Re: Insurance Billing Question

[Guest guest]

Correction, only Dan Marino center MCH offers ABA, not Coral Springs, they offer

OT, PT & Speech

>

> Hi Friends,

> I guess we are gonna see and help each other with a lot insurance

> questions this November as it is enrollment month in several companies.

> I'm considering the moving from Coventry to BCBS plans as well as

> however I have a question for you.

> Customer service at both insurance companies advised me that the ABA may

> be covered under deductible & maximum out of pocket $1000/$3000 or

> whatever amounts it is as long as they bill as an outpatient facility

> (code 21, 22). My guess is Dan Marino Center MCH, or Coral Springs

> Medical Center although they advised me they bill as outpatient

> hospitals

> On the other hand, freestanding facilities (code 10, 11), meaning places

> that only offer ABA and are not part of a hospital, like Foundations

> Therapy, or ABA Pros, etc... will always have a copay ($50.00 / $70.00

> or whatever the specialist rate is) without ever reaching an out of

> pocket limit.

> 2 questions:

> - Am I understanding this right?- Is there any other hospitals that like

> Coral Springs or Miami Children's Hospital offer ABA in the tri-county

> area?

> Thank you

>