For many care providers, navigating credentialing is one of the more complex aspects of establishing and growing your practice. Credentialing is the process that the payer uses to verify that the practice or provider meets specific standards. The payer establishes those standards, which typically involves verifying that the provider has proper licensing and certification, along […]
It’s estimated that, as of 2023, there are over 33,600 ABA therapists employed in the US. This sounds like a high number, but when one considers that one in every 44 American children is diagnosed with an Autism Spectrum Disorder, it’s easy to understand why the majority of ABA therapy practices have a waitlist. As […]
Many people who need ABA therapy benefit from coming into the office for care. Yet, telehealth for ABA has proven to be highly effective for patients who prefer this approach, and it improves access for many people who don’t have another method of getting care. The pandemic helped highlight the importance of connection — especially […]
Initiating ABA services can be a cumbersome and time-consuming process for both the patient and the provider. Documenting medical necessity and the need for services andthe proper consents, are a critical part of a patient’s medical record. Most of this information is gathered during the intake process, which starts before the patient’s first appointment.
Applied behavioral analysis or ABA therapy is considered medically necessary by most, but certainly not all, insurance companies or plans. Payers require that services they approve and reimburse are medically necessary, and providers must have documentation to justify these services. Review these guidelines to help prepare treatment plans.
Need help with funding for ABA or other related services for a child with autism? Here are tips for providers and parents.
Medical records are a critical service piece for both patients and providers. These records document the health, well-being, medical needs, plan of care, medical necessity and treatment(s) rendered for a patient during their time with a clinician or therapist. This information is frequently reviewed by internal and external medical professionals, patients, and third-party payers. Failure to document information correctly can not only be detrimental to a patient’s care, but it can greatly impact payment for services.
Missing Piece has found the following elements are key to surviving a medical necessity review or an audit. Each treatment request must include all ten (10) components listed below: