Re: United Healthcare hippotherapy

[Guest guest]

Hi Trina,

We got coverage, but it was a few years ago. We went for an OT evaluation

through West Houston Medical Center and were preapproved for hippotherapy. On

the other hand, they denied speech therapy. And naturally, no behavior

modification. We no longer have United, so I can't speak for what they're

declining nowadays.

Aliza

United Healthcare hippotherapy

Hello,

Are any of you doing Hippotherapy and is United Healthcare providing any

assistance in payment? Thanks. Trina

[Guest guest]

Is this the way to go about it - ask for it through an OT evaluation?

Wasn't sure where to begin with checking into it.

>

> Hi Trina,

>

> We got coverage, but it was a few years ago. We went for an OT evaluation

> through West Houston Medical Center and were preapproved for hippotherapy.

> On the other hand, they denied speech therapy. And naturally, no behavior

> modification. We no longer have United, so I can't speak for what they're

> declining nowadays.

>

> Aliza

>

> United Healthcare hippotherapy

>

> Hello,

> Are any of you doing Hippotherapy and is United Healthcare providing any

> assistance in payment? Thanks. Trina

>

>

[Guest guest]

That's exactly right.

[Texas-Autism- Advocacy] United Healthcare hippotherapy

>

> Hello,

> Are any of you doing Hippotherapy and is United Healthcare providing any

> assistance in payment? Thanks. Trina

>

>

[Guest guest]

We have United PPO through Hewlett Packard which is self funded. I

don't know if they would cover Hippo therapy but since we had a

referral for " OT evaluation and treatment " the have never questioned it

and are covering it.

[Guest guest]

Trina,

I have UHC but never consider this for Hippotherapy as the CLASS

program helps for this treatment. Interesting though.

Any luck of CLASS yet?

Irma

>

> Hello,

> Are any of you doing Hippotherapy and is United Healthcare providing

any

> assistance in payment? Thanks. Trina

>

[Guest guest]

You would think that if CLASS is paying for this that insurance would. I

am on the CLASS list and my son is 12 hopefully our number will come up

before he's 30. Trina

>

> Trina,

>

> I have UHC but never consider this for Hippotherapy as the CLASS

> program helps for this treatment. Interesting though.

>

> Any luck of CLASS yet?

>

> Irma

>

>

> >

> > Hello,

> > Are any of you doing Hippotherapy and is United Healthcare providing

> any

> > assistance in payment? Thanks. Trina

> >

>

>

[Guest guest]

>

> You would think that if CLASS is paying for this that insurance

would. I am on the CLASS list and my son is 12 hopefully our number

will come up before he's 30. Trina

I have been searching for my notes in regards to the billing code

given to me awhile back in May out at Autism One conference at least

to contact and see if UHC will pay for it. Still looking and will post

it as soon as I find it.

Hopefully will not be too long by the time your son begins receiving

the CLASS program.

You will already have us to help with the Specialized services it will

help pay for when he comes aboard.

Is your son on the so call " interest list " with the GR funds?

Irma

[Guest guest]

Trina,

Have you called around the places near you that provides the services?

Posting from my notes I have, but then once again revolves on your

health insurance plan.

When using the horse or equine movement as a treatment tool within a

therapeutic procedure it is then very appropriate to bill for units of

service depending on how the tool is used. APTA and AOTA have both

agreed that use of the CPT codes 97110 (therapeutic exercise), 97112

(neuromuscular education), 97530 (therapeutic activities) or 97770

(sensory integrative activities) could all be appropriate codes

depending on how the tool of the horse is used by a therapist within a

treatment procedure.

97799 (for unlisted therapeutic procedure)which then requires that

additional documentation be submitted in order to be reviewed for

reimbursement.

Have you had a chance to request for the Master policy?

Wishing you some luck to see what codes you can play around with.

Irma

[Guest guest]

Yes, I called ROCK in town and they said that with the $20 copay

and the fact that since they are out of network I would have to pay 20%

of the private therapeutic riding fee that it would probably be a pain

to try to get United to pay. The fee for private therapeutic is $55 an

hour a group lesson is $45 which would be $31 for private and $29 for

group. It might make more sense if I could get UHC to pay for therapy a

block at a time and not have to file every week. Can I do that?

Trina

>

> Trina,

>

> Have you called around the places near you that provides the services?

>

> Posting from my notes I have, but then once again revolves on your

> health insurance plan.

> When using the horse or equine movement as a treatment tool within a

> therapeutic procedure it is then very appropriate to bill for units of

> service depending on how the tool is used. APTA and AOTA have both

> agreed that use of the CPT codes 97110 (therapeutic exercise), 97112

> (neuromuscular education), 97530 (therapeutic activities) or 97770

> (sensory integrative activities) could all be appropriate codes

> depending on how the tool of the horse is used by a therapist within a

> treatment procedure.

> 97799 (for unlisted therapeutic procedure)which then requires that

> additional documentation be submitted in order to be reviewed for

> reimbursement.

>

> Have you had a chance to request for the Master policy?

>

> Wishing you some luck to see what codes you can play around with.

> g

> Irma

>

>

[Guest guest]

>

> Yes, I called ROCK in town and they said that with the $20

copay and the fact that since they are out of network I would have to

pay 20% of the private therapeutic riding fee that it would probably

be a pain to try to get United to pay. The fee for private therapeutic

is $55 an hour a group lesson is $45 which would be $31 for private

and $29 for group. It might make more sense if I could get UHC to pay

for therapy a block at a time and not have to file every week. Can I

do that?

Trina

You know I know there are limited time grace period something like

this, its been awhile since I worked in this dept., please confirm this.

Eval's are turn in separately with a recommendation or a treatment

protocol, a doctor's script, keep copies, try to fax a progress report

on a weekly basis, by the 6th week, unless its changed, have a doc's

script once again for a re-eval. that your child will require further

services.

It is proving its a medical necessity.

Once upon a time when I use to work at a Physical Therapy clinic

dealing with some of the Worker's Comp. patients & other injured patients.

I manage to get several of the therapy paid by turning in

documentations needed, you know its educating the insurance system and

ended up being thanked for this because they do not have a clue.

The more they denied services, which was about 95% of the time, they

end up getting a commission for it, which I found out off the record.

It will involve paper work but it was well worth it.

I just figure I had to find a way to work around the system at the

time it was such a battle appealing, writing medical reconsiderations

letter for attorney's, etc.

I was always polite and firm and never gave up.

Gosh, it's been too long, would not even know where to start anymore,

bombarded with learning too much nowadays with whatever is thrown my way.

My boss was very happy when the mailman would arrive and most of all

the patients not having to worry too much with the finances.

During Marketing time, the medical physicians whom I ended up getting

to know had admired this too because their patients who they had

referred out were taken care of.

Hopefully the Hippotherapy place will be able to work with you on this

by turning in the proper documentations needed..

How about paving the way here?

Wish you luck, keep us posted on an update on how it's going.

Irma

" The greatest act can be one little victory, " N. Peart

[Guest guest]

Interest list? GR funds? No clue, need a clue...like clues...used to

have a clue...longing to be no longer clueless...T

>

>

> >

> > You would think that if CLASS is paying for this that insurance

> would. I am on the CLASS list and my son is 12 hopefully our number

> will come up before he's 30. Trina

>

> I have been searching for my notes in regards to the billing code

> given to me awhile back in May out at Autism One conference at least

> to contact and see if UHC will pay for it. Still looking and will post

> it as soon as I find it.

>

> Hopefully will not be too long by the time your son begins receiving

> the CLASS program.

> You will already have us to help with the Specialized services it will

> help pay for when he comes aboard.

> Is your son on the so call " interest list " with the GR funds?

>

> Irma

>

>