Well, the insurance company isn't going to make things easy on us. I spoke with the lady who sent us the letter and she informed me that Failure to Thrive is not a diagnosis that warrants occupational therapy. She said they need a medical illness that specifically identifies what is causing it. This is most likely due to the fact that our coverage does not cover therapy due to developmental delay. Therefore unless a doctor can give a diagnosis of a medical reason she isn't eating, we will most likely not have coverage for the therapy.
I have made phone calls to Mary Free Bed and her pediatrician as well as talking to her therapist from Ken-O-Sha and Mary Free Bed and tried to figure out the best approach to take . At this point, her pediatrician's office doesn't have any additional info that they can provide to give a specific diagnosis and they think it's not likely for them to change their recommendation. The therapist from Ken-O-Sha thinks that the neurologist might be able to find something but it might be more likely to be connected to her developmental delays and not necessarily feeding problems. Her therapist and nutritionists at Mary Free Bed were very surprised that it was denied because it was a feeding issue and could becoming a life-threatening issue if not resolved.
Today her therapist did a brief re-evaluation of her and said that she would place more severity in the diagnosis and recommend additional treatment because she doesn't think that 8 weeks will be enough for her. She also said that we can do the video swallow study and see if that identifies anything specifically, however, it will most likely not show a medical illness.
Jordan has another MFB therapy appt next Tuesday and then sees the KOS neurologist on Wednesday. Hopefully we will have more info on this after that time.
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