Amvik Solutions not only understands the requirements your agency needs to get a single case agreement, we also recognize that it can be important to get your assurance proof so that you can increase your patient`s burden, receive payment for your rights and do what you can do best – offer useful and quality ABA therapy services. Contact us today at (805) 277-3392 to learn more about our services and how we can help you in your ABA practice. Off-grid Providers While it may seem difficult to obtain refunds with an SCA, off-network refunds may be higher in effective negotiations, resulting in increased profitability. Health care providers may have greater flexibility to set higher reimbursement rates. In-network providers do not have the option to change rates because medical reimbursement rates are set in accordance with the contract. Agreements on a case-by-case basis can be very cost-effective with Panacea`s help. If the patient has not had the chance to find a sufficiently qualified network provider, then the patient pleads for an SCA with the out-of-network provider before the start of treatment. Takeaway At Panacea, we offer premium services to negotiate with unique case agreements and make maximum profits. We are experts in providing solutions for political loopholes and exclusions in the SCA.
Call us at 866-731-6777 to find out how to help you today. In the case of a patient who needs to move from your care to a new network provider or a patient who prefers to remain in your care, you may need to help the patient make the request to the insurer. Some insurers require that the agreement on a case-by-case basis be in the rendering provider, which must be submitted on the 1500 application form. Next, the therapist must accurately describe the benefits of pursuing the patient. It is important to note that insurance companies are legally required to offer clients appropriate ABA treatment by a qualified physician. If no in-network provider is available or if you, the out-of-network practitioner, offer some kind of special care to a new customer, you can negotiate with the insurance provider the normal and complete costs. In such a scenario, a new customer may not select you specifically, but does not have another sufficient network provider. As an ABA treatment provider, you may want to consider negotiating a single case agreement (SCA) to provide services to a patient. These agreements exist between insurance companies and off-grid providers (OONOs) for which OON is recognized as an in-network provider (D.D.D. While it is usually the patient who asks his insurer for the SCA, on the basis that there are no other INN providers for ABA therapy in their field, your agency still has to agree on the terms and rates for the services provided. Since insurers are not legally required to provide an CAS, it is essential for you to present them with the benefits of providing you with this opportunity. Keep in mind, however, that if you provide the reasons for the need for an SCA, it remains honest and justified.
To beautify is to cheat. The application for an SCA is usually in two categories: the new client or the current patient. If you are trying to get an ACS for a new patient, you should consider considering the need of the patient (family) for your specialty and the benefit of your closeness to them. If you help a current patient apply for an CAS from a new insurer, you justify the need for the agreement by insisting on continuity of care. Also keep in mind that you must have defined your patient`s financial responsibility to your agency until an CAS is issued. You may decide not to provide services until the CAS has been authorized or you can agree on a financial agreement for meetings that are not covered by the agreement (just because an CAS is in good standing does not mean that it will be backdated).