How JustAnswer Works:
  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site.
    Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.
Ask Loren Your Own Question
Loren, Attorney
Category: Business Law
Satisfied Customers: 33531
Experience:  30 years experience representing clients .
Type Your Business Law Question Here...
Loren is online now
A new question is answered every 9 seconds

Greetings, My daughter is enrolled in Applied Behavior

Customer Question

My daughter is enrolled in Applied Behavior Analysis. The owners of the facility she currently attends claim that she has Autism in order to charge the insurance more money. She actually carries a diganosis of Rett Syndrome, which, although the symptoms are similar, is a completely different disorder. It seems to me like they are scamming, is there any legal consequence to this action?
Thank you,
Submitted: 1 year ago.
Category: Business Law
Expert:  Loren replied 1 year ago.

Good afternoon. I am Loren, a licensed attorney, and I look forward to assisting you.

Expert:  Loren replied 1 year ago.

Have they made a diagnosis which they can support?

Expert:  Loren replied 1 year ago.

Are you online with me?

Customer: replied 1 year ago.

My daughter was diagnosed with autism a couple of years ago because they were unfamiliar with Rett Syndrome. As of Febrary, genetic testing was done and a diagnosis of Rett Syndrome was confirmed and autism was removed. At that time her ABA therapy decided to keep the documentation of autism active;however, they unofficially changed her treatment plan to be geared toward Rett Syndrome without putting it on paper.

Expert:  Loren replied 1 year ago.

It is really only a problem if there is an intent to defraud. In other words, if there is any medical support, using current diagnostic standards and protocol for a finding of autism then it is not illegal or improper for the faciliry to include it in her treatment.

However, the autism diagnosis has been withdrawn then it is, potentially, a basis for insurance fraud to continue billing for treatment based upon the withdrawn diagnosis and the billing should be updated.

Expert:  Loren replied 1 year ago.

Did you have further questions? Have I answered your question?

Related Business Law Questions