In an off-grid scenario like this, it may be possible to use a case-by-case agreement to ensure that your client has the coverage he or she needs to receive the care he or she depends on as a doctor or therapist. If a new patient requests an CAS, the insurance can ask if the patient needs your specialty or geographic convenience. Similarly, CAS could be authorized if the treatment you can offer could reasonably be argued to keep the patient away from the hospital or to reduce the cost of medication. When we are going through difficult times, we need mental health professionals more than ever. Understanding the process and elements of strong pretension for a single care agreement is one way to continue to serve and strengthen our local communities. 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. In the case of a patient who needs to move from your care to a new network provider or a patient who prefers to remain in your care, you may need to help the patient make the request to the insurer.
Some insurers require that the agreement on a case-by-case basis be in the rendering provider, which must be submitted on the 1500 application form. This is particularly true if, in the past, there is evidence that the individual poses a danger to himself or others, or if he is at risk of suffering a serious setback from his mental health. Case-by-case agreements are most common in patients who have created trust problems and developed a professional relationship with their current ABA provider. If you are a practitioner seeking a case-by-case agreement for a current client who requires further care, the negotiated rate may be more flexible depending on the client`s preferences.