Elevating Your Payer Relationships becomes clinically important the moment a team has to turn good intentions into reliable action inside clinical documentation, payer communication, supervision records, and leadership review. In Elevating Your Payer Relationships, for this course, the practical stakes show up in service continuity, accurate reporting, and defensible clinical decisions, not in abstract discussion alone.
Provider: BehaviorLive — via Council of Autism Service Providers
Take This Course →Including ethics, supervision, and topics like this one. New live CEU every Wednesday.
Join Free →Using real-life examples, Jonathan Mueller and Emily Roche will provide expertise in navigating relationships with insurance payers. Many families and individuals seeking autism services cannot do so without accessing care through their health insurance, and therefore, most providers must rely on insurance funding in order to provide these services. In the current healthcare landscape, working with insurance companies is often complex and difficult. And, providers have to navigate this relationship with multiple payers. This discuss will provide studies of real life challenges each presenter has navigated with payers including rate negotiations, going out of network, escalations of denials to state divisions of insurance, and negotiated A/R settlements. Good relationships with payers are important for providers to be able to ensure sustainable reimbursement, to obtain authorizations for services, and to better advocate for individuals receiving treatment. As an industry, autism service providers need to work closely with payers to not only open up access to care for individuals, but to also work to ensure our payer partners are covering services in a sustainable and effective manner.
| Certification Body | Credits | Type |
|---|---|---|
| BACB® | 0 | — |
| APA | 0 | — |
| COA | 1 | — |
Jonathan Mueller has been a leader in the autism services field for more than a decade. He’s the Co-CEO/co-founder of Ascend Behavior Partners, a multi-state, independent ABA practice; and of Element RCM, a billing and insurance partner to ABA owners/operators, founded by ABA owners/operators. Jonathan’s a fierce advocate for families and for building world-class organizational cultures. Ascend received higher team member and family satisfaction scores in each of its reaccreditations through the Behavioral Health Center of Excellence (BHCOE), while doubling in size every year from 2018-2020. Ascend's “walk the talk” track record on culture helped make Ascend the first ABA provider to earn BHCOE's highest 3-year AND Telehealth accreditation (2020). Ascend is a pioneer in integrated service models that support a range of families' needs: diagnostic testing, ABA treatment, mental health counseling, parent/sibling support groups, and strong care coordination. He co-founded Element RCM to democratize access to billing and insurance best-practices for the 6,000+ providers in the ABA field. Element RCM is a BHCOE Preferred Provider and partners with ABA practices to provide full-service revenue cycle management. Jonathan’s work at Element is also redefining “Customer Experience” in the ABA field to ensure providers, families and teams are front and center in organizational decision-making.
Dig into the research behind this topic — plain-English summaries written for BCBAs.
279 research articles with practitioner takeaways
258 research articles with practitioner takeaways
239 research articles with practitioner takeaways
You earn CEUs from a dozen different places. Upload any certificate — from here, your employer, conferences, wherever — and always know exactly where you stand. Learning, Ethics, Supervision, all handled.
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All behavior-analytic intervention is individualized. The information on this page is for educational purposes and does not constitute clinical advice. Treatment decisions should be informed by the best available published research, individualized assessment, and obtained with the informed consent of the client or their legal guardian. Behavior analysts are responsible for practicing within the boundaries of their competence and adhering to the BACB Ethics Code for Behavior Analysts.