How Do I Get a Referral For DS Under the Mental Health Scheme?
So, DS has some issues....his 3 yo kindy teacher has flagged him and suggested an OT might be helpful. From my research, it looks like it could be a sensory problem. So I've booked him in to see an OT for an assessment. The info from the OT suggested there may be funding available under the Mental Health Scheme and to see a GP for a referral.
So off we trot today to the GP. When I explain what's going on and ask her about whether the Mental Health Scheme might be an option, she looked at me as though I wanted to have my son committed and said something like, 'Im not diagnosing a little boy with a mental condition just so you can save a few bucks'!!! Seriously?! It was obvious she didn't think there was a thing wrong with him. Did I go about it wrongly? Did I ask for the wrong thing? Did I miss a step? What should I have done instead? Or, was she just rude and obnoxious (I can't say the words I'd like to)?
She also dismissed my concerns about DS having been sick and the suggestion from the community health nurse after his 3yo check up last week that he get checked for a uti. She didn't even look at him, despite me saying we were there for a check up. I didn't push it as I was so angry by this time and just wanted to get out of there!
For the record, DS hasn't seen a Dr since we moved to Perth, but he's been with me twice when I've seen this Dr before. We won't be returning.
Does anyone know if this plan is the right one and how to go about getting a GP to give us one? Is there any other funding we might be able to access? Should we have asked for a paed referral?
Sorry can't help but I'm very interested in the answer to this question! My son has been flagged for sensory issues and possible asd so if we can get funding for the pediatrician visit that would be massively helpful, I've heard they are super expensive. Hope someone stops in soon with an answer!
It's never okay for a medical professional to make you feel bad for asking the question! I'm sorry you were made to feel that way.
Medicare can cover the cost of things but the Dr does need to make a diagnosis or at least a tentative diagnosis of "something" so perhaps there is no appropriate diagnoses for your DS that will allow such a referral. It would be totally reasonable to ask the question again perhaps like "I was a bit confused last time, my understanding is that medicare can cover some OT sessions, am I mistaken? And is my DS eligible for that?"
The other option is that local community health centres often provide these services at a lower cost, and maybe you can access something that way for some screening at least. The maternal health nurse may also be able to advise??
I hate it how medicos make you feel stupid for asking questions, nothing should be out of bounds and if it was inappropriate that should have been explained rather than making such a judgement about you. I'd be going back to a different GP and trying again if u were you. Even if she is right, she s a right royal cow for treating you like that..
You weren't asking for a diagnosis, you were addressing his teacher's concerns. she had no right to make you feel that way.
We got a referral for an OT with an enhanced primary care plan, because ds has poor fine motor skills and his prep teacher was concerned. Try that, but not with that doctor, obviously. You didn't do anything wrong.
A health care plan is what a DR can write to give you 5 subsidised sessions thru what ever allied health etc is needed. My GP wrote one for my DS1 for speech pathology. And I know others who have had them for OT, counsellors, psycologists, dieticians.
Probably issue was you asking for a mental health scheme, but NO way should they have been so rude and horrible.
Thanks ladies. I did ask if maybe I'd gotten the name wrong, if there was another source of assistance, or if there was additional information she needed, but I think she tuned out after I asked the first time. Still really peeved, and the more I think about it, the more unhappy with her manner I am. DH saw a dr in another practice that he was happy with, so we might go there next time. Feeling really nervous and anxious about how I might be treated now though - I was shaking and felt sick by the time I left yesterday. DH said to tell them I've had a bad experience when I book, and to book in person so I can ask questions and see the place (which I did here. The original Dr I was seeing was great, but has just gone on maternity leave ).
That dr was very rude, what you needed to ask for is an EPC (enhanced primary care) plan. As Feeb mentioned, you then get 5 sessions at nominated specialists, this can be at a reduced rate or some are free.
i had one for my DS. 1 session was for audiology (free) and 4 went on speech (reduced rate). I also had one for DD1 and used 5 on OT (reduced rate per session)
Copied from the Department of Health and Ageing...
Enhanced Primary Care (EPC) care planning items were removed from the Medicare Benefits Schedule in 2005 and replaced by the Chronic Disease Management (CDM) items (721 -732). The term 'EPC plan' is now obsolete.
Not sure if it's the same all around, but with the ecp we get $50 back from medicare. Luckily we found a lovely OT who only charges $150 (and she came to the school and talked to ds' teacher about her concerns before evaluating him in the classroom) but the first one I called was asking $350 for the initial consult. So it's worth ringing around.
GL
Our paed was the same about SPD AndiE. That was frustrating, because I was more interested in the SPD diagnosis than the ADHD. I wanted that under control - at least to try get that under control - before we went further with the ADHD diagnosis.
No matter what we did for her SPD though. nothing was working for the lack of concentration & I had to go the other way
When I was first referred to the OT with DD, we were under an EPC Plan - 5 sessions. The initial assessment cost about $250. I don't think that was covered by the EPC though :/ After that I paid the amount minus the EPC, then received money back from medicare. In total I was out of pocket about $20 for each session from memory.
Once there is a diagnosis you can get the Mental Health Care Plan. Pretty sure its 12 sessions a year under the MHCP. My GP was able to give me those, but still only after I had paed diagnosis.
How Do I Get a Referral For DS Under the Mental Health Scheme?
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I'd be going back to a different GP and trying again if u were you. Even if she is right, she s a right royal cow for treating you like that..
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