Medical Billing Forum

Payments => Insurance Payments => : wharta September 30, 2010, 12:43:07 PM

: Anthem Lumenos plans
: wharta September 30, 2010, 12:43:07 PM
One of my practices is an ABA that works with children that have autism. These children have individual policies through Lumenos which is specifically for mental health. There may be a possibility that one of our pts might get diagnosed with a seizure disorder. His mom and the provider were curious if his individual policy might drop him if he was to receive a second diagnosis?
: Re: Anthem Lumenos plans
: medauthor September 30, 2010, 01:39:35 PM
I believe his seizure disorder would be considered 'medical' and would be billed to his 'medical' plan by his pediatrician or neurologist, no? 
: Re: Anthem Lumenos plans
: wharta September 30, 2010, 04:27:19 PM
Thats what I was thinking. That it would be a diagnosis for the primary care doctor, not her as she is the specialist only treating the disorder. Is that right?
: Re: Anthem Lumenos plans
: medauthor October 01, 2010, 12:38:04 AM
That is what I believe....As the biller of the ABA Therapist, you will not be billing for services related to his seizure disorder---so i don't believe this would affect you in any way.