Confessions….

I have a confession to make. Sit down. This might take a while.

I tried not to mix business with pleasure. My daughter was diagnosed with autism abruptly. We knew she wasn’t hitting her milestones and she had some odd ways about her but we never expected to hear the word, autism. But we did. The neurologist watched her for five minutes & the diagnosed was made. And we left. With everything & nothing all at the same time. I admit it was the most confusing moment of my life. And it was & still is.

The next step was following procedure. The neurologist recommended OT & speech therapy and so we started out our hunt to find them. We couldn’t have been more excited to find them both at the same facility when my husband called to tell me he thought he had found the perfect place. He excitedly sent me texts with photos of the facility and gave me the phone number so I could call and talk to someone about what the therapy was all about. I was elated. We found something. Our journey was about to start. I was ready. But I was terrified.

I called the number my husband gave me. The woman who answered the phone spoke with me for at least an hour throwing out the life raft that would save me from my own fear of uncertainty that was staring me in the eyes. She told me what to expect. That was all I needed to know. And because of that I trusted her.

We started taking Lily to see the woman that she would love & learn to call Ki Ki. And everything went as expected. Lily progressed & so did therapy for both speech & OT at this facility so everything was well. Nothing changed except for Lily.

Fast forward a bit. Here we are. Lily is still seeing the same occupational therapist and still improving as her therapist has made note of. We have since then changed speech therapy and she attends speech at a different facility that offers a different approach for children with Apraxia. She’s doing great. Unfortunately, this new speech therapy is not covered by our Empire BCBS plan because it is out of network. So we pay out of pocket. The therapy is worth it so we do what we do.

However, our OT is covered by insurance as it always has been since day 1 of Lily’s treatment. This is fantastic. Except that recently I received a bill from my service provider stating that I owed them about $1600.00. Curious, I called BCBS to see about the charges so I could understand why I was not being covered by insurance. They explained to me that I had not been pre-certified & that penalties & late fees had been applied to visits claimed before pre certification. I was a deer in headlights. Right away I got it but not all at once. I was blinded by Trust. Surely, I thought this could be resolved. The office made a mistake and would do right by me. I was certain I was protected anyway–because it was a simple error. But I asked BCBS just to be sure and they told me the complete opposite of what I expected to hear. The ultimate responsibility of paying the bill is the insured party. That would be me. I knew our service provider, the clinic, had pre certified us before. They did the initial legwork for us & set us up for success so we could start therapy & get Lily better. That’s what it is supposed to be about. Getting better right? But somewhere along the way and lost in the middle and in between different office assistants and personnel was the failure to make a phone call to pre-certify my daughter for additional therapy after the time was up. It started adding up. I know. I should have known better. I know it’s my responsibility, my insurance, my problem. It’s my job to make sure my provider is doing their job to protect myself & my family. I wasn’t walked through the whole insurance bit in the beginning. I learn by doing. But I never did the pre-cert so I never really learned it needed to be done by myself until I received a bill that was backdated with dates from the beginning of our therapy sessions with this place. It wasn’t just the amount it was the amount of sessions that were fined. Never mind, no one told me and continued to accept co pay as though everything was fine. I feel like the paperwork probably piled up in a desk somewhere and I was an easy target. So much time went by before they even noticed there was a problem. I was reminded almost right away by their accounting offices that my contract reads that I am to pay. No apologies. No explanation. No problem.

I try not to mix business with pleasure. You see, therapy is just that. It’s a business. A very personal kind of business that rips it’s way into your heart by any necessary method it can albeit trust. A working relationship. A family. And family they were. Each email written with excitement over a new word or skill Lily learned was full of respect and love that that person had helped your child to get to that point. They believe in your child like you do. But business is business even if it’s bad business. And therapy is not just about getting people better it’s about filling people’s pocket books. A job is a job & you get paid to do your job at the end of the day and you go home. Somebody’s gotta pay no matter who it is. It matters not even if it’s the child you are rehabilitating that needs your help & the mistake is yours that was made. You can not admit your fault long enough to save your own soul from dying right in front of you. Why don’t you swallow your mistakes so you can fill your heart with what you teach the children you steal from so well because your life raft has been sucked into the ocean. I wonder what kind of hell that must be. My daughter has Apraxia and can not always speak her mind but she has long ago taught me that actions speak louder than words. You don’t have to say anything. You’ve shown me everything I need to know. Some things are left better without words.

I don’t usually mix business with pleasure. Don’t take it personally. But you have entered a very personal part of my world and started out with an open hand that is now closed. You bait & switch and it matters little what your clients think of you as long as you get your money’s worth. Who gets their money’s worth? It keeps me up at night counting the other people who might have been touched by your greed. How many mothers will ignore the colors that shine through your smile when you tell them they are doing everything that they can, to slow down a little? How many will write a check with late fees added & not even realize what they are paying? When you are a professional business and you take it upon yourself to do something for someone you don’t just do it once and forget about it. You keep track of the things you do. It is what makes you good at what you do. Sometimes you do more than you have to because it needs to be done. You do what you can. If you are great at your job & you know something needs to be done & it will directly affect someone you inform them. You don’t just do this to be a professional. It doesn’t just make you good at your job. It makes you good at being a person. Actions speak louder than words people. And I don’t want to hear it.

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