Re: Insurance and ABA in TX

[Guest guest]

I have Blue Cross/Blue Shield of Texas and they denied all claims.

R.

Insurance and ABA in TX

Greetings all -- have any of you successfully had insurance

(specifically BC/BS of TX, but any other insurance info would be

useful) cover ABA therapy? If so, how did you go about it --

diagnosis codes, etc?

Many thanks for any help you can provide -- best,

--

------

Dell'

Austin, TX

Texas Autism Advocacy

www.TexasAutismAdvocacy.org

Texas Disability Network

Calendar of Events

www.TexasAutismAdvocacy.org

[Guest guest]

Ditto United HealthCare even though they pre-approved speech and OT. After

claims were filed and refiled and denied, we got socked with the full amount of

the therapy we had done based upon their pre-approval.

Please keep in mind that pre-approval does not mean they will pay for

services. Read your contract.

Best of luck.

Aliza

kgreeceman@... wrote:

I have Blue Cross/Blue Shield of Texas and they denied all claims.

R.

Insurance and ABA in TX

Greetings all -- have any of you successfully had insurance

(specifically BC/BS of TX, but any other insurance info would be

useful) cover ABA therapy? If so, how did you go about it --

diagnosis codes, etc?

Many thanks for any help you can provide -- best,

--

------

Dell'

Austin, TX

Texas Autism Advocacy

www.TexasAutismAdvocacy.org

Texas Disability Network

Calendar of Events

www.TexasAutismAdvocacy.org

[Guest guest]

It depends on the cpt code used. We have been always re-imbursed by UHC.

Insurance and ABA in TX

>

>

> Greetings all -- have any of you successfully had insurance

> (specifically BC/BS of TX, but any other insurance info would be

> useful) cover ABA therapy? If so, how did you go about it --

> diagnosis codes, etc?

>

> Many thanks for any help you can provide -- best,

>

>

> --

> ------

> Dell'

> Austin, TX

>

>

>

> Texas Autism Advocacy

> www.TexasAutismAdvocacy.org

>

> Texas Disability Network

> Calendar of Events

> www.TexasAutismAdvocacy.org

>

[Guest guest]

Unfortunately it all has to do with how the claim is coded. For example, if

you receive speech or OT from Easter Seals, they bill as a rehab hospital.

Many plans pay rehab at a higher percentage and have higher limits for # of

visits.

_____

From: Texas-Autism-Advocacy

[mailto:Texas-Autism-Advocacy ] On Behalf Of Aliza Ratterree

Sent: Monday, June 05, 2006 3:20 PM

To: Texas-Autism-Advocacy

Subject: Re: Insurance and ABA in TX

Ditto United HealthCare even though they pre-approved speech and OT. After

claims were filed and refiled and denied, we got socked with the full amount

of the therapy we had done based upon their pre-approval.

Please keep in mind that pre-approval does not mean they will pay for

services. Read your contract.

Best of luck.

Aliza

kgreeceman@... wrote:

I have Blue Cross/Blue Shield of Texas and they denied all claims.

R.

_____

[Guest guest]

In a message dated 6/5/2006 3:50:16 P.M. Central Standard Time,

loganfalls@... writes:

Unfortunately it all has to do with how the claim is coded. For example,

if

you receive speech or OT from Easter Seals, they bill as a rehab hospital.

I was referring to Applied Behavior Analysis in my posting, BC/BS covers

speech and OT but caps visits per calendar year, but denied ABA billed by the

BTTC/Texana/MHMR down in Rosenberg. R.

[Guest guest]

& White covered a portion of my son's ABA therapy; the therapy

needed to be recommended by his doctor, and the therapist had to be a

certified ABA therapist. & White is in Temple, so I think their

region also extends to Austin.

Good luck!

Anita Karney

Waco

> Greetings all -- have any of you successfully had insurance

> (specifically BC/BS of TX, but any other insurance info would be

> useful) cover ABA therapy? If so, how did you go about it --

> diagnosis codes, etc?

> Many thanks for any help you can provide -- best,

>

> --

> ------

> Dell'

> Austin, TX

[Guest guest]

Can you share the code for UHC, I am filing for aba therapy.

ginam wrote: It depends on the cpt code used. We have

been always re-imbursed by UHC.

Insurance and ABA in TX

>

>

> Greetings all -- have any of you successfully had insurance

> (specifically BC/BS of TX, but any other insurance info would be

> useful) cover ABA therapy? If so, how did you go about it --

> diagnosis codes, etc?

>

> Many thanks for any help you can provide -- best,

>

>

> --

> ------

> Dell'

> Austin, TX

>

>

>

> Texas Autism Advocacy

> www.TexasAutismAdvocacy.org

>

> Texas Disability Network

> Calendar of Events

> www.TexasAutismAdvocacy.org

>

[Guest guest]

,

Don't tell me that UHC paid for ABA???!!! How?

Ruiz wrote:

Can you share the code for UHC, I am filing for aba therapy.

ginam wrote: It depends on the cpt code used. We have

been always re-imbursed by UHC.

Insurance and ABA in TX

>

>

> Greetings all -- have any of you successfully had insurance

> (specifically BC/BS of TX, but any other insurance info would be

> useful) cover ABA therapy? If so, how did you go about it --

> diagnosis codes, etc?

>

> Many thanks for any help you can provide -- best,

>

>

> --

> ------

> Dell'

> Austin, TX

>

>

>

> Texas Autism Advocacy

> www.TexasAutismAdvocacy.org

>

> Texas Disability Network

> Calendar of Events

> www.TexasAutismAdvocacy.org

>

[Guest guest]

not for ABA...but for OT and Speech..

Insurance and ABA in TX

>>

>>

>> Greetings all -- have any of you successfully had insurance

>> (specifically BC/BS of TX, but any other insurance info would be

>> useful) cover ABA therapy? If so, how did you go about it --

>> diagnosis codes, etc?

>>

>> Many thanks for any help you can provide -- best,

>>

>>

>> --

>> ------

>> Dell'

>> Austin, TX

>>

>>

>>

>> Texas Autism Advocacy

>> www.TexasAutismAdvocacy.org

>>

>> Texas Disability Network

>> Calendar of Events

>> www.TexasAutismAdvocacy.org

>>

[Guest guest]

can you share what the CPT codes are. I've got revenue codes but my

insurance Blue Cross wants CPT codes. My provider does not know the CPT

codes

thanks

" ginam "

<ginam@...

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06/05/2006 03:35 Insurance and ABA in TX

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It depends on the cpt code used. We have been always re-imbursed by UHC.

Insurance and ABA in TX

>

>

> Greetings all -- have any of you successfully had insurance

> (specifically BC/BS of TX, but any other insurance info would be

> useful) cover ABA therapy? If so, how did you go about it --

> diagnosis codes, etc?

>

> Many thanks for any help you can provide -- best,

>

>

> --

> ------

> Dell'

> Austin, TX

>

>

>

> Texas Autism Advocacy

> www.TexasAutismAdvocacy.org

>

> Texas Disability Network

> Calendar of Events

> www.TexasAutismAdvocacy.org

>

[Guest guest]

for Speech, 784.5 and 784.69. I cant recall for OT.

Insurance and ABA in TX

>>

>>

>> Greetings all -- have any of you successfully had insurance

>> (specifically BC/BS of TX, but any other insurance info would be

>> useful) cover ABA therapy? If so, how did you go about it --

>> diagnosis codes, etc?

>>

>> Many thanks for any help you can provide -- best,

>>

>>

>> --

>> ------

>> Dell'

>> Austin, TX

>>

>>

>>

>> Texas Autism Advocacy

>> www.TexasAutismAdvocacy.org

>>

>> Texas Disability Network

>> Calendar of Events

>> www.TexasAutismAdvocacy.org

>>