As part of my CSHA role as the STAR (State Advocate for Reimbursement) for the state of CA, I am a liaison with the STARs from other states. At the ASHA conference, I participated in meetings with other representatives from around the country to share our knowledge and experiences in the reimbursement world. I learned that in California, we are actually doing better than some other states as far as the required paperwork (which is worse elsewhere!) and our ability to provide services to people on the spectrum. At the conference, I also attended a number of sessions about insurance billing and coding since so much of our work is now coming from insurance companies – especially since the regional centers are required to have their clients go first through insurance if the family is insured. In the coming months, we will be sharing more updates with our SLEA staff on templates for insurance treatment plans and assessments, and the required codes that should be included when working with insurance clients.
Yesterday, we got great news from CSHA on the subject of insurance. The Department of Managed Care posted a cease and desist order to Anthem Blue Cross, Blue Shield and Health Net Insurance Companies for the unlawful denial of medically necessary speech therapy and occupational therapy health care claims! This will make it easier for us to get authorizations for services going forward.