At 10:24 PM 8/3/2004, Ajey Godbole wrote:
>----- 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!
Yes. I've been unsuccessful in reversing this. I've decided to play it
their way and I do bill it as something else.
But this will be a major bone of contention the next time my group
negotiates a contract with BCBS.