By: Pearl Walia For Applied Behavior Analysis (ABA) providers–those who offer research-based behavioral therapy–receiving notice of a payer audit or payment suspension can be one of the most disruptive events their practices face. An ABA payer audit occurs when a health insurance company conducts a formal review of a provider’s claims, documentation, and billing practices to verify that its services are correctly coded and documented, and that they align with the payer’s policies. When an audit identifies potential concerns, providers may face payment suspensions, contract termination, prepayment review, or even fraud investigations. These challenges can hinder cash flow or create…
The post ABA Payer Audits and What Providers Need to Know What is a Payer Audit first appeared on Jones Health Law, P.A..