Navigating Insurance & Autism Care – The Balancing Act
In April of 2018, the Center for Disease Control and Prevention (CDC) released new data indicating the prevalence of Autism in the United States. The new study indicates that 1 in 59 children have been diagnosed with Autism Spectrum Disorder (ASD). This is a 15% increase since the last study conducted in 2016. As the rate of diagnosis continues to increase, both parents and healthcare professionals, are faced with the exorbitant costs associated with the multidisciplinary approach needed for effective treatment. Even with early intervention, high upfront costs can be prohibitive; even if it can save costs down the line.
Autism treatment is still relatively new to the insurance industry. In 2008, the State of Illinois passed a mandate, requiring fully-funded individual and group health insurance policies (including HMO contracts), to provide insurance coverage for autism diagnosis and treatment. Most major carriers will only recognize evidence-based treatment methods, such as Applied Behavioral Analysis (ABA), for coverage to be considered. What isn’t so new, are the many administrative requirements that most providers are subjected to by major carriers.
That’s where ML Medical Billing comes in! We have the in-depth experience, key payer relationships, and effective processes, that differentiates us from the rest. Our access to various specialized software, practice management platforms, and other revenue cycle tools allows us to deliver results that assist in maximizing your billing and collections experience. Our team is highly equipped to handle a variety of billing and other insurance-related services, leaving you free to focus on what you do best – providing high-quality treatment to your patients!
Here’s just a snapshot of what we provide:
- Cutting-edge technology and cloud-based software
- Secure, accurate electronic claims submission within 24-48 hours of receipt
- Detailed reports
- Internet-based client access to all patient and account information
- Payment collection and follow-up methods that maintain your cash flow
- Compliance with HIPAA Regulations
- Tracking of coding changes and updates
- Continuing education on industry-related nuances
- Understanding Utilization Management (UM) Requirements
- Additional Customized Services
Our services can help you increase practice revenue by 10%-20% through increased billing and outstanding payment collection. Additionally, we can help you save on administrative and other overhead costs that an in-house billing department can often incur.
At ML Medical Billing, we have the expertise you are looking for in the following areas:
- Understanding of the specific administrative and billing insurance guidelines for treating autism (including in/out of network, contracting, and credentialing)
- Proper verification of insurance autism benefits essential for billing and reimbursement
- Expert navigation of ASD-related bureaucracy and paperwork
- Translating “care delivery” into “coverage” for providers and insurance carriers
- Other customized support services
We understand the authorizations, referrals, clinical policies, and other payer requirements that impact not only the treatment you provide but also the reimbursement you deserve.
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