As many individuals throughout the United States can attest, getting insurance coverage for certain conditions can best be described as another form of hell. And it’s especially the case for many individuals with autism.
Treatments, even when shown to be effective, are regularly rejected. As one couple recently told Capital Public Radio, their insurance provider rejected their adult son’s ABA treatment because it was “not medically necessary based on recent and relevant scientific evidence.”
LittleStar ABA Therapy is addressing many of those challenges with the workshop, “Navigating the 10th Circle of Hell: A Roadmap to Writing Medically Necessary Treatment Plans.” The workshop is 9 a.m.-5 p.m. on Jan. 19, 2018, and can be attended online or in person at the Public Forum Room, National Louis University-Lisle Campus, 850 Warrenville Road, Lisle, Ill.
The one-day workshop provides tips for writing successful treatment plans that support medical necessity for health-insurance funded individuals with autism. These letters of medical necessity (LOMN) are reviewed by insurance companies or governmental agencies in determining whether to approve coverage for treatment.
The workshop will be led by Tim Courtney, MS, BCBA, the COO for Little Star Center, a non-profit organization based in Indiana.
Courtney regularly advocates for ethical billing, the enforcement of insurance mandates and medical necessity documentation. In 2006, he earned a master’s degree in applied behavior analysis from the Florida Institute of Technology (FIT). In addition to earning his certification as a behavior analyst, he has been an instructor in the ABA department of FIT since 2008.
The topics covered during the workshop include:
- How to organize all of the steps of a medically necessary treatment plan from pre-authorization through re-authorization.
- How to state the necessary components of a comprehensive and focused treatment plan to meet medical necessity.
- How to review diagnostic reports, behavioral assessments and the written treatment plan to ensure they justify medical necessity.