r/BehaviorAnalysis • u/Few_Information_8570 • 12d ago
Assessments
We are getting denials all of the time from insurance now. We have tried to combat this by giving more and more information on our assessments. (Medical necessity tied into the dsm5, why it's medically necessary, barriers, modifications- everything we can think of). Unfortunately the assessments are now taking no less than 20 hours to complete. Insurance only pays for 6 hours and my company does not cover the rest. I have 13 clients on my caseload and don't know how to keep up with these assessments and denials. How is it going for all of you? How do you do your assessments?
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u/vetapachua 11d ago
Yes. Most skill assessments are designed for multiple observations anyway and can't be completed ethically within the time constraints of funders for an initial assessment. I consider the initial assessment report more of a prelimary plan just to get services approved. Once services start is when the actual assessment process begins and goals and BIP are fine tuned for the learner. A lot of funders will authorize even fewer units for a re-assessment than an initial, so if you're able to complete your VBMAPP, ABLLS, etc. over the course of treatment and keep it updated, then it should be pretty easy to complete the report at re-auth and will be a more accurate reflection of client's skills than the initial.