About This Course

What Information We Will Cover

As many healthcare providers accept insurance coverage for ABA therapy, which is typically funded by most insurance companies, there is a growing need for documentation that supports the medical necessity of ABA services for clients with ASD. Writing complete, accurate, objective, and medically necessary treatment plans is a critical skill for behavior analysts who accept funding from healthcare payors. However, few behavior analysts are trained through a medical model which presents difficulties when documenting medically necessary services. It is likely that insurance companies will start requiring more accurate documentation of medical necessity, and justifications for the level of ABA services requested, before giving prior authorizations. Therefore, it will be important for BCBAs to better understand the range of medical or behavioral health conditions that might impact the client’s ability to participate in ABA services, as well as provide supporting evidence for the level of care requested during the authorization process.

Course Objectives

What Participants Will Learn During This Course

  • Identify medical necessity and understand its importance to ABA treatment plans for prior authorization

  • Determine if ABA services are medically necessary and document the client’s level of care

  • Determine the essential clinical and non-clinical components of a treatment plan

  • Provide guidance to staff on how to write treatment goals that support the medical necessity of ABA services

  • Develop a quality assurance (QA) system for delivering feedback and monitoring treatment plan reports

Course curriculum

  1. 1
    • Course Syllabus

    • About Your Instructor

    • Course Overview

  2. 2
    • Lesson 1: Understanding Medical Necessity

    • Medical necessity article

    • Medical Necessity Criteria Considerations xls

    • Lesson 2: ABA and ASD

    • ASD Levels of Support

    • Lesson 3: Writing Initial Reports & Treatment Plans

    • Treatment Plan Components

    • Record Review Form

    • Record Review Form_Example

    • Schedule_example

    • Hours Equation Worksheet

    • Lesson 4: Writing Reassessment Reports & Treatment Plans

    • Lesson 5: Writing ABA Treatment Goals

    • Medical Necessity vs Social Significance

    • ABA Treatment Goal Development Aid

    • Framework for Writing ABA Treatment Goals

    • Framework for Writing Treatment Goals_Example

    • Lesson 6: Putting it all Together

    • Initial and Reassessment Report Bundle

  3. 3
    • Course Completion Quiz

    • Course Survey

    • Access the Certificate

    • Review the Course