Gifted Issues Discussion homepage Forums Parenting and Advocacy how to get insurance to pay for testing

Hi gang:

In a recent post, Incogneato suggested it might be possible to get insurance to pay for testing. Can you tell me how this is done? Would you expect insurance to pay for IQ and achievement testing?

bk

Hi everyone,

I have had one child tested in which I had to pay for it. We decided to have the other tested two months later and insurance paid for it. The girls both had straightforward IQ tests. The difference between paying for one and not the other is that in the short months between, BCBS had pulled their behavioral health benefits back in house and had less restrictvie policies. For example, we used to be outsourced to Magellan. They didn't pay for much. I've also heard if the doctor is screening for ADHD insurance companies will pay, but I don't know about that. I was going to pay for the second child anyway, so when I was verifying benefits with the tester's billing service, she called the insurance and discovered all tesing services were paid in full. I was thinking I wouldn't get anything, but it never hurts to check again. She mentioned that more and more insurance companies were taking these services in house and there seems to be more instances when insurance is paying for the tests. I would recommend calling your insurance company if behavior health benefits are not outsourced and asking what they pay for in terms of testing. Better yet, see if your Dr./tester's billing company will do it for you. They know what to say and ask. I haven't tried to have insurance pay for achievement testing, so I don't know anything about that. I tend to ask a lot of questions and try not to take a simple no for an answer when it counts. The downside is I can be quite annoying and am annoyed myself quite a bit of the time.....:)

Incog

Hi.

We have had to pay for all I.Q. testing. However, we did get very important assessment information through our insurance, which included a myriad of other testing.

Our daughter was seen by an educational psychologist (PhD type) after the initial school district evaluations when we were concerned that she was mentally checking out of school due to under-challenge following retention in K (for age) in addition to 2E clues. The report prepared by the school psychologist was illogical and sarcastic. Our doctor discussed this issue with the insurance and convinced them to allow us to have her seen by an expert.

The doctor also managed to bypass the waste of time (and conflict of interest) of dealing with the district, allowing our son (and daughter) to be seen directly by a developmental pediatrician when his school brought up issues of ADHD. She probably would have ordered I.Q. testing, but we had current results that she believed �fit�.

We were told that usually the insurance requires the parents to pursue the school district testing before they will step in. However, in the case of my son, the Dr. convinced the insurance provider that since our family had a valid grievance with the district team, we should be allowed to skip that step. Hurray for assertive doctors!

delbows,

Would you be comfortable sharing what transpired with the school district after you had the appropriate testing? My daughter is currently in kindergarten and has tested in the 99th%. She also is mentally checking out. She seems to spend most of her time mentally creating elaborate stories which she shares with me when she gets home. Her teacher says she might not send her to the gifted classes because she sees no evidence that she is gifted. The school already has her test results and recommendations that she attend all gifted programming the school has to offer. I'm spinning my wheels trying to figure out what to do next. It is a very political environment at her elementary school and I do volunteer and know what's going on with which teachers. The principal patently refuses to accelerate. If you have had some success, I would love to hear what is working for you.

Thanks,
Incog

We vigilantly followed all due-process guidelines to no avail. This included meetings with the teacher, principle, superintendent and writing to and addressing the school board. Our daughter was highlighted as �gifted� by the teachers, but there was no differentiation available (other than reading a novel during class) until 4th grade (and then, only pull-out). The school psychologist implied that she was �average� (her IQ test was 141) with the unfortunate circumstance of having pushy parents. We suspected then, and now, we know that she is 2E.

Since the district wouldn�t �play fair� and we wanted her grade advanced and moved to a school with interior walls, we were forced to leave the public school and move her to the Catholic school which accomplished both objectives. Although we would have preferred to put that money towards college savings while she received a �free and appropriate� education, it has worked out quite well.

Now we are on the fence as to what to do about high-school. Our local public HS is apparently quite good and managed by a different system, so we are once again hoping that the �free� (a relative term when you consider our property taxes) option might work.

We had psychoeducational testing done at the Belin-Blank Center in Iowa. They submitted to our insurance and part of it was paid. Our insurance paid only if a psychologist did the testing (not MS level trained) and only with a diagnosis. They submitted with an anxiety diagnosis, for the sake of getting payment, which was something that was "of concern to watch" per the final report, but not an acute condition.

You might want to call your insurance and see what types of psychological testing they cover, done by who and with what limitations.
HTH

Thanks everyone!

I guess I will call my insurance and see what might be available.

Tracy