I was educated this week about new procedures Tricare is now requiring potential and current patients of therapy (OT, Speech, PT and ect) to renew or approve their requests. Due to this, my son’s OT has now been denied twice by insurance. When I called both times they stated it was due to X reason. So I fixed X reason, and it was denied again. Then a few days later Bug’s OT got in contact with me and told me the real reason behind his therapy denials per Tricare. But before insurance would consider renewing his services, they required proof that he was not receiving OT during school hours. You can no longer receive private therapy if you are also receiving the same therapy provided by the school system. Another way companies are trying to cheat their customers. Another day another post. To solve this issues, Bug’s OT asked for a copy of his PLEP.
<invison jaw dropping here>
For the past three years I have dealt with the special education platform. Being involved with it for three years does not make me an expert by any means, but I have become familiar with some of the parts, pieces and protocols involved with IEP’s and the SPED. So I had to look up what PLEP was and figured since I had to, I’d pass on the knowledge and a little extra to help be one step ahead on understanding your child’s IEP.
The Autism Center for Education has a great resource online here, explaining what PLEP and PLAAFP are. In addition to what they have provided there is also a well written explanation on the steps of how one is put together before the IEP meeting. I don’t see you or I sitting down to write a PLEP or a PLAAP (unless you are a SPED teacher), but seeing how they are written allows us as parents and advocaters to be one step ahead and educate ourselves on the process so we are able to ask more educated questions about the IEP itself.