What’s with all the insanely long waitlists in the DMV

[Anonymous]

Anonymous wrote:

Anonymous wrote:Unfortunately, it’s only an issue if you are using insurance. If you are full pay, you can get any of these services in a “reasonable” amount of time. It’s not fair but that is how the system works. I called a week ago to schedule a neuropsych and have an appointment for my daughter the first week of January.

Why is this though? Is there a reason so many of these providers don’t want to deal with insurance? It seem like that is public policy issue if insurance plans are not covering things or not offering enough to be worthwhile to providers. I’m having a hard time right now finding a child psychiatrist in network without a super long waitlist. It’s depressing.

Could this be legislated like the pre-existing condition or maternity coverage? I think the pandemic exacerbated the waitlists because kids fell behind in services and are still trying to catch up. It would be nice if Congress would do something to make these services more available using insurance. The OOP costs are too high for most families

Here’s one example. It’s a bit dated, and things have only gotten worse.

As a psychotherapist, working with kids, I often: Observed kids in multiple school settings at multiple times, provided consultation to their multiple teachers, met as-needed with parents for short periods of time, coordinated with other health care providers, coordinated referrals for other services. None of those services were reimbursed. Crisis intervention usually wasn’t reimbursed— if the kid was admitted to a higher level of care. Insurances only authorized a limited number of sessions, so, periodically, I’d wait on hold, then justify my request for more services. That’s not billable time either. Insurance usually doesn’t pay for missed sessions— and missed sessions can’t usually be filled on short /No notice. And of course there’s the paperwork time that gets compounded with insurance reimbursement.

I have many years of experience working with kids and families in multiple settings. I learned to do psych testing in a setting that focused on learning disabilities and differences. I have a lot of the skills that seem to be in high demand right now. Insurance reimbursement, at least in my experience, requires a lot of therapist time that doesn’t directly benefit clients, and reduces actual profit — once you take away the costs expenses and unbillable but critical tasks — to relatively little.

[Anonymous]

Anonymous wrote:

Anonymous wrote:We spend almost $1k/month for our developmentally disabled child’s speech therapy. Thankfully we can afford it. Those who cannot are screwed. There is no social safety net and our society does not care about anyone, particularly the disabled. Just look at the way we treat our children whose parents can’t afford to feed them 3 square meals/day.

We had no issue getting therapists via insurance and those parents struggling get food stamps and Medicaid. It’s the families in the middle who are struggling.

My child had a less common condition and none of the therapists qualified to treat it take private insurance. I don't believe that Medicaid reimbursed for their services either - I know our therapist specifically said Medicaid would not reimburse. It breaks my heart because the condition is severely impairing but treatable but only by people trained to treat it.

[Anonymous]

I would look into Casey’s special Education Services - I heard they do not have a long waitlist for special ed tutoring

[Anonymous]

It’s much more backlogged in the DMV. I think it’s a couple of reasons:

Tight job market leading to poor office staff. There’s no practice manager so few offices run well. Plus these horrible hospital electronic forms. Other areas have very efficient doctors offices. It’s a short visit but at least you get in.

Lengthy and not helpful evals. I just want to try ADHD meds. I don’t need a $5000 eval. This is really crazy.

Overconsumption of mental health care. Holy cow people love their therapists. A whole lot of therapist addicts here. Some folks hang out for years or therapy. If you have a SMI fine, but a lot of people need to move on from a tough situation.

Peds refusing to do ADHD meds or much of anything beyond annual checkups. The local doctors are very conservative on prescribing.