Obtaining insurance authorization for applied behavior analysis (ABA) services has become a routine job expectation for many board certified behavior analysts (BCBAs). Navigating insurance authorizations can be daunting for BCBAs because it requires them to write goals that align with medical necessity and each funder’s unique requirements. Failure to write goals in this manor can lead to partial or full denials for authorization for services, resulting in less access to care for clients. This presentation will focus on understanding funder-specific requirements for ABA services, tying the core deficits of autism to those requirements, and writing treatment goals that are individualized to the client and that are likely to be authorized by funders. We will review how to write goals for activities of daily living, practical functional assessment and skills-based treatment, and leisure skills. Participants will be guided through case examples and practice describing medical necessity, writing treatment goals, and requesting authorization for services from funders.
Learning Objectives
- Articulate the core deficits of autism
- Find and interpret funder requirements
- Describe how to write goals and collect data that algins with funder requirements
About the Presenter
I really would have loved to see more goal examples and how to make them so they meet that DSM 5 requirements.
This training really broke down the meaning of medical necessity and what funders are looking for when writing goals and I found this very beneficial.
This course was so helpful! Kara taught me some very strategic ways to increase my likelihood to get funder approval for goals that I have consistently gotten denials for. Breaking down the core deficits of Autism to assist in goal writing is a great tool to have in my BCBA toolbelt.
This training was exceptionally thorough and provided high-quality, practical information and visuals. I plan to share it with others and reference it in my future assessment endeavors.
This was a great course, very helpful!
This course was an excellent introduction into ensuring our goals align with the adherence to medical necessity needed by payers. I recommend anyone who frequently works with insurance providers to take this course.
Content was very helpful
this is a great continuing education course if you are directly dealing with insurance but if you have a part of your company that deals with the authorization and you don't know your funder requirements, it gives some insight on how to tie the core deficits of ASD to your goals. I wish they provided more examples on how to write goals in different domains.
Excellent presentation! As someone who works for a funder, I appreciated the presenters honesty and clarity around writing plans of care that demonstrate medical necessity.
I work as a BCBA on the funder side and I wish more providers understood exactly what you portrayed in this training. Easy to follow, very well done
Course information
- Title: Aligning goals with medical necessity and funder requirements
- Presenter: Kara LaCroix Ph.D., BCBA-D, LABA
- CEUs: 2 Learning
- Duration: 1 hour and 40 minutes
- Customer Rating: (193)