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Fw: BCBS not paying for ADHD

----- Original Message -----
From: Ajey Godbole
To: 
Sent: Tuesday, August 03, 2004 10:23 PM
Subject: BCBS not paying for ADHD


I was informed by my billing manager that BCBS of Texas is not paying the
practice for a patient with ADD (without H) I have seen 6 times in the office
already. Apparently they and a lot of other insurance companies in Texas are
not paying for 'mental health' diagnoses if billed by a primary care provider.
They will only pay for these diagnoses if seen by a 'mental health
professional'. The subliminal msg. is: bill for 'something else' and it will
get paid.

I wonder if any of you has run into this. I am drafting a letter to send with
an appeal of the denials and I plan to fight it for months if necessary but my
manager tells me it is futile!

=ajey