Blue Cross finally covers some of our therapy!

[Guest guest]

Dan: Do you have Blue Care Network?

Kim

[Guest guest]

On Friday, I received a letter from Blue Cross, expecting yet another

rejected claim. However, to my delight, I saw that they're agreeing

to cover at least the follow-up work with our HOPE Center therapist.

Furthermore, our company's Blue Cross representative took it upon

herself to call the HOPE Center and inform them that, if they re-

wrote the receipt for this summer's therapy with the correct code, it

would have a better chance of getting covered. I'm really hoping it

does!

Dan

[Guest guest]

I can't take all this GOOD NEWS in one day. You must be jumping for joy!

Congratulations!

Lynn

2:16 p.m.

> On Friday, I received a letter from Blue Cross, expecting yet another

> rejected claim. However, to my delight, I saw that they're agreeing

> to cover at least the follow-up work with our HOPE Center therapist.

>

> Furthermore, our company's Blue Cross representative took it upon

> herself to call the HOPE Center and inform them that, if they re-

> wrote the receipt for this summer's therapy with the correct code, it

> would have a better chance of getting covered. I'm really hoping it

> does!

>

> Dan

[Guest guest]

That is awesome, Dan! This is what I am hoping for-- more individual awareness on the part of the benefits administrators and case managers! I know that people can bend the rules when needed to get things covered. The people who work in the business KNOW what codes will work. I am glad your case had some personal attention-- hope it continues to work! I've been on a first-name basis with most of the insurance people who have helped me in past years, and have met quite a few of them, face to face (have even stooped to the level of bringing with me to hand-deliver claims forms and appeal letters!). Whatever works. I am hoping that a little more education and awareness will help so that people won't have to "work" the system so much to get what we need covered.

Congratulations to your success, Dan!

Blue Cross finally covers some of our therapy!

On Friday, I received a letter from Blue Cross, expecting yet another rejected claim. However, to my delight, I saw that they're agreeing to cover at least the follow-up work with our HOPE Center therapist.Furthermore, our company's Blue Cross representative took it upon herself to call the HOPE Center and inform them that, if they re-wrote the receipt for this summer's therapy with the correct code, it would have a better chance of getting covered. I'm really hoping it does!DanSupport Everyday Miracles by shopping online at IGIVE.COM, where a portion of every purchase is donated to this support network. Proceeds received will be used for a variety of functions, such as educational activities, therapy, famiy outings, etc. http://www.igive.com/EDM

[Guest guest]

Dan -if you don't mind me asking what code did your representative have them use?

Blue Cross finally covers some of our therapy!

On Friday, I received a letter from Blue Cross, expecting yet another rejected claim. However, to my delight, I saw that they're agreeing to cover at least the follow-up work with our HOPE Center therapist.Furthermore, our company's Blue Cross representative took it upon herself to call the HOPE Center and inform them that, if they re-wrote the receipt for this summer's therapy with the correct code, it would have a better chance of getting covered. I'm really hoping it does!DanSupport Everyday Miracles by shopping online at IGIVE.COM, where a portion of every purchase is donated to this support network. Proceeds received will be used for a variety of functions, such as educational activities, therapy, famiy outings, etc. http://www.igive.com/EDM

[Guest guest]

,

She had them use the following:

Service Type: Mental Health Care

Procedure: Psychiatric Office Service

Procedure Code: 90808

Note, however, that this may not apply to every insurance company and/or type of

therapy.

Dan

> Dan -if you don't mind me asking what code did your representative have them

use?

>

>

> Blue Cross finally covers some of our

therapy!

>

>

> On Friday, I received a letter from Blue Cross, expecting yet another

> rejected claim. However, to my delight, I saw that they're agreeing

> to cover at least the follow-up work with our HOPE Center therapist.

>

> Furthermore, our company's Blue Cross representative took it upon

> herself to call the HOPE Center and inform them that, if they re-

> wrote the receipt for this summer's therapy with the correct code, it

> would have a better chance of getting covered. I'm really hoping it

> does!

>

> Dan

>

>

>

>

> Support Everyday Miracles by shopping online at IGIVE.COM, where a portion

of

every purchase is donated to this support network. Proceeds received will be

used for

a variety of functions, such as educational activities, therapy, famiy outings,

etc. http:

//www.igive.com/EDM

>

>

[Guest guest]

No, we're currently with Blue Cross traditional, but changing to Blue Cross PPO

next

year. I hope we don't lose anything in the transition.

Dan

> Dan: Do you have Blue Care Network?

>

> Kim

[Guest guest]

Dan,

Do you know what code they will accept. The one we used for speech

at Lepak was denied though the DX was apraxia.

Carolyn

> On Friday, I received a letter from Blue Cross, expecting yet

another

> rejected claim. However, to my delight, I saw that they're

agreeing

> to cover at least the follow-up work with our HOPE Center

therapist.

>

> Furthermore, our company's Blue Cross representative took it upon

> herself to call the HOPE Center and inform them that, if they re-

> wrote the receipt for this summer's therapy with the correct code,

it

> would have a better chance of getting covered. I'm really hoping

it

> does!

>

> Dan

[Guest guest]

Dan- that is great news. Thanks for giving out the magic code. We currently have BC/BS PPO Community Blue and it's been good, as long as it has the correct code in the first place. We've been lucky most of our doctors have worked with us on getting the correct code when submitting or if it's denied they re-file with a new code until it gets paid. Working with a representative hasn't been helpful.

Blue Cross finally covers some of our therapy!> > > On Friday, I received a letter from Blue Cross, expecting yet another > rejected claim. However, to my delight, I saw that they're agreeing > to cover at least the follow-up work with our HOPE Center therapist.> > Furthermore, our company's Blue Cross representative took it upon > herself to call the HOPE Center and inform them that, if they re-> wrote the receipt for this summer's therapy with the correct code, it > would have a better chance of getting covered. I'm really hoping it > does!> > Dan> > > > > Support Everyday Miracles by shopping online at IGIVE.COM, where a portion of every purchase is donated to this support network. Proceeds received will be used for a variety of functions, such as educational activities, therapy, famiy outings, etc. http://www.igive.com/EDM> >

[Guest guest]

Carolyn,

We haven't done speech since last year, and were never successful in

getting it covered. Blue Cross says that they'll cover speech only

if it was necessitated by an illness or injury, not cognitive

problems, which are supposed to be dealt with by the school system

(yeah, right).

Dan

> > On Friday, I received a letter from Blue Cross, expecting yet

> another

> > rejected claim. However, to my delight, I saw that they're

> agreeing

> > to cover at least the follow-up work with our HOPE Center

> therapist.

> >

> > Furthermore, our company's Blue Cross representative took it upon

> > herself to call the HOPE Center and inform them that, if they re-

> > wrote the receipt for this summer's therapy with the correct

code,

> it

> > would have a better chance of getting covered. I'm really hoping

> it

> > does!

> >

> > Dan

[Guest guest]

Hey Everyone,

go to this link to get a pdf version of a case filed against Aetna Insurance

Co in July of 2003 to make them pay for speech therapy for a child with

autism. The parents were successful in this case. Whether you have Aetna

or not, the arguements used in this case can easily be used to challenge ANY

insurance policy. I had lost track of this link and had promised it to a few

people when I found it. Best of luck to all of you. The case is called

(Wheeler v. Aetna Life Insurance Co., N.D.Ill., No. 01 C 6064,7/21/03)

another way you may be able to find it is to go to:

http://autismmidtenn.org/html/modules/Downloads/files/5522800_25.pdf

Maureen

Re: Blue Cross finally covers some of our

therapy!

> Carolyn,

>

> We haven't done speech since last year, and were never successful in

> getting it covered. Blue Cross says that they'll cover speech only

> if it was necessitated by an illness or injury, not cognitive

> problems, which are supposed to be dealt with by the school system

> (yeah, right).

>

> Dan

>

>

> > > On Friday, I received a letter from Blue Cross, expecting yet

> > another

> > > rejected claim. However, to my delight, I saw that they're

> > agreeing

> > > to cover at least the follow-up work with our HOPE Center

> > therapist.

> > >

> > > Furthermore, our company's Blue Cross representative took it upon

> > > herself to call the HOPE Center and inform them that, if they re-

> > > wrote the receipt for this summer's therapy with the correct

> code,

> > it

> > > would have a better chance of getting covered. I'm really hoping

> > it

> > > does!

> > >

> > > Dan

>

>

>

> Support Everyday Miracles by shopping online at IGIVE.COM, where a portion

of every purchase is donated to this support network. Proceeds received will

be used for a variety of functions, such as educational activities, therapy,

famiy outings, etc. http://www.igive.com/EDM

>

>

[Guest guest]

I had my son in for speech therapy through Beaumont Hospital for 3 or 4

years. We have BC/BS and they paid for it. I think it was up until he

reached the age of 8.

Mindy

Re: Blue Cross finally covers some of our

therapy!

> Carolyn,

>

> We haven't done speech since last year, and were never successful in

> getting it covered. Blue Cross says that they'll cover speech only

> if it was necessitated by an illness or injury, not cognitive

> problems, which are supposed to be dealt with by the school system

> (yeah, right).

>

> Dan

>

>

> > > On Friday, I received a letter from Blue Cross, expecting yet

> > another

> > > rejected claim. However, to my delight, I saw that they're

> > agreeing

> > > to cover at least the follow-up work with our HOPE Center

> > therapist.

> > >

> > > Furthermore, our company's Blue Cross representative took it upon

> > > herself to call the HOPE Center and inform them that, if they re-

> > > wrote the receipt for this summer's therapy with the correct

> code,

> > it

> > > would have a better chance of getting covered. I'm really hoping

> > it

> > > does!

> > >

> > > Dan

>

>

>

> Support Everyday Miracles by shopping online at IGIVE.COM, where a portion

of every purchase is donated to this support network. Proceeds received will

be used for a variety of functions, such as educational activities, therapy,

famiy outings, etc. http://www.igive.com/EDM

>

>

[Guest guest]

WAS THIS DUE TO A MEDICAL REASON OR WAS IT DEVELOPMENTAL?

SONIA

> I had my son in for speech therapy through Beaumont Hospital for 3 or 4

> years. We have BC/BS and they paid for it. I think it was up until he

> reached the age of 8.

>

>

> Mindy

> Re: Blue Cross finally covers some of our

> therapy!

>

>

>> Carolyn,

>>

>> We haven't done speech since last year, and were never successful in

>> getting it covered. Blue Cross says that they'll cover speech only

>> if it was necessitated by an illness or injury, not cognitive

>> problems, which are supposed to be dealt with by the school system

>> (yeah, right).

>>

>> Dan

>>

>>

>>>> On Friday, I received a letter from Blue Cross, expecting yet

>>> another

>>>> rejected claim. However, to my delight, I saw that they're

>>> agreeing

>>>> to cover at least the follow-up work with our HOPE Center

>>> therapist.

>>>>

>>>> Furthermore, our company's Blue Cross representative took it upon

>>>> herself to call the HOPE Center and inform them that, if they re-

>>>> wrote the receipt for this summer's therapy with the correct

>> code,

>>> it

>>>> would have a better chance of getting covered. I'm really hoping

>>> it

>>>> does!

>>>>

>>>> Dan

>>

>>

>>

>> Support Everyday Miracles by shopping online at IGIVE.COM, where a

>> portion

> of every purchase is donated to this support network. Proceeds

> received will

> be used for a variety of functions, such as educational activities,

> therapy,

> famiy outings, etc. http://www.igive.com/EDM

>>

>>