In an off-grid scenario like this, it`s possible to use a case-by-case agreement to ensure your client has the coverage they need to get the care they rely on from you as a practitioner or therapist. Amvik Solutions not only understands the requirements your agency needs to get a unique case agreement, but we also know how important it can be to get your insurance license so you can increase patient load, get payments for your claims, and do what you do best – offer quality ABA therapy services. Contact us today at (805) 277-3392 to learn more about our services and how we can help your ABA practice. In case a new patient watches an ACS, the insurance may ask if the patient needs your specialty or geographic comfort. Similarly, if the treatment you can offer could reasonably be argued to keep the patient away from the hospital or reduce the cost of medication, FCC could be authorized. Whenever the economy moves, as we are currently seeing with COVID-19, it is more likely that patients will lose or change insurance. Since insurance coverage is an important factor in any patient-therapist relationship, a change in this coverage can pose a risk to your practice. Most importantly, at a time when patients probably need it most, they leave without their usual support. The client has tried and cannot find in their network a practitioner or provider that meets their needs in a way that makes them feel comfortable. In case of treatment with ABA, this should be done before the start of treatment. Case-by-case agreements must also use ABA CPT authorized medical billing codes. It is important to describe them in the negotiation process with the insurer.
This reduces the risk of late claims. When switching to a new network provider, the SCA CPT code may be specific to the number of remaining sessions. Insurers can only assign a specific code for this case or for patients. There are many therapeutic processes such as ABA therapy, where continuity of care is essential to achieve treatment goals. When a customer switches to a new insurance provider, it is important to maintain continuity of supply or establish a transition plan to a new network provider. In many of these scenarios, it is often necessary to negotiate an agreement on a case-by-case basis. If you are a practitioner looking for a case-by-case agreement for a current client who requires continued care, the negotiated rate may be more flexible depending on the client`s preference. In this case, the negotiated rate may be influenced by the customer`s agreement. Although they need to be duly informed and may need to sign official documents indicating that they are aware of the process and may possibly cost more out of pocket. When we are going through difficult times, we need mental health professionals more than ever. Understanding the process and the elements of a strong argument for a single care agreement is one way to continue to serve and strengthen our local communities. Some insurers require that the case-by-case agreement be that of the rendering provider, which must be submitted on claim form 1500.
A single case agreement (SCA) is a contract between an insurance company and an out-of-network provider for a given patient, so the patient can see that this provider is enjoying their network benefits (i.e. the patient only has to pay their routine network extras for meetings after fulfilling their network deductible (if any)). . . .