|ABAI Practice Board Presents Advice for Professional Behavior Analysts: How to Access and Maintain Medical Insurance Coverage for Your Behavioral Services
|Sunday, May 30, 2010
|4:30 PM–5:50 PM
|Domain: Service Delivery
|Chair: Arthur E. Wilke (Center for Autism and Related Disorders, Inc.)
|Abstract: Until recently, medical insurance funding for applied behavior analytic services for individuals with autism and other developmental disabilities was virtually unheard of in most parts of the United States. In the past several years, 15 states have passed legislation mandating medical insurance companies to cover behavioral intervention services, particularly for children with diagnoses on the autism spectrum. Furthermore, multiple advocacy groups are in the process of pushing through similar legislation across the country. The availability of medical insurance funding for applied behavior analytic services is a novel and exciting development and one that many behavior analysts are still quite unfamiliar with. This symposium, organized by the ABAI Practice Board, provides of an overview of developments in this area, with a brief review of the history of third party funding for behavioral services, a review of the current state of medical insurance legislation in 15 states, and practical advice for professionals on how to navigate the system and access funding.
|A Behavior Analyst’s Perspective on the History of Third Party Funding for Applied Behavior Analytic Services for Children With Autism
|DOREEN GRANPEESHEH (Center for Autism and Related Disorders, Inc.), Michael F. Dorsey (Endicott College)
|Abstract: Only a short time ago, medical insurance funding for applied behavior analytic (ABA) services for children with autism was non-existent. The past 30 years has seen dramatic change in the acceptance of ABA practice in the general community and tremendous strides in research demonstrating its effectiveness, particularly within the autism population. Along with tireless advocacy by parents of those on the spectrum, these developments have led to states mandating insurance coverage for ABA services. Today, 15 states have passed legislation requiring medical insurance companies to cover behavioral treatment for children on the spectrum. This presentation will review the history of developments in this area, leading up to the current status.
|Legislation Requiring Insurance Coverage for Applied Behavior Analytic Services in 15 States: What Every Behavior Analyst Should Know
|DOREEN GRANPEESHEH (Center for Autism and Related Disorders, Inc.), Jonathan J. Tarbox (Center for Autism and Related Disorders, Inc.)
|Abstract: To date, 15 states in the US have passed legislation that mandates medical insurance companies to cover behavioral intervention services for children with autism whom the companies insure. However, the quality of the legislation differs and the amounts of funding differ considerably. This presentation will describe the basic components which are common to most or all state legislation of this kind, as well as highlighting some of the more important opportunities and limitations of the laws in the various states.
|How to Get Approved by Insurance Companies Who Fund Behavioral Services: Practical Advice for Behavior Analysts
|BRYCE MILER (Center for Autism and Related Disorders, Inc.)
|Abstract: Obtaining medical insurance funding for behavioral services is still quite foreign to most behavior analysts. This presentation will give practicing behavior analysts practical advice on the process for obtaining insurance funding for their services. Requirements in each state are different, as are the processes that each insurance company follows, as they approve, or don’t approve, each individual behavioral service provider. The need for insurance companies to approve a large number of providers in states with autism insurance legislation presents unique opportunities for behavior analysts but the question of how to ensure quality of care and treatment integrity presents unique challenges as well. This presentation will share our experiences and give practical advice regarding how to move through this process in multiple states.
|Navigating the Maze of Billing Medical Insurance for Behavioral Services
|DENNIS DIXON (Center for Autism and Related Disorders, Inc.), Bryce Miler (Center for Autism and Related Disorders, Inc.)
|Abstract: The medical insurance funding process is remarkably complex, even after a behavior analyst has been approved as a provider by a particular insurance company. Dozens of terms which are generally foreign to behavior analysts must be learned and new protocols must be followed in multiples areas. To make matters more complex, each insurance company is unique. This presentation will walk through the process of billing insurance companies for behavioral services and discuss the day-to-day difficulties that often arise. Practical tips will be provided throughout, based on our experience across several states and with multiple insurance companies.