Intensive Feeding Therapy

When we took Caden to see his GI doctor right before Christmas she told us she was going to refer him to an intensive feeding therapy program called Clinic 4 Kidz with Dr. Patel. This is a very expensive program and apparently it is not easy to get it approved through many insurance companies. But it is an in-home treatment with a very high success rate (96%) of getting kids to eat by mouth. Each treatment plan is tailored specifically to each child.

Once insurance has authorized services, Dr. Patel comes in and does her initial evaluation and give us “homework” to work on until our time comes up on the waiting list (there is currently an 8-month wait). Caden was put on the list the end of December, so by the end of August, hopefully we can get started. When the team of case workers come to start therapy, they come in for 5 days straight for 10 hours/day! Then, after that, they return for 2 days every month for 3 months, followed by 1 day every month for 3 months. And, over time, they reduce the frequency of their visits.

I started the initial legwork to find out whether our insurance will cover this or not. The initial response was a resounding “no.” They said they didn't think there was any reason why they would pay for us to have therapy to change how our child eats. Apparently they have never dealt with a child with feeding issues or g-tube dependency! This could save them money in the long run if we don't have to pay for the monthly feeding tube supplies. It's just really frustrating!

But I talked with insurance again yesterday and the person I normally talk to transferred me to someone else. I gave her the billing codes used for the program to see if they were covered. She said they weren't codes that were denied or ones with strict policies involved. From her perspective, she thought it looked like it would be something that would be covered without prior authorization. But she said the person I normally talk to would need to make final confirmation regarding medical benefits/policy. So, I need to call her again next week and hopefully we will have more of an answer.

In the meantime, I had asked our GI doctor to provide a letter documenting medical necessity for the intensive feeding therapy. They called me yesterday and told me I could pick the letter up. When I read it I was very disappointed in its content. I don't think it spoke to the therapy being medically necessary at all. I will not use that to submit to insurance. I am going to call the office back on Monday and ask them to do it again.

Another great thing about being referred to this program is I got connected with a feeding support group. This is an area I have felt very isolated in. Feeding issues are really emotional for me and the thing I stress about the most. So to be able to connect with other parents who “get it” is a HUGE thing! In fact, I talked to one of the moms on the phone on Thursday and it was such a relief! We have many of the same doctors and have experienced many of the same feelings. She also told me to have the GI doctor copy the majority of the letter of medical necessity that they wrote for her son to appeal their insurance. She said it was really well done. When I call their office back on Monday I will ask them to do that.

And, tomorrow, I am meeting up with another mom to talk about our kids feeding issues. I am just so grateful to have found this group. I have felt so alone in this area for so long and it's really discouraging. So things are looking up. I definitely would appreciate prayers that we can get this intensive feeding therapy program approved through insurance. We are really motivated to get Caden off the g-tube and eating like a normal child. I'll keep you posted.