The purpose of this blog is to assist providers on obtaining insurance reimbursement for the treatment of Autism Spectrum Disorder Therapies (ASD). Please feel free to add your comments, suggestions, and personal experiences with different insurance carriers.

Saturday, February 26, 2011

Where to find fee schedule for BCBSFL

In follow up to our blog last week we want to help in finding the fee schedule for BCBSFL. Go to www.bcbsfl.com. Once there you click on the provider tab. Click on the tools & resources link. Next go to provider manuals prior to 10/30/10. On this page scroll down to Ancillary Providers link PDF file. While in this file go to page three and click on the Ancillary Common Fee Schedule. On this next page click on May 2010 under the Behavioral Health section. On this page you will see the codes 96150 & 96152. These are the ABA therapy codes for billing. If you do not have a CPT code book yet it is suggested you get one to find the descriptions of the codes. As you know by now each insurance company is giving different codes for our services therefore it is important to know the descriptions and billing frequency for the codes.


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Location:www.bcbsfl.com

Friday, February 18, 2011

Codes for Blue Cross & Blue Shield of Florida

i have received some emails regarding what are the codes for Blue Cross & Blue Shield of Florida for ABA therapies. The following are the billing codes 96150-assessment,96152-therapy. You can find this information on www.bcbsfl.com. Find the "for providers" tab. Click tool and resources. Go to provider manuals. In part II find Ancillary Providers and click to open PDF file. You can find the codes on page 9. BC & BS will pay 70% of the allowable. Look for our next tweet or blog for the fee schedule.


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Location:Miami

Saturday, February 12, 2011

Parker Autism Foundation

In our constant search to assist the many children who are need of financial assistance to receive ABA therapy we found The Parker Autism Foundation www.parkerautismfoundation.org. Here families are able to apply for a limited scholarship for ABA therapy at the Parker Autism Foundation or an approved center.

All information is available at www.parkerautismfoundation.org, scroll down to the bottom of the page and read the FAQ's. There is a downloadable and printable application with instructions.

We will continue to inform families on additional funding information as we discover them. We hope this is helpful.


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Location:Torremolinos Ave,Doral,United States

Saturday, February 5, 2011

Where have we been?

I would like to apologize for not blogging for quite a while. During the past year we have had an increase in the number of insurance companies that have credentialed us or we are working on a case by case assignment. We have been able to add Blue Cross & Blue Shield, Aetna and UBH. As you all know there are many different codes for our service depending on the insurance providers. We have now also learned that there are many different guidelines for service, depending on the insurance provider or carrier. these guidelines appear to establish medical necessity for or clients. Failure to meet medical necessity guidelines will result in the termination of case.

So, if you are going to take on any new cases from new insurance providers we suggest the following:

1. Contact provider relations representative to see if you can get a copy of the guidelines.
2. Do some online research for the documentation.
3. Review the documentation to develop a checks and balances on what activities must occur so that you may stay in compliance with the insurance provider or carrier. this could be done by creating a super-bill that includes all of the activities that BCBA must do on a monthly basis and a template for the quarterly or six month reviews that reflect the actions of the BCBA and your line-staff.

I currently have the guidelines for Cigna, Aetna, UBH and Humana Tricare. I am currently looking for Humana, AvMed, & Blue cross & Blue Shield.

If you have any questions, or info please post them on the blog or email me at newwayday@gmail.com Please subject your emails, Attn. Jose & Cary Blog questions.



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Location:SW Shannon Ave,Melbourne,United States