LTCH and postpartum

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  • stephen87

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    So, long story short, after our son was born, my girlfriend's doctor put her on Zoloft. She never diagnosed her with depression or postpartum, but she still gave her the Zoloft. She doesn't take it and is perfectly fine. She has her days where she's not happy-go-lucky, but everyone has those days. Would this stop her from getting her LTCH? Should a treatment without a diagnosis be included on the LTCH application? Anyone ever dealt with this before?
     

    Captain Bligh

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    It doesn't rise to the level to be disqualifying. That said, in all likelihood, the doc gave her a diagnosis. She may not know what it is, but the doc isn't going to get reimbursement for her/his services without a diagnosis. Insurance pays according to medical necessity; no necessity (diagnosis), no payment. Plus the doc would likely be at risk for prescribing medication in the absence of a treatable condition (a diagnosis). Look on the billing sheet. Odds are the doctor wrote a diagnostic code number.
     

    bradmedic04

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    Just be very mindful of her state of mind. Post partum depression is a lot more serious than most people think, and it can sneak up months down the line.

    That said, I'm glad to hear she'll be that much more able to protect herself and your child.
     

    stephen87

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    It doesn't rise to the level to be disqualifying. That said, in all likelihood, the doc gave her a diagnosis. She may not know what it is, but the doc isn't going to get reimbursement for her/his services without a diagnosis. Insurance pays according to medical necessity; no necessity (diagnosis), no payment. Plus the doc would likely be at risk for prescribing medication in the absence of a treatable condition (a diagnosis). Look on the billing sheet. Odds are the doctor wrote a diagnostic code number.


    Could be, I'm just going by what she said. I know there would be some type of diagnosis, but I know the doctor has not even mentioned PPD, at least when I'm around.


    Brad, thanks for the heads up. We work opposite schedules. I'm sure you know that routine. We talk every chance we get and I help her out as much as I can. I understand it's stressful and with her being home with the baby a ton more than I am, I know it's overwhelming for her.
     

    1911ly

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    That said, IF she was "officially" diagnosed, should THAT be reported on the LTCH form?

    PPD seems to be pretty common. My only question would be is do you think she is a threat to anyone? Has she threaten to harm her self or anyone else. If she has then I would not consider a LTCH. Just being depress is not an issue. Lot's of people have depression to different degree's. And to a degree it should not affect there ability to carry a weapon. And be able to protect themselves and there family.

    I know what you are going threw with your wife! Support her and make sure you help her and or have someone come in and help her with the baby. It will pass. My wife came out of it. I am sure yours will too!
     

    stephen87

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    If I thought she was a threat or had tried, I wouldn't consider it. Like I said, she has her days, just like I have mine and I'm sure you have yours.

    We have plenty of support. We live about 5 minutes from either set of parents.
     
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