RE: OT: insurance coverage for speech--BCBS PPO

[Guest guest]

The speech path or Dev Ped needs to code it in a way that insurance will cover -

such as Apraxia. You should not have to pay out of pocket.

Dana

merchant_darshana wrote:

> hi all

> i need some input here...i live in MA. we have BCBS of Kansas City PPO

> in the benefits section is says that speech therpay has to be pre approved.

> speech therapy is paid for loss of speech due to injury or cleft palate ie

physical problems

> in the exclusion and limitation section it says that no coverage for any

therapies related to autism, learning disablity etc.

> so does that mean there is no chance of getting private speech covered?

> even though the codes mentioned on the bill from speech path does not have

autism code 299.00, when i called BCBS they asked for assessment report from

speech path which mentions the autism word many times.

> for so many years i have been paying out of pocket. i feel i should try again

to get the insurance pay for it...

> so what are my options?

> thanks

> darshana

>

[Guest guest]

Hi, We have Aetna PPO and they did not cover speech. They covered the

evaluation only. I tried to work around it but didn't have a positive outcome as

far as money is concerned.

Anjana

> > hi all

> > i need some input here...i live in MA. we have BCBS of Kansas City PPO

> > in the benefits section is says that speech therpay has to be pre approved.

> > speech therapy is paid for loss of speech due to injury or cleft palate ie

physical problems

> > in the exclusion and limitation section it says that no coverage for any

therapies related to autism, learning disablity etc.

> > so does that mean there is no chance of getting private speech covered?

> > even though the codes mentioned on the bill from speech path does not have

autism code 299.00, when i called BCBS they asked for assessment report from

speech path which mentions the autism word many times.

> > for so many years i have been paying out of pocket. i feel i should try

again to get the insurance pay for it...

> > so what are my options?

> > thanks

> > darshana

> >

>