Author Topic: Anthem Lumenos plans  (Read 1421 times)

wharta

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Anthem Lumenos plans
« on: September 30, 2010, 09:43:07 AM »
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?

medauthor

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Re: Anthem Lumenos plans
« Reply #1 on: September 30, 2010, 10:39:35 AM »
I believe his seizure disorder would be considered 'medical' and would be billed to his 'medical' plan by his pediatrician or neurologist, no? 
Michelle Rimmer, CHI, CPMB
President-Professional Medical Billers Association
Owner-ABA Therapy Billing Services
Author, 'Medical Billing 101' and 'Coding Basics: Understanding Medical Collections

wharta

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Re: Anthem Lumenos plans
« Reply #2 on: September 30, 2010, 01:27:19 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?

medauthor

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Re: Anthem Lumenos plans
« Reply #3 on: September 30, 2010, 09:38:04 PM »
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.
Michelle Rimmer, CHI, CPMB
President-Professional Medical Billers Association
Owner-ABA Therapy Billing Services
Author, 'Medical Billing 101' and 'Coding Basics: Understanding Medical Collections