How To Request A Single Case Agreement
What is the extent of the single box agreement We have already mentioned how you should focus on the services included in the agreement. If your patient needs multiple treatments and therapies, the contract must cover reimbursement for all treatments or the maximum number of treatments. The SCA will also provide approved CPT codes, start and end dates and number of meetings. You can request an extension of the SCA if there are only a few sessions left (2 to 3). If the patient has recently switched insurance providers, the insurance company may accept a limited number of sessions (approximately 10) and a period (for example. B 60 days since the insurance change) to allow the patient to continue treatment with the current network provider while switching to a network provider. If there is evidence that the person could pose a danger to himself or others, or if it affects the patient psychologically or mentally (for example. B failures in the progress of therapy), if this proves necessary to switch to an in-network provider, a case could be advanced for an increase in adequacy with the current provider. Examples: a patient has an uncertain bond and finds it very difficult to trust others.
The therapeutic relationship already established with the current supplier can be considered as a factor in granting the SCA. If you receive a CSA for an ongoing patient for further treatment, the negotiated price will be based on the patient`s informed agreement and agreement when they begin treatment with you. Rate increases are consistent with your pricing policy in informed consent. You cannot charge the patient a lower horizontal rate out of your pocket and then charge the insurance company your full normal rate if the CAS has been dated in the past to cover the meetings. The client has tried and cannot find a practitioner or supplier in his network that meets his needs in a way that allows him to feel comfortable. For treatment with ABA, this must be done before the start of treatment.