Wiki CREDENTIALING WITH ANTHEM

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Pkirsch1

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Location
Bristol, CT
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One of our providers just got her LMFT license and she is credentialed now with Anthem. Why are some claims being paid out of network or
not being paid at all? This is so frustrating.

Can someone please help?

Thanks,
Pamela
 
Hi Pkirsch1
It could be the service/treatment LMFT will not be covered or it could be the other policies associated with Anthem not cover this type of clinician. LCSW and MD get covered in most psych's behavioral health therapy services whereas the LMFT( licensed marriage therapist ) are not. Umm also maybe the patient does not have unlimited coverage for behavior health or used all psych services for the year.
Well hope these suggestions helped you understand
Lady T
 
Hi Lady T,
Thank you for answering. We are in CT., and there is some miscommunication going on in the background between Carelon and Anthem. We just need to get in touch with the right person to help us. My credentialing person is having a hard time.
Thank you,
Pamela
 
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