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: