting October 11th ending November 8th, and a college tour on Saturday, November 3rd. The time of the workshops will be 6:00 – 6:30 for dinner, and 6:30 – 8:30 for training. Here is a link about the project.
You can click this link http://www.thrivectr.org/new-events-1/ to register online.
Writing a Letter of Medical Necessity
- Name of child, names of parents (parents and child may have different names)
- Date of birth of child
- Insurance plan name (there may be more than one plan)
- Relevant diagnoses (codes are helpful only if they are accurate!)
- Item/service requested
- Why item/service is medically necessary (refer to the plans’ definition)
- What positive/negative impacts the item/service will result on (include financial) scope and duration of treatment
- Supplemental documents (letters from other providers, research articles, product information, PAR)
- Include funding streams NOT able to help (denial letters help)
Terms to use; medically necessary, clinically based, promoting independence, preventing secondary disability, cost-effective, safety.
Terms to avoid; custodial, rehabilitate, developmental delay/disability, speech delay (without a diagnosis such as aphasia), Caregiver convenience.
- Ask if your Letter of Medical Necessity answers the following:
- Is there a licensed provider stating in writing the item/service is medically necessary?
- Is this item/service not for care giver convenience?
- Is this item/service costs effective and if so have you explained how?
- Is this item/service considered standard medical practice?
- Have you explained how long and how often the item/service will be used.
- Is this item/service right for the need of individual?
The Responsibilities of Each Role
Care provider needs to know the process if the parent is not yet skilled
- pertinent benefits
- limitations and exclusions
- appeals process
- terms and their definitions
- distribute instructive materials to parents (empowerment)
- write perfect letters of medical necessity
Parent needs to
- become knowledgeable about the policy (a-d above)
- supply information to providers
- keep a paper trail of all communications
- confront conflicting information
Advocate’s role is to
- assist with the appeals process
- guide providers and parents to resources
- influence systems’ change
Health insurance plan’s staff member
- confuse the member as much as possible (i.e., change the rules often), and deny benefits to contain costs.