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Kids With Special Needs and Disabilities
Reply to "Is an autism diagnosis retroactive for insurance purposes?"
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[quote=Anonymous]I am trying to figure out how to get our insurer to pay for some OT and speech therapy that is theoretically covered by our insurance plan. They have been rejecting claims and I am working with them to figure out why. One issue is an administrative one (getting prior authorization, putting the right codes on the superbills). I am not sure if another possible issue may be that we started these services prior to getting the diagnosis. We are still waiting for the report from the assessment but the evaluator has told us verbally about the diagnosis and recommended we keep these services. If the diagnosis is an issue for getting these services covered, when would it take effect? After we get the report? When the providers put it on the superbill? Can it be retroactive (she's obviously always had autism)?[/quote]
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