Insurance Eligibility & Verification

Speedy. Accurate. Easy-to-understand.

That’s what your clients’ families deserve when it comes to insurance eligibility.

We handle the insurance benefit checks and parent questions so you can focus on the quality of care.

P.S. Does your RCM provider do monthly verification checks to verify that insurance is up-to-date? That’s important! If not, get in touch with us today.

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ABA Insurance Benefit Checks:
Resources for Best Practices

Obtain insurance card: Always obtain a copy of the front and back of a prospective client’s insurance card so you have the right information to verify benefits.

Build rapport and document: When calling an insurance company to check benefits, ask (kindly) for the name of the person with whom you’re speaking and use their first name (treat them like a human being). Always obtain a reference number so you can refer back to the conversation if there’s a dispute about benefits in the future.

Automated benefit checks? For commercial insurance companies or Medicaid plans that allow you to check electronically, periodically double-check via phone call.

Trust … and verify: Don’t accept the benefit feedback on blind-faith. Call back if you need to. Eg:

  • Verify whether you were quoted mental health or ABA benefits
  • Use the right provider (or organization) NPI number who is in network and who will likely do the assessment
  • Use the right adaptive behavior CPT codes (eg 97151, 97153, 97155, etc.)
  • Trust your gut, double-check anything that sounds fishy (eg 25 sessions of ABA in a calendar year likely incorrect)