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Autism Spectrum Disorder

Notice of Increase in Coverage for Autism Spectral Disorders - 01/01/2012 PDF

The autism spectrum disorders (ASD) are a range of complex behavioral disorders that are also referred to as pervasive developmental disorders (PDD). These disorders are comprised of autism, Asperger’s syndrome, Rett’s disorder, childhood disintegrative disorder, and pervasive development disorder not otherwise specified. Each of these disorders cause varying degrees of problems in communication skills, social interactions, and repetitive, stereotyped behavioral, speech, and interests patterns.

While there are no conclusive medical interventions that are effective in curing autism; the condition is manageable through a combination of behavioral, pharmacological and educational interventions. There is no single approach that is best for all individuals with ASD. Each individual case and optimal treatment approach varies.

Health Tradition Health Plan has developed a complete provider network for services covered within the ASD. For more information about the coverage of ASD, please reference the provisions found in the Wisconsin Statutes 632.895(12m) and the Wisconsin Insurance Code 3.36. If you are a PCP and wish to make a referral please contact the Plan at (888) 758-7848. Health Tradition does require prior authorization for covered services under these provisions.

For this complex diagnosis it is very important for the treatment team to work together, so please remember to sign Releases of Information or encourage your patients to sign releases so that the treatment team may effectively provide the services needed.

If you are a provider looking to join the Health Tradition network for Intensive and Non-Intensive level services, please contact our Network Development Dept. at (608) 781-9692.

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