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Therapy Brands and BHCOE

Therapy Brands and BHCOE Form Partnership in Latest Effort to Support the ABA Community

BIRMINGHAM, Ala., May 4, 2020 — Therapy Brands and Behavioral Health Center of Excellence Accreditation (BHCOE) have announced a partnership that will align the two organizations’ efforts to assist Applied Behavioral Analysis (ABA) providers more effectively. 

 

BHCOE’s mission is to dramatically improve the quality of care for consumers across the world through the accreditation of organizations providing behavior-analytic services. Therapy Brands’ strives to  destigmatize mental health by providing technology solutions that serve the underserved populations of mental and behavioral health, Applied Behavioral Analysis, rehabilitation and substance abuse providers.

 

The new partnership will give BHCOE members first access to continuing education unit (CEU) courses and software discounts from Therapy Brands. Therapy Brands’ software options include a suite of solutions that empowers ABA providers to manage their businesses with tools for scheduling, data collection, telehealth, claims submissions, payment processing, revenue cycle management, and more. 

 

“Providing this additional benefit to our BHCOE members is something we’ve been working toward this year,” said CEO Sara Litvak. “Partnering with Therapy Brands will allow ABA leaders access to CEU courses for their staff and top-of-the-line data collection software services. We’re excited to build this relationship to benefit the autism community.”

 

About Therapy Brands: At a time when both topics of mental health and digital connectivity are at the forefront of the cultural conversation in the U.S., Therapy Brands is equipping tens of thousands of practitioners to effectively address the mental and behavioral needs of some of the country’s most vulnerable populations. Through fully integrated practice management and EHR solutions provided by Therapy Brands, mental and behavioral healthcare providers are able to improve patient quality of care and support better health outcomes for those they serve. Therapy Brands is headquartered in Birmingham, AL and employs more than 500 people nationally. For more information, please visit us at https://www.therapybrands.com/.

 

About BHCOE Accreditation: BHCOE Accreditation is a trusted source that recognizes behavioral health organizations committed to continuous quality improvement. BHCOE offers a third-party measurement system that differentiates and provides independent feedback on clinical quality indicators. The BHCOE criterion features standards that subject-matter experts developed to measure effective applied behavior analysis services. 

 

For more information, visit www.bhcoe.org.

 

Media Contacts:

Emily Claypool: Eclaypool@therapybrands.com

Sarah Cox: Sarah.cox@bhcoe.org 

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History of ABA Therapy and Treatment

History of ABA Practices in the United States

Applied Behavioral Analysis (ABA) has not always existed in the United States’ behavioral health system. Today, ABA therapy is the most common form of treatment within the autism community. ABA embraces the science of learning and behavior, using data-driven methods to help clients improve language and communication skills; develop attention, retention, and memory skills; and address disruptive behaviors.

 

During Autism Awareness Month, the CodeMetro team wants to explore the history of our field. How did it begin, and why?

History of ABA Therapy in the U.S.: The Early Days

ABA History Blog

There was a time when behavior analysis treatment did not exist. Our culture had a hundred different reasons and explanations for why people behaved in specific ways or why some people were outside of what society considered “normal.” The study of behavior emerged within psychology and neurobiology as we developed observational and technological scientific methodologies.

 

Behavioral analysis is the study of behavior, how it works, and how it is influenced. In the early years of psychology, most professionals did not consider or analyze behavior or its relationship to the psyche. Back then, psychology centered on internal thoughts and consciousness, or parts of the mind that were considered unobservable. (They didn’t have neurologists and MRI machines in those days!) This was the Freudian model of understanding consciousness.

 

In 1913 American psychologist John Watson stepped away from Freud’s model and developed another school of thought in the emerging field of psychology: behaviorism. In simple terms, the new field could be described as the science of observable behavior.

 

Behaviorism rejected the unobservable mind, as Watson thought this research method was subjective and unscientific. Watson’s theories became influential in their application to the study of child development. He asserted that a child’s observable environment is the most critical factor for determining their behaviors.

 

As time progressed, Watson’s theories of development were embraced by influential behaviorists in history, including Jacob Robert Kantor, Ivan Pavlov, and B.F. Skinner. Skinner’s theory of Operant Conditioning, which believes that associations between behavior and consequence can lead to behavioral changes, is probably the most famous theory to emerge within the field. Every Psychology 101 course in college touches upon Operant Conditioning and Skinner’s work.

History of ABA Therapy in the U.S.: The Modern Period

When we fast forward to the 1960s, we meet Ole’Ivar Lovaas, the founder of the Lovaas Method, which is also known as Applied Behavior Analysis. His theory was that operant conditioning could be applied to treating individuals with Autism.

 

His first peer-reviewed research was published in 1987. This study included 40 children who received ABA therapy for 2-6 years. The data revealed social skills and cognition improvements for 90% of children, compared to their control group (those who received no specific interventions). The follow-up to this study, completed in 1993, showed that those children retained the skills they learned in the trial into their adolescence.

 

Many of the techniques established in Lovaas’s study are still used today. They include positive reinforcement for good behaviors, environmental manipulations, and other interventions that focus on using rewards, motivations, and learning to develop behavioral skills.

 

That is not to say that the early years of ABA history were not without problematic theories and treatments. Some of the methods used in Lovaas’s study are no longer acceptable today. For example, in the 70s, electric shock was thought to be a suitable technique to discourage unwanted behavior.

 

Today, treatments focus heavily on positive reinforcement, learning, and skill development to help children improve their communication, academic, and social skills while ultimately enhancing their independence and quality of life as they age.

 

Over the course of U.S. ABA history, several different clinical practice types have evolved and methods of ABA therapy delivery.

Types of ABA Practices and Treatment Venues

ABA History

ABA practices–and types of treatment– can be broken down into four primary categories.

 

Solo Practitioner / Emerging ABA Practices

A solo practitioner/BCBA is a provider trained in behavior analysis, has a master’s degree or higher, has gone through intense supervision, and has passed the necessary exams to practice. Someone with these credentials does not need to work for a facility and can practice independently.

 

In-Home Sessions


In-home ABA therapy involves a qualified BCBA or Registered Behavior Technicians (RBTs) within a supervisory relationship with a BCBA that comes to a client’s home to administer services. In-home delivery of care is an excellent opportunity for providers to build strong relationships with their clients in their most natural and comfortable environment, along with the opportunity for parent/guardian attention for family training. Clinicians who deliver in-home ABA therapy sessions could be solo practitioners or work for any size ABA practice.

 

Facility/Larger Practice

Many BCBAs choose to work in a facility setting for a larger practice or multi-site organizations. Providers who select this type of professional setting will get the opportunity to mimic different environments (like educational) and expose their clients to more social activity than they might get within home sessions. BCBAs might be responsible for supervising Registered Behavior Technicians (RBTs), who are generally in charge of administering most service or unit hours.

 

School-District


ABA providers that work inside schools are often RBTs referred to as School Behavior Technicians and can also include school-based BCBAs. A school-based BCBA is usually an employee of the school district and works in a supportive role to supervise the RBTs providing the ABA services within the school’s jurisdiction. More than just supervisors, they are also responsible for crisis intervention and de-escalation. Some practitioners or practices may have school district contracts as well.

Conclusion

ABA History Conclusion

ABA therapy will continue to evolve and change over time. Throughout ABA history, best practices have evolved, old ones being left behind and new ones introduced. As providers, staying ahead of the curve is essential to making sure we are always working in the best interest of the client. For example, ABA history is unfolding right before our eyes. Its use is applied to social distancing behaviors and other areas like the opioid addiction crisis and bullying in schools. ABA history has revealed so much over the last 50 years into the study of behaviors, how they work, and how they are influenced. Time will only tell what the next 50 years will bring to our profession and community.

This post is for informational purposes only and is not meant to be used in lieu of practitioners own due diligence, state and federal regulations, and funders’ policies. 

ABA Insurance Billing Codes

ABA Billing Codes and Challenges for Providers in 2021

ABA billing codes do not have to put a strain on your therapy practice. For many providers, keeping up with ABA billing codes, changes in regulation/coverage, and chasing down payments has become a burden. It sometimes feels as though there are so many details to keep track of that it would be impossible for you to keep up.  

 

The issue is that the role billing plays within your practice is paramount to your ability to work with the clients. What is causing strain on your practice is the fact that you have yet to perfect the billing process. The use of ineffective billing solutions is what is holding your practice back from a streamlined, effective, and flourishing billing process. 

 

The good news that with the right technology or partnerships, your practice can finally tackle the ABA billing codes and challenges that have held you back for so long. 

ABA Billing Code Challenges

ABA Billing Challenges

Claims Management 

One of the most integral components of your claims process is coding each claim accurately with the correct ABA billing code. Doing so will offer you your best chance at an approved claim. This is one of the biggest challenges for providers offering ABA therapy. ABA billing codes are complex, specific, and require great understanding. With clients to focus on, it can be difficult to be an expert on billing as well. 

 

Denial Management 

Even when ABA billing codes are accurate, denials still happen. One of the biggest challenges that ABA therapy providers face is their denial management process. When a denial is not caught, corrected, and submitted within the required time-frame, revenue is lost. 

ABA Billing Codes

The most-used ABA billing codes include: 

 

97151 – Behavior Identification Assessment 

 

0362T – Exposure Behavioral Follow-Up Assessment 

 

97155 – Adaptive Behavior Treatment w/ Protocol Modification 

 

97156 – Family Adaptive Behavior Treatment Guidance

 

97157 – Multiple Family Group Adaptive Behavior Treatment Guidance 

 

0373T – Exposure Adaptive Behavior Treatment with Protocol Modification 

 

97152 – Observational Behavioral Follow-Up Assessment 

 

97153 – Adaptive Behavior Treatment by Protocol 

 

97154 – Group Adaptive Behavior by Protocol 

 

97158 – Adaptive Behavior Treatment Social Skills Group 

Improving Your Claims Process

ABA Insurance Claims

In order to improve your claim and denial management process, providers should access the following tools and services. 


Built-in End-to-End Billing Software
 with Revenue Cycle Management Options

What many providers do not realize is that they do not have to try and become ABA billing experts on their own. In fact, providers with the highest-functioning billing processes outsource claim and denial management to a qualified practice management or revenue cycle management billing partner.  

 

The right tool will simplify your billing process and save time by generating reliable electronic claims, easily posting payments/adjustments, tracking the status of claims, and much more. 

 

Billing software, such as NPAWorks by CodeMetro, can take over your claim/denial management to ensure you optimize your revenue cycle and fortify your bottom line. They will scrub each claim for errors such as incorrect ABA billing codes and track the claim to make sure you are receiving a high number of timely payments. On average, ABA practices collect on 80% of their insurance claims. NPAWorks has an average claim clearance rate of 95%…just think what your practice can do with the extra revenue!

 

With the right partner of either managed billing or ABA billing software, your practice can tackle the burden of ABA billing codes and claims while building confidence in its bottom line. To schedule a consult with an NPA Works billing expert that is ready to help you, click here.   

This post is for informational purposes only and is not meant to be used in lieu of practitioners own due diligence, state and federal regulations, and funders’ policies. 

ABA Therapy Negative Punishment

Examples of Negative Punishment in ABA Therapy

Negative punishment can be incredibly effective: People will likely change their behavior if you take something away from them that they enjoy. Although this form of discipline is often difficult to implement, it’s important to understand that negative punishment is a way to hold people accountable for their behavior, so, in the end, it is positive for everyone involved.  

 

There are many forms of negative punishment, and certain ones are more effective than others depending on the situation. In this day and age, taking away a person’s phone will likely lead to an improvement in their behavior for example. Within the world of Applied Behavioral Analysis, negative punishment techniques can be effective tools in client work. 

Why is Negative Punishment Effective?

Time Out ABA Negative Punishment

This form of punishment is tremendously effective because the individual who faces consequences will associate the absence of the item they love with their poor behavior. For this reason, they are likely to change their ways. This won’t usually happen all at once, but, as they begin to realize that the consequences are consistent, they will probably adjust their behavior.  

 

Negative punishments are essential in many areas of society, including the classroom, law enforcement, and businesses. They can be an excellent way to maintain firm boundaries when you are running a company, teaching a class, or driving down the road: Consequences, when implemented fairly across the board, make the world a safer place for everyone involved.  

The Importance of Remaining Consistent

It’s important to note that negative punishment is only effective if it is implemented consistently. For instance, if a student answers his phone on Monday and you take it away, but then you let him scroll through his Facebook feed on Friday, he probably won’t be motivated to follow your rules. Instead, he’ll keep testing you because he knows he can. In order for this method of punishment to actually work, you must take away the kid’s phone every single time he uses it in class, so he understands that his behavior is absolutely unacceptable.  

Shame Versus Guilt

When someone does something bad, it’s important that they are held accountable for their behavior. However, it’s also essential that they understand that you are not telling them they themselves are a bad person, but simply stating that they need to behave differently. This will lead them to question their actions instead of their worth as human beings, which has proven to be quite effective in many cases: Shame is feeling like there is something wrong with you as an individual while guilt is feeling bad about your behavior

Autism & Negative Punishment

ABA

As a clinician, it can be challenging to provide consequences to someone on the autism spectrum. While physical discipline is never the answer, negative punishment can be an effective method to enforce boundaries when other methods have failed. Negative punishments deliver consequences for inappropriate behavior as part of the learning experience. Clients on the autism spectrum  often struggle to understand what is and is not acceptable behavior and its our job to help them. 

 

In ABA therapy, negative punishment is used to decrease an individual’s inappropriate behavior. It is of the utmost importance to only implement these techniques along with positive reinforcement: You want your client to understand what they’re doing wrong, but you also want them to know what they’re doing right. Furthermore, negative punishment techniques should only be used when multiple reinforcement strategies have become ineffective. 

ABA Therapy & Negative Punishment Techniques

ABA List of Negative Punishments

As an ABA clinician working with clients it’s important to be empathetic while also providing structure and feedback  when necessary to enforce good boundaries. There are many procedures that are  effective. 

Negative Practice

If your client is stomping on the floor, they must do so over and over again until they’re completely exhausted. For example, you may want to ask them to engage in this behavior at least three times. 

Response Blocking

In this case, your client may be playing with their hair frequently. As a form of negative punishment, you’ll want to have them tie up their hair in a ponytail and wear gloves so that they have trouble engaging in this type of behavior. 

Restitutional Over-Correction

In this case, you would ask your client to repair the damage they’ve done. For instance, if someone throws a pack of cards on the floor, you would ask them to pick them up and put them back in the box.

Time Outs

In order to implement this technique, you’ll want to give your client a “time out from a reinforcement opportunity.” In this case, you’re removing the opportunity for your client to earn a reinforcement. You will want to use this one cautiously: The last thing you want to do is engage in negative reinforcement. 

Conclusion

It’s important to note that clients may not change their behavior immediately: These are often ingrained patterns, particularly in the case of someone on the autism spectrum, and it is essential to practice patience with your clients. Clinicians must strike a balance between being empathetic and patient while also consistently enforcing boundaries. 

This post is for informational purposes only and is not meant to be used in lieu of practitioners own due diligence, state and federal regulations, and funders’ policies. 

Need Help Putting the Pieces of Your Practice Together?

NPAWorks by CodeMetro has all the revenue cycle and practice management tools ABA practices like yours need. Our scheduling and billing features lead the industry.
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4 Top Tools for Managing Your ABA Telehealth Practice in Quarantine

As an ABA professional therapist, your clients need you more now than ever. You want to remain available to your clients during this ongoing pandemic and ABA telehealth programs seem to be the way to go.  When you consider opening up your practice to telehealth appointments, picking the top tools for managing your ABA telehealth practice in quarantine might seem a little daunting at first, but don’t worry; we’ve got four tips to help you get started.

 

Loom is a free screen and video recording software that can help snap a video of your face right on your screen along with your voice to help you create videos that you can share with your clients and their parents. For example, you might want to send a video explaining how you will still meet with clients over the internet instead of in-person. Loom makes it easy to explain how telehealth works and the kind of tools your clients need on their end if they want to participate. Loom plays well with Mac, iOS, Windows, and Chromebook so wherever you work, with whatever system you prefer, you can use Loom.

You can use Loom for training videos about the remote telehealth appointments or other teachable moments that help clients and parents feel more secure when using telehealth.

If you’re working from home for the first time, it can be a challenge. You might have kids screaming in the background or dogs barking in the middle of your client discussion. Even traffic can be an issue. What you need is a way to block out all that extra noise so you and your client can concentrate on what’s important during your session. The following apps for windows may just provide the answer you seek.

  • Krisp removes annoying background noise in real-time. It works with over 600 conference and message/streaming apps with a very low latency (15 milliseconds). You can use any headset/headphones and any microphone/speaker of your choice. Krisp also allows you to answer calls anytime anywhere. Best of all, you just turn it on once and the software cancels the noise locally at your computer. So, your data stays safe.  Krisp comes in a free version and a premium version that charges a small fee. Krisp is also available as a Google Chrome extension. 
  • Noise Gate. Noise Gate cancels noise in real-time in accordance with levels that you pre-select for input, output, and volume.
Managing Your ABA Telehealth Practice

 

Blue light has shorter wavelengths but more energy than wavelengths on the red side of the light spectrum. Human eyes are not very good at blocking blue light. In practical terms, this means that blue light passes through the eye’s cornea and lens all the way to the retina. Too much exposure to blue light can damage light sensitive cells in the retina. It can also cause cataracts and other eye problems, increases eye strain, and interferes with sleep patterns. Blue light also may damage the macula and lead to macular degeneration which can lead to blindness.

On the other hand, you don’t want to block all blue light because blue light has some good  health benefits. Blue light plays an important role in controlling our circadian rhythms that helps us wake and sleep on a regular cycle. Too much blue light at night, however, can cause sleeplessness and tiredness during the daytime.

Anyone who works on computers all day and looks at their cell phones for email and browses the internet a lot probably has heard that the blue light emitted from the computer screen is bad for the eyes. Other devices also emit blue light such as LED lighting, fluorescent bulbs, and those popular flat-screen TVs.  PCs, though, usually have a setting for lowering the level of blue light on the screen, especially in the evening hours, to help people adjust to upcoming sleep time.

Manufacturers have jumped into the market by making blue light filter glasses that will allow you to filter out more blue light and there are blue light shields for mobile devices. Here are nine examples of available blue light glasses their suggested uses and the range of prices:

  • LifeArt Blue Light Blocking Glasses – low price, UV400, refringence aspheric resin lenses, for computer and cell phones
  • Fitover Anti-Blue Blocking Computer Glasses – low price, amber lenses, for computers, cell phones, and outdoors
  • TiJn Blue Light Blocking Glasses – low price, composite lens, UV400, for TV and computers
  • Spectra Blue Blocking Amber Glasses – moderate price, for cell phones, computers, and TV 
  • Gamma Ray Blue Light Blocking Glasses – low price, orange amber lenses, for gaming, TV, and cellphones
  • Cyxus Blue Light Filter Computer Glasses – low price, UV400, for reading and computers
  • Prospek Premium Computer Glasses – moderate price, good for all screen types
  • Uvex Skyper Blue Light Blocking Computer Glasses – economical price, orange lens, for computers and TV
  • Gamma Ray 003 Glasses – low price tag, not polarized lens, for computers, TV, and fluorescent lights

If you anticipate spending a lot more time in front of computers than you normally do when in-person meetings are possible, you may want to invest in computer blue light glasses to protect your eyes. Contact your vision specialist for further details on the best blue light shield or glasses for your eyes and your computer use.

No one is sure how long the social distancing practices will last and your clients need to meet with you now.  So the next best thing to being there is telehealth. When meeting with clients and their parents, you want to make sure you’re using a service that is HIPAA-compliant and convenient. One service worth mentioning is thera-LINK.

 

While switching to telehealth options may seem scary for ABA practictioners, there are options that make it easy. With thera-LINK, you’ll find unique features like a custom waiting room and file sharing. You actually have your pick of useful features including:

  • Appointment scheduling
  • Client and session notes
  • Client payments
  • Secure messaging
  • Client profile
  • Directory listing

Need Help Putting the Pieces of Your Remote Practice Together?

CodeMetro has all the tools ABA practices need to make a remote practice work.

This post is for informational purposes only and is not meant to be used in lieu of practitioners own due diligence, state and federal regulations, and funders’ policies. During the Coronavirus pandemic, and when implementing telehealth, be sure to use your resources and complete the proper follow-up with funders and insurance.

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ABA practice and COVID

How to Keep Your ABA Practice Running During COVID-19

The COVID-19 pandemic has interrupted many sectors of the economy, including many ABA therapy offices that are now grappling with the question of whether to retain their employees and stay open. Fortunately, there are various federal government relief programs as well as other resources that can help small businesses like therapy practices weather this storm. We’ve compiled a list of resources that may help your ABA therapy office stay in business in the next few months.

COVID-19 FINANCIAL ASSISTANCE FOR YOUR ABA PRACTICE

Small Business Administration Relief Options

The Small Business Administration is also administering several other COVID-19 relief options that your ABA therapy practice could qualify for. The Economic Injury Disaster Loans can provide up to $2 million in loans to small businesses. When you apply for the EIDL, you may also qualify for the EIDL Emergency Advance which can provide up to $10,000 in grant funding for small businesses that have experienced a temporary loss of revenue due to the pandemic. SBA Bridge Express Loans can give businesses who already have a relationship with an SBA lender access up to $25,000 quickly. The SBA Debt Relief program is also providing up to 6 months of debt relief for SBA loans. Compare SBA COVID-19 Disaster Loans in this chart.

Employee Retention Tax Credit

If your practice has been impacted by COVID-19, you can apply for either the Paycheck Protection Program or an Employee Retention Tax Credit, which is 50% of up to $10,000 in wages paid to employees. Read about eligibility requirements and how to receive the credit at the IRS website.

State, Local, and Private Sector Relief Programs

The federal government isn’t the only entity providing emergency loans and grants. The U.S. Chamber of Commerce Foundation has compiled a List of Programs Providing Financial Assistance to Small Businesses run by state and local governments and the private sector.

SBA Access to Capital

Your practice may opt to take out regular loans to increase your liquidity during this time. The SBA offers a number of loans (that are not disaster relief loans) to small businesses. Find out more about them here.

Paycheck Protection Program

Note: The Paycheck Protection Program is not currently accepting applications, but this may change based on new regulations and need.

 

As part of the economic stimulus bill passed by Congress in response to COVID-19, the Paycheck Protection Program will provide $350 billion in forgivable loans to small businesses that keep their employees on payroll. As an ABA therapy practice, if you retain or quickly rehire your therapists or office staff, you can apply for a loan amount equal to two months of your average monthly payroll costs plus an additional 25%. The loan amount that you spend on payroll, rent, mortgage interest, and utilities will be forgiven.

 

All businesses with less than 500 employees are eligible to apply. To be considered, you’ll need to apply by June 30, 2020 through any existing SBA lender or through any federally insured depository institution, federally insured credit union, and Farm Credit System institution that is participating. Read more about who can apply and how to apply in this FAQ sheet.

 

FAQs: Treasury.gov PPP Information Sheet and U.S Chamber of Commerce Guide

Form: Paycheck Protection Program Application Form

Business Continuity Strategy

CO: Surviving the Coronavirus – Resources for Small Business (visit)

The U.S. Chamber of Commerce has created a resource hub with a growing collection of articles intended to help small businesses during the pandemic. The blog posts cover topics such as strategies to curb business losses, managing employees, keeping up morale, communicating with customers, and transitioning to virtual work.

COVID-19 Business Resource Center – Hello Alice (visit)

This resource center curates a large number of resources (articles, webinars, guides) produced by various companies and organizations to help small businesses during the crisis. Recommended by the U.S. Chamber of Commerce.

Coronavirus Small Business Resource Hub – SCORE (visit)

SCORE, an organization which partners with the Small Business Administration to provide advice to small businesses, is publishing a variety of articles with a focus on small business financing, solving cash flow problems, and managing employees during the crisis.

SBA Small Business Guidance and Loan Resources: COVID-19 (visit)

The SBA provides guidance on financial assistance and common issues small businesses may face during the crisis.

Business Interruption Insurance

As a group practice, you may have business interruption insurance coverage through your insurance policy (which is also known as business income insurance). This blog post provides some answers as to whether your business interruption insurance might cover some of your recovery costs. The New York State Department of Financial Services has also released a helpful FAQ on business interruption insurance during COVID-19.

Business Continuity Software

Telehealth

Telehealth allows your clients to keep their sessions with your practice without having to leave the comfort of their home. thera-LINK is partnering with CodeMetro to provide an industry-leading telehealth video platform that is easy to use and HIPAA-compliant. Take your ABA practice online with telehealth provided by thera-LINK.

EHR Software

The speed and efficiency of your business operations can help ensure that you are continuing to serve your patients and bringing in revenue. Practice management software can keep every aspect of your business running smoothly and features scheduling, billing, payroll, and reporting.

Data Collection

Improve your clinical results by using Catalyst to collect the data you need from your client sessions. You can also enable employees to track and review data from wherever they are.

This post is for informational purposes only and is not meant to be used in lieu of practitioners own due diligence, state and federal regulations, and funders’ policies. During the Coronavirus pandemic, and when implementing telehealth, be sure to use your resources and complete the proper follow-up with funders and insurance.

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ABA EVV Updates

The EVV Update ABA Providers Need

Disclaimer: This blog is purely for informational purposes and should not be used in lieu of federal and state regulatory sources. We encourage you to complete more research and follow deadlines as you see fit.

The upcoming deadlines for electronic visit verification (EVV) have some ABA providers confused and scrambling to make changes. Before you make any big changes to the way you do business its important to know exactly what changes need to be made and why. We’re here to guide you.  

A few notes about EVV:

  • EVV creates a digital record of ABA services by notating who the services were provided to (client), who provided the services (provider), where they were provided, when they were provided, and what exact services were provided.
  • “States must require EVV use for all Medicaid-funded PCS by January 1, 2020 and HHCS by January 1, 2023.” This does not include ABA services, but states can include ABA if they deem it necessary.
  • Some providers may have been doing some form of EVV before the mandate occurred. 
  • Only two states (thus far) have decided to require EVV for ABA services. Those states are Colorado and Florida.
  • Each state that is working to require EVV for ABA services has approved vendors that providers can work with. However, in most cases you can request to use an alternative vendor.

Next steps for ABA providers.

  • Know the rules for your state. Right now, if you’re an ABA provider outside of Colorado and Florida then the new mandate does not apply. However, states can change this at any time.
  • Colorado ABA providers will need to work to comply with the EVV mandate by late summer 2020. Under the Colorado model, providers can you the state solution, Sandata or an alternative EVV vendor. In both cases, providers must contact Sandata to start the process. (Colorado HCPF)
  • Florida ABA providers need to receive training to start using the Tellus EVV system. Florida’s mandatory launch date is no earlier than March 1, 2020. At this time providers will be required to begin using the approved system. (AHCA)

CodeMetro has you covered

At CodeMetro, we’re ahead of the game! With our new Clock In/Out feature in both NPAWorks and NPAGo, you are able to capture the date, time, and geolocation of your provider at the start and end of the session. With this great new feature, you can provide electronic verification of services (EVV) or track exact arrival and departure times for internal purposes. If you are interested in using Clock In/Out, please reach out to support@codemetro.com for help in enabling this feature!

 

 

 

Colorado ABA Providers and Customers

Each provider must reach out to Sandata directly to begin the process of testing with CodeMetro. The contact information for Sandata is listed below. When you reach out to them, please reference CodeMetro as your chosen “alternate EVV vendor” to determine your next steps. More information about this process can also be found on the Colorado HCPF website at Colorado HCPF EVV Provider Choice Systems Process. During “Phase 2” of Sandata’s process, a representative should provide you with contact information for the Sandata technical interface support team. When you receive this information, please contact us at 646-926-7081 and provide the contact details so we can begin the work on our side. Sandata Technologies: Phone: (855) 871-8780 Email: CO-HCPF-EVVProviderHelpdesk@etraconline.net

Ready to Get a Handle on Your Practice Management?

CodeMetro has you covered from start to finish. We help you with contracting and credentialing and submitting claims through our practice management system. Start with a quick demo and get everything you need.
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ABA Telehealth

5 Questions on Telehealth: ABA Therapy in the Time of COVID-19

We hope you were able to join us for the latest ABA Community Chat. This series allows us to welcome providers for a Facebook Live session where they can have their questions answered by an industry professional. For this session, we were joined by Dr. Joy Pollard, Co-founder and CEO of Clinical Operations at Behavior Change Institute. Dr. Pollard has been working in the area of telemedicine or telehealth practices for the past seven years. Her own clinical practice is focused on the delivery of service through telehealth modalities in homeschool and residential settings. As a subject matter expert on telehealth guidelines for the Council for Autism Service Providers (CASP) she gives great insight into how practitioners can continue providing care during the COVID epidemic. Below you’ll find a summary of common questions and answers from Dr. Pollard’s ABA Community Chat.

 

Q: Our practice has never used telehealth before, where do we begin?

 

A: CASP has been working on guidelines and organizational standards for providers to use during the pandemic. One chapter on telehealth guidelines has been pre-released and its a great opportunity to learn more about teleheath service delivery and how to being developing your clinical and business infrastructure.

 

Find the guidelines here.

 

Q: A lot of funding sources have approved reimbursement for absences/cancelled appointments for ABA clients in March. Now that telehealth services have been approved by most funding sources would they still reimburse for absences/cancellations after March?

 

A: It will really depend on the healthcare funders whether they are going to continue to allow for reimbursement beyond the month of March. If you’re not receiving clear answers, inquire whether there are any supervisors that you would be able to speak with and obtain that information in writing. Its likely that they’re not sure whether they’ll be able to continue providing reimbursement past the month of March. Funders are changing their policies in accordance with the changing environment almost daily. Be sure to check back as much as you can. Its also appropriate to discuss with funders how the move to telehealth affects the way you care for your clients and your business overall.

 

You can find updated lists on funders who have approved or changed their policies on telehealth here.

 

Q: Do we need consent from parents? If so, is there a sample form?

 

A: Yes, you’ll need to appropriate a separate consent form for any type of telehealth service delivery model. Typically you’ll want to to include a background on the risks and benefits of the services being delivered through this modality as well as what different types of modalities might be delivered. You can find a sample consent form in the appendix of the CASP Practice Parameters for Telehealth-Implementation. The sample consent form identifies telephonic, synchronous, and asynchronous modalities and both the provider and client can notate which modalities they are comfortable with and give consent for.

 

Q: How do we get parent signatures per visit if we are doing telehealth?

 

A: It depends on each organization and how they are currently obtaining signatures. If an organization is already using an electronic practice management system that allows their providers to obtain signatures electronically, then there is likely going to be an option to still have parents sign for these sessions. Potentially, what clients may need to do is log in to their own client account, or their family account, and sign for each of the sessions either individually or in bulk, depending on how the provider has that set up.

 

If providers are using paper signatures then it might be worthwhile to speak with your funders and ask them what will be acceptable for their signature requirements just to be sure that you are meeting those requirements and that you are able to respond appropriately if you have to do an audit. This is possible another funder specific question that would require providers to speak with their funders and notate who they spoke with as well.

 

Q: A lot of funding sources have approved reimbursement for absences/cancelled appointmendts for ABA clients in March. Now that telehealth services have been approved by some funding sources would they still reimburse for absences/cancellations after March?

 

A: It will likely depend on those healthcare funders whether or not they are going to continue to allow for reimbursement beyond the month of March. If you’re not currently receiving clear answers, inquire whether there are any supervisors that you would be able to speak with and obtain that information in writing. Its likely that they’re not sure whether they’ll be able to continue providing reimbursement past the month of March.

 

Q: Can sessions be recorded?

 

 

A: Sessions can be recorded and that should be included in the consent form to obtain consent from the caregiver. The consent form should also indicate what the recordings will be used for, including caregiver training and supervision of technicians.

 

Need a reliable, HIPAA-compliant, telehealth platform? Go here

More Resources

 

This post is for informational purposes only and is not meant to be used in lieu of practitioners own due diligence, state and federal regulations, and funders’ policies. During the Coronavirus pandemic, and when implementing telehealth, be sure to use your resources and complete the proper follow-up with funders and insurance.

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ABA Insurance Billing Tips

5 Ways ABA Therapists Can Save Time on Insurance Billing

You may know, or at least suspect, that you need a guide to insurance for ABA providers. We agree and we want to help you make billing with insurance as painless as possible. That’s why we’ve provided these 5 tips to help you start improving the way you do ABA insurance billing. 

 
Tip #1: Make sure you understand insurance coverage as it relates to your clients and your state. 

Not all insurance plans cover applied behavior analysis (ABA) therapy in the same way. One way to make sure you are eligible to receive payment for services rendered is to confirm whether your patient has health insurance and how it covers ABA therapy. As of October 1, 2019, 50 states and the District of Columbia mandate insurance coverage for ABA therapy; however, not all 50 states cover ABA therapy at a universal level.

 

  • California, for example, requires that every health insurance policy must cover “behavioral health treatment for pervasive developmental disorder.” (Cal. Insurance Code Sec. 10144.51 and Sec.10144.52 2011 Cal. Stats., Chap.650; SB 946) Such coverage does not require that the benefits paid exceed the federal essential health benefit level under the Patient Protection and Affordable Care Act.
  • California also requires ABA therapy coverage for a person of any age under the same rules that apply to other medical infirmities.
  • Other states mandate a specific age limitation. In Maryland, for example, the age limit is 19; in others, like Delaware, it’s age 21.
  • Florida mandates that health insurance plans cover ABA therapy but limits that coverage to $36,000 per year, subject to a $ 200,000-lifetime maximum. 
  • In addition to maximum age thresholds and maximum benefit limitations, insurance company policies may also restrict how long a person may receive ABA therapy treatment, restrict in-home ABA therapy, and so on.

These variations make it especially important that you know the rules as they apply in your jurisdiction. Always take things a step further and speak with your clients’ provider to verify coverage before you start a session.

Tip #2: Make sure you're credentialed.

You have to check your clients’ coverage, but you also have to make sure your practice is recognized by the insurance company. Every insurance carrier has its own conditions and prerequisites that a therapist must meet before the company will pay for ABA therapy by that provider. The conditions include credentialing for the therapist.

 

Credentialing means providing documentation in support of your application for approval, such as your medical licenses, a salient overview of your education and work-life (curriculum vitae or C.V.), proof of medical malpractice insurance and its limits, a list of hospitals where you have admission privileges — to name a few. It can take about a month for the initial credentialing process to gather the necessary information and responses from schools and boards and other references. After your practice completes the initial vetting process, the insurance company will verify the sources on your application and then submit your application for approval or disapproval to a credentialing committee. 

 

Credentialing is critical for a medical provider’s eligibility to accept payment from a third-party payor (the insurance company).

 

Tip #3: Become an in-network provider.

Patients covered by what’s known historically as an indemnity plan can go to any doctor they want. On the other hand, patients covered by a preferred provider organization (PPO) or a health maintenance organization (HMO) must receive their health insurance from a preferred provider or the HMO’s staff. A preferred provider is also known as a provider that operates in-network. Insurance plans reimburse in-network providers at a higher rate than out-of-network providers. Sometimes they won’t pay out-of-network providers, making the patient 100% responsible for the cost of services rendered.

 

In-network providers (physicians, hospitals, and labs) sign a contract with the health insurance carrier to provide services at a discounted rate. In return, the insurance company provides an ongoing patient stream which requires that patients use the insurance company’s preferred provider list in order to receive maximum payment. This agreement allows the health provider to spend less time searching for new patients. 

 

Providers are selected based on education, credentialing, the size of the discounted fee the provider sets for the covered patients/insurance company, and the provider’s availability to accept new patients. After application approval, the insurance company will offer a contract to the provider. In-network providers must also agree to follow all the rules the insurance company sets.

Time-Saver Tip

Contracting and credentialing can be a time-consuming process. Save time by letting someone else do the work for you.

Tip #4: Have the right system in place for filing claims (and getting paid).

Once you receive approval as a credentialed provider, you might think it a simple matter to submit invoices for services rendered. However, if you don’t have a practice management system in place that also covers billing, then claims submissions (and payments) can become a hassle.

 

Each insurance company has its own forms that providers must complete. Each claim form requires appropriate medical coding for the service performed and other pertinent information about the client and your practice. Therefore, you must maintain your updated familiarity with the Current Procedural Terminology (CPT) codes that apply to ABA therapy services. You must also maintain updated records on your client’s personal contact information and insurance information.

If any of the information completed on the form is in error, the company will deny the claim. Companies also have filing deadlines to which providers must adhere or the company will deny the claim. 

Tip #5:  Don't ignore claim denials.

If a client’s insurance company denies your request for payment, under certain circumstances, you may appeal the decision. So, it’s important to know the appeal procedures of that particular insurance company. Generally, you may appeal if:

 

  • you don’t know why the claim was denied;
  • you received payment but it was in the wrong amount;
  • you disagree with the insurance company that the patient had a disqualifying preexisting condition;
  • you disagree with the insurance company’s determination that the services were not “medically necessary”;
  • the company’s payment does not reflect special circumstances that required complicated medical services;
  • your payment was denied because you did not obtain pre-certification but you had determined special medical conditions precluded pre-certification.

Alternatively, you can secure services that will review and fix claim denials for you (and even lower the occurrence of denials in the future).

A few final thoughts for a successful relationship with insurance companies.

Bear the following suggestions in mind when working with insured patients:

 

  • Make sure you collect all co-payments and deductible amounts as required under the patient’s policy at the time of service or in weekly or monthly invoices covering those services. This is your responsibility as a provider. The insurance company will not collect those for you.
  • Document the name and phone number of any insurance company staff member to whom you speak.
  • Take good notes of your conversations and provide all documentation within the time frames requested.

Ready to Get a Handle on Your Billing?

CodeMetro has you covered from start to finish. We help you with contracting and credentialing and submitting claims through our practice management system. Start with a quick demo and get everything you need.
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ABA CEU

CEUs for ABA Therapists

Understanding Continuing Education Units (CEUs) for ABA Therapists

Healthcare is a rewarding career which allows you to make a positive difference in the lives of others. But becoming a healthcare professional isn’t always easy. Specialized education and certification are required, which can be costly and time-consuming. But it’s important to understand medical professionals, including ABA therapists, are never truly finished learning.  

Even after earning a graduate degree and becoming certified by the required professional organization, you’ll still need to return to the classroom frequently. Here’s a closer look at Continuing Education Units and the role CEU ABA requirements play in effective therapy.

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ABA Billing Codes

Applied behavior analysis is a type of therapy for those diagnosed on the autism spectrum and has developmental disorders in categories like language and social interaction.

 

If you’ve tried looking for information on autism CPT codes and other codes related to applied behavior analysis in the past, you know it can get confusing quickly. Especially with all the current changes in applied behavior analysis billing codes that are happening.

 

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ABA CPT Codes for Adaptive Behavior Services – Effective January 2019

The temporary ABA CPT codes have come (mostly) to an end at long last. January 1, 2019 marks an important time for the ABA world—the new CPT codes the American Medical Association CPT Editorial Panel released this August will go into effect.

 

(more…)

How to Start an ABA Therapy Practice- Code Metro

How to Start an ABA Therapy Practice

Starting an ABA program can be one of the most rewarding and enjoyable things you can do as an ABA therapist.

 

Each day, you’ll get ready for work knowing you are about to make a profound impact on the lives of your patients.

 

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The Best ABA Podcasts

The area of applied behavior analysis (ABA) has exploded with growth over the last ten years and expects more progress in the future. Applied behavior analysis can be used to treat a wide range of neurological conditions and helps to provide insight on individuals and conditions as a whole.

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