This year, the Superior Alliance for Independent Living will be holding their annual chocolate bash at a new time and place. The popular chocolate feast, featuring treats from such fabulous local venders as the Marquette Baking Company and Donckers, will be held in the Great Lakes Rooms of NMU's Bottom Center on a Friday evening.
Mark your calendar for Friday, February 8, 6-9 pm. Come before or after dinner, or just dine on dessert! Tickets, available at the door or at the SAIL office, are just $5 and the money raised benefits a wonderful asset to our community.
A regional grassroots Autism Spectrum Disorders support blog for those in the Marquette, MI area who live with, care for, work with someone on the autism spectrum. (If you have any doubt, let me assure you that you are welcome here.)
Sunday, January 27, 2013
Blue Cross Autism Coverage
The following comes from a Blue Cross newsletter:
Services other than applied behavior analysis require an autism diagnosis from a BCN health care provider participating with the member’s health plan.
Physical, occupational and speech therapy services, when performed for an autism diagnosis, are managed by BCN’s Care Management department, not Landmark or BCN Behavioral Health. The treating provider must submit an authorization request to BCN through e-referral or call BCN Care Management at 1‑800‑392‑2512. A treatment plan does not need to be submitted for physical, occupational or speech therapy services for autism unless these therapies are being reviewed for medical necessity.
Physical, occupational and speech therapy providers who provide autism services can request autism as a service in their listing in the online BCN provider directory. Send an email with the annual number of autism patients you treat and the percentage of your practice focused on autism to bcnproviderpictures@bcbsm.com.
Nutritional counseling requires an order or prescription from a physician, but does not require authorization by BCN.
BCN, together with parent company, Blue Cross Blue Shield of Michigan, mailed letters in October explaining the new autism benefit to primary care physicians, psychiatrists, fully licensed psychologists, pediatric neurologists and therapy providers. A copy of the letter is available on web-DENIS in BCN Provider Publications and Resources on the Autism page. Check this page for the latest information on BCN’s autism coverage. Resources available on the web-DENIS Autism page include:
Remember:
Expanded autism benefits now available Blue
Care Network began offering expanded coverage for autism spectrum
disorder on Oct. 15 in compliance with Michigan law. There have been
some updates since we first announced the expanded coverage in the Sept.‑Oct. 2012 BCN Provider News.
Only applied behavior analysis counts toward the $50,000 annual benefit limit.
In
order for applied behavior analysis services to be covered the
following must occur: An autism diagnosis must be made or confirmed by a
BCN-approved autism evaluation center.
The treatment plan recommendations prepared by the AAEC must include a recommendation for applied behavior analysis.
The
applied behavior analysis must be provided by a board-certified
behavior analyst who participates with the member’s health plan.
The board-certified behavior analyst must obtain prior approval from BCN before providing applied behavior analysis services. Services other than applied behavior analysis require an autism diagnosis from a BCN health care provider participating with the member’s health plan.
Physical, occupational and speech therapy services, when performed for an autism diagnosis, are managed by BCN’s Care Management department, not Landmark or BCN Behavioral Health. The treating provider must submit an authorization request to BCN through e-referral or call BCN Care Management at 1‑800‑392‑2512. A treatment plan does not need to be submitted for physical, occupational or speech therapy services for autism unless these therapies are being reviewed for medical necessity.
Physical, occupational and speech therapy providers who provide autism services can request autism as a service in their listing in the online BCN provider directory. Send an email with the annual number of autism patients you treat and the percentage of your practice focused on autism to bcnproviderpictures@bcbsm.com.
Nutritional counseling requires an order or prescription from a physician, but does not require authorization by BCN.
BCN, together with parent company, Blue Cross Blue Shield of Michigan, mailed letters in October explaining the new autism benefit to primary care physicians, psychiatrists, fully licensed psychologists, pediatric neurologists and therapy providers. A copy of the letter is available on web-DENIS in BCN Provider Publications and Resources on the Autism page. Check this page for the latest information on BCN’s autism coverage. Resources available on the web-DENIS Autism page include:
Letter to providers
Provider FAQ
Reimbursable autism procedure codes
Member notice
Letter to hospitals about approved autism evaluation center designation
Letter of intent to apply for AAEC designation Remember:
Expanded
autism coverage does not apply to all members. Always check member
eligibility and benefits before providing services. If a member has
autism coverage, it will be noted on web-DENIS on the Medical Benefits page under Mental Health Outpatient.
Autism-related
physical, occupational and speech therapy services are subject to
medical outpatient therapy deductible, copayment or coinsurance. Other
outpatient autism-related services apply the primary care physician
copayment and deductible when applicable. Physical, occupational and
speech therapy services used as part of the autism benefit do not count
toward the number of medical visits or day limit for these therapies.
There
is an age limit through the age of 18 (until the member’s 19th
birthday) for any autism services. There is also an annual benefit limit
of $50,000 applicable only for applied behavior analysis services.
Services beyond the dollar benefit limit or age limit will be reviewed
for medical appropriateness and may be covered if medically necessary.
If you have questions, please contact your BCN provider representative.
You can find this and more on page 24 of: http://www.bcbsm.com/ newsletter/providernews/ current/bcnprovidernews.pdf
Autism Society of Wisconsin Conference in the Dells
I got an email from the Autism Society of Wisconsin about this year's convention. It is scheduled for April 18th – 20th at the Kalahari Convention Center in Wisconsin Dells.
For additional conference information visit the ASW Website.
I attended this conference last spring when it was held in Green Bay and found it to be very informative. I learned a lot about what was possible in the area of autism supports and education. Because we are so isolated here in the U.P., I found it very refreshing to be surrounded by so much expertise.
Their full conference program will be available soon but here are some highlights:
· Don’t Worry, Be “Appy” presented by Susan Stokes
· Use of Psychiatric Medication in Autistic Disorders presented by Dr. Richard Barthel
· The Nuts and Bolts of the Children’s Long Term Support Waiver
presented by Julie Bryda and William Murray
· The Hidden Curriculum of Getting and Keeping a Job: Navigating the Social Landscape of Employment presented by Judy Endow
I attended this conference last spring when it was held in Green Bay and found it to be very informative. I learned a lot about what was possible in the area of autism supports and education. Because we are so isolated here in the U.P., I found it very refreshing to be surrounded by so much expertise.
Thursday, January 3, 2013
Best of 2012 Research
I stumbled upon this top ten list from Autism Speaks-- thought others might find it interesting.
Wednesday, January 2, 2013
MGH Parenting Workshop
Once again, Marquette General Hospital is offering a Love and Logic parenting class. Love and Logic gives parents some nice strategies for child management.
More information here or call 225-3081.
Parenting your Toddler with Love & Logic™
January 19th, 2013 10:30am-2:00pm @ MGH's Conference Room 1. Cost: $15 per individual/ $25 per couple. Healthy lunch included.More information here or call 225-3081.
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