Ottawa mom says son living with autism denied thousands in therapy claims

Published: Sep 08, 2024 Duration: 00:03:03 Category: News & Politics

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an Ottawa mom says she is worried she could be out thousands of dollars because an insurance company is refusing to approve her claims the expenses are a result of numerous services that help make life better for her son who lives with autism ctv's Caitlyn Wilson joins us live now with more Caitlyn Patricia this is a mother who works two jobs to help pay for her son's medical needs she's currently on sick Le because of the sheer stress of the situation and says the claims are piling up Sophie Brett's days are filled with appointments for her six-year-old son he had a brain injury at Birth and then later uh received an Autism diagnosis so we have had uh numerous care needs for him over the last many years which add up to hundreds of invoices each year it's all for speech and OT um ABA therapy um psychology meticulously documented and folders like this ready to submit to her insurance providers these are uh the claims from 2022 I tend to want to do this just to create some transparency since I do have three insurance providers 3 years ago she opted into Beneva insurance through her work paying $6,000 per year in premiums and that's when she says her troubles began they would come back as denied they would come back as invoices not submitted uh under payments uh throughout the entire year the next year suffering from caregiver burnout Chio wrote biva a letter of support in April ail 2023 asking to exempt her from the 12th Monon window to submit her 2022 claims I was on sick leaves at work um really unable to cope with everything and when she did submit earlier this year she says she was initially approved over the phone before being denied in an email the next day the decision was made to decline my claims based on the fact that they're saying I was actually never entitled to sign up with this insurance company which is the first I've ever heard of it she said she's owed upwards of $30,000 in outstanding claims from 2022 and 2023 including claims she submitted in both March and April of this year and has yet to receive any money the problem now is that I'm blocked from my third insurance provider because I cannot um proceed with my third insurance without having an outcome for my second Insurance in a statement Beneva telling CTV News it cannot comment on a specific case because of confidentiality we've had our hands full mhm yeah this is uh I mean I have a lot of money outstanding and so I can't really provide him with what he needs right now in the meantime she says that 18-month window to submit to her third provider is past and until things are cleared up with biva and they write a letter explaining the situation she will be unable to submit with that provider meaning she'll be out more money Patricia it's quite a pile and Incredibly stressful obviously uh Caitlyn thank you very much ctv's Caitlyn Wilson live for us tonight

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