Due Diligence: Provider Documentation Essentials for Being Audit-Ready   

Original Webinar Date:  March 2019

CEU offered: 2.0 Learning CEU (including 1.0 Ethics CEU)

Short Title:  Due Diligence: Provider Documentation Essentials

Webinar Duration: 2 hours 

CE Instructors:

  • Rebecca Womack, BCBA
  • Sarah Schmitz, CMRS-I, CPB, CPC


This recorded webinar was originally presented by the Behavior Analysis Advocacy Network (BAAN).  Upon BAAN's dissolution in June 2020, its CEU course library was transferred to CASP.    

Abstract: 

The new Category I Current Procedural Terminology (CPT) codes introduced in January of 2019 require providers to make significant changes when rendering billable applied behavior analysis (ABA) therapy services. The TRICARE military benefit allows for some of these new codes to be billed in their Autism Care Demonstration program. Providers must bring their rendering of services and documentation processes into alignment with the new Category I CPT code content. 

Distinct changes in the landscape of ABA services both in practice and in notation must occur to ensure the fidelity of code implementation. Not only does this enable providers to meet their contractual obligations, but also allows them to be prepared for audits. Sarah Schmitz, President of Comprehensive Billing Consultants, and Rebecca Womack, Executive Director of the Behavior Analysis Advocacy Network (BAAN) will discuss ways to deliver and document services reflected in the Category I CPT codes. Providers will be educated about general auditing processes and how to be audit-ready. All clinical recommendations will be aligned with the Behavior Analyst Certification Board (BACB) Professional and Ethical Compliance Code standards.  

Participants will receive:

  • Education about the Category I CPT codes approved for rendering in the ACD program
  • Strategies for rendering and documenting services associated with these codes
  • Information about general auditing processes
  • Recommendations on how to be audit-ready

Instructor(s)

MS, BCBA, LBA Rebecca Womack

Rebecca several years of experience rendering services via telehealth as well as researched this topic when advocating on behalf of providers and military families in DC regarding the TRICARE ABA benefit.
 Rebecca has been privileged to serve adults and children using ABA in a variety of capacities. From facility-based care, to working in group homes, daycare centers, schools, and family homes, her experience includes implementing evidence-based therapy across multiple settings. As part of this, she has traveled across the United States and overseas to provide consultation for families with children and adults who have autism. Rebecca currently serves as the Director of Clinical Compliance for Blue Sprig Pediatrics, Inc. There she works collaboratively with a team of interdisciplinary professionals to create quality assurance policies and ensure that related processes are ethically and contractually aligned with health plan standards.

CMRS-I, CPB, CPC Sarah Schmitz

Sarah discovered her love for medical billing and coding over 15 years ago. She completed training at the top of her class and received Magna Cum Laude from the American Academy of Professional Coders. After her son was diagnosed with autism, she had to stop working full time to put all her energy into learning the most she could about the available therapies for autism. When a provider said they would no longer be taking her insurance, Sarah recognized the need for an advocate for ABA providers who had much heart and education but a gap in knowledge of the ins and outs of medical insurance. Putting her passion for billing and coding into practice, she founded Comprehensive Billing Consultants, a nationally recognized autism services billing, consulting, and credentialing company. Sarah has also created an ABA Billing Bootcamp and multiple onsite consulting opportunities for providers who are trying to ensure that they have the strongest team possible. Many members of Sarah's team have family members on the autism spectrum. The mission of Comprehensive Billing Consultants is to provide the best support and service to ABA providers, knowing that they are providing the opportunity for children to grow and evolve in such a beautiful way. Sarah is co-author of Revenue Cycle Management for ABA Therapy.