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| Navigating Insurance Coverage for Applied Behavior Analysis Services: An Organizational Process for Obtaining Insurance Approval |
| Saturday, May 28, 2016 |
| 8:00 AM–3:00 PM |
| Michigan ABC, Hyatt Regency, Bronze East |
| Area: PRA/AUT; Domain: Service Delivery |
| CE Instructor: Gwen Dwiggins, Ph.D. |
| GWEN DWIGGINS (Accelerated Learning Clinic), KARA BATSON (Accelerated Learning Clinic), JILLIAN JARVIS (Accelerated Learning Clinic) |
| Description: As insurance coverage for applied behavior analysis in the treatment of autism expands, BCBAs need to become proficient in the processes of the insurance industry. Providers will need to be prepared to field questions regarding insurance coverage, understand the steps to obtaining benefits, prior authorizations, and the development of treatment plans. The process can be overwhelming to practitioners unfamiliar with insurance funding. While regulations vary in every state in accordance to each plan, several steps in the process are common across carriers. Practitioners opening a new practice often have no mentoring in working with insurance companies. The goal of this workshop is intended to alleviate participants learning through trial and error. Presenters will share lessons learned in navigating insurance funding and provide solutions to challenges faced along the way. The workshop will also serve as a work group. Participants will create documents they can use in practice to include an organizational flow chart, tracking and intake forms, and an initial evaluation and treatment plan. |
| Learning Objectives: At the conclusion of the workshop, the participant will be able to: (1) define key terminology and technical jargon related to the insurance industry and how these terms translate into behavioral terms; (2) create their own organizational flowchart from intake to setting up initial assessments with families outlining each step in the insurance approval process; (3) identify all the key components required for initial evaluation and treatment plans as outlined by the insurance industry; (4) produce a template of their flow chart, tracking forms, and initial evaluation and treatment plans. |
| Activities: Instructional strategies will include: lecture, group discussion, role-play, and small-group activities |
| Audience: The workshop is at the intermediate level. Participants should have a basic knowledge of assessment and treatment planning. The targeted audience is practitioners looking for information on how the insurance process works. |
| Content Area: Practice |
| Instruction Level: Intermediate |