Applied Behavior Analysis (ABA)
Fewer Headaches, More Time For Changing Lives
As a BCBA supporting people with autism and developmental delays, we know that you face daily and weekly stresses as you provide excellent service for your patients. The work you do is draining – emotionally, mentally, and at times, physically.
Each day, you’re spending 2-3 hours with each of your patients, balancing it with travel between sessions and the demands of parents, family members, schools and insurance companies, not to mention the endless reports you compile tracking the progress of your patients!
Are you tired of
Most of these things probably aren’t your favorite part of your job, and worse, they can interfere with your ability to provide superior care to your patients.
We want to remove the burden of managing authorization packets, confirming and communicating patient benefits, and following up on claims status with insurance companies from your shoulders.
With nearly 30 years of experience supporting ABA providers with their medical billing, we’ve seen it all. Our professional team partners with you and supports your patients by navigating the intricacies of insurance, saving you an average 10-15 hours a week so that you can get back to working with the patients you love.
You got into the ABA field because you care about the children and families you support. We feel the same way about providers, and we want you to have the most up to date information possible and to be aware of pertinent topics of interest:
Colorado Medicaid Information
Changes to the Medicaid Management Information System have made navigating the system problematic and extremely confusing for many providers, so much so that Colorado HCPF has extended the timely filing requirements from 120 days to 240 days.
We’ve worked hand hand-in-hand with DXC Technology and the Colorado Department of Health Care Policy and Financing to to resolve several of these issues, and have successfully processed 300+ provider enrollment applications with Medicaid.
Click here for information on the current known issues with Medicaid.
Autism Insurance Reform
Great news: 46 of 50 states now have laws to cover autism services!
But there is still a struggle to determine which insurance coverage is required comply, and there are huge differences when it comes to self-funded coverage and fully-funded plans.
Tricare & Autism
TRICARE ’s has new managed care support contractors effective January 1, 2018. TRICARE East will be handled by Humana Military (previously only served the South region), and TRICARE West will be serviced by Health Net Federal Services.
Mental Health and ABA services are not processed through Health Net, but through a third party company.
Are your patients’ plans affected by the changes to TRICARE?
ASD Patients
For ASD patients, you will need to reach out to the correct managed care support contractor for authorizations.
Facts about and requirements to get started providing autism services.
See Chapter 18 TRICARE Operations Manual for important changes impacting ABA services.
As of July 2015, the AMA created CPT codes to specify ABA services, and most insurance companies are now using these codes. Aetna, Anthem, Cigna, RMHP, Tricare and Value option are among the carriers relying on these codes, but others companies have choose to not adopt them.
Find out how to use the right codes under the Comprehensive Autism Care Demonstration.
Get facts about CPT codes 0359T–0374T? from The Association for Behavior Analysis.