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Insurance Provider Workgroup

Mission

The NJABA Insurance Provider Workgroup is dedicated to promoting the professional practice of applied behavior analysis (ABA) in the context of publicly and privately insurance funded services and increasing the insurance industry’s capacity to provide high-quality behavioral services to all insureds.

Leadership Committee

Craig Domanski, Ph.D., BCBA-D, Chair
Cara Graham, M.A., BCBA, Secretary
May Beaubrun, M.Ed., BCBA, FAQ Coordinator

Current Activities

1. Communication with insurance carriers
2. Becoming credentialed with insurance carriers and CAQH
3. CPT codes
4. Entire claims submissions process
5. In-network exceptions
6. And more!

Click Here for Insurance Provider Frequently Asked Questions!

Resources

Department of Banking and Insurance – Autism Mandate Bulletin
Department of Banking and Insurance – Appeal and Complaint Guide for New Jersey Consumers
BACB’s ABA Treatment of ASD – Practice Guidelines for Healthcare Funders and Managers

Meetings

Announcement
In the upcoming weeks, we’re going to have an opportunity to meet with individual carriers about repeated issues providers have faced regarding implementation of ABA therapy. In order to make sure these meetings are productive, it will be beneficial to have clearly organized and prepared agenda items. We are reaching out to you to identify the most pressing provider concerns. Please respond by listing issues that you have encountered frequently and include the specific carrier, area of concern (e.g., credentialing, claims, authorizations), and examples of specific situations (e.g., taking more than 2 weeks to receive an authorization for an initial assessment).

Please reply to Craig Domanski, Ph.D., BCBA-D to have your feedback included. Everyone’s experiences are important to identify problematic trends and help us work to improving the systems for the profession and those we serve.

And, if you haven’t already, consider joining the NJABA Insurance Provider Workgroup to learn ways to improve the insurance navigation and reimbursement process.

2016-2017 IPWG Meeting Schedule: 

  • Tuesday, September 20, 2016
  • Thursday, October 27, 2016 at AutismNJ Conference, Harrah’s Resort and Conference Center, Atlantic City (in-person)
  • Tuesday, December 6, 2016
  • CANCELLED!!!! Tuesday, January 31, 2017 CANCELLED!!!! 
  • Tuesday, February 28, 2017 (in-person)
  • March date – TBD, 2017 in-person meeting to be held at NJABA Conference
  • Tuesday, April 25, 2017
  • Tuesday, May 23 , 2017 (in-person)

Note that all meetings will begin at 4:00 pm. Some will be held via conference call, and some will be in-person meetings held at Autism New Jersey, 500 Horizon Drive, Suite 530, Robbinsville, NJ (5 minutes from NJ Turnpike Exit 7A). Conference call will also be available for those who cannot attend the in-person meetings.

Please RSVP to Craig Domanski, Ph.D., BCBA-D, Insurance Workgroup Chair

Interested but unsure if you’d like to officially join? Come to a meeting to learn more and network with colleagues. All are welcome!

For general inquiries, contact Amanda Cortez, amanda@amg101.com, or 609-910-0394.

“I enjoyed participating in the NJABA Insurance Provider Workgroup call. It was great to learn more about the issues faced by others. Just wanted to say thank you for providing an invaluable resource to all of us by taking on issues like these. It is a comfort to know we have a strong advocate in our corner!”
Tracy A. Menzie, Psy.D., BCBA-D