The KY-ABA Insurance Billing Task Force: Forging the Way to More Funding for Applied Behavior Analytic Services in Kentucky

The KY-ABA Insurance Billing Task Force was formed in 2017 to assist ABA providers in diversifying their funding beyond behavior support services through state Medicaid waiver programs. With licensure and an autism insurance mandate, Kentucky providers are in a prime position to access benefit coverage under participant and families’ commercial insurance and Medicaid health plans. Doing so requires a re-working of fee structures, clinical practices, and sometimes organizational staffing models. Most importantly, it requires a detailed knowledge of the insurance billing world. Not just what CPT codes to bill, but how to understand the entire process from benefit determination to collection of payment, and all the wonderful steps in between. In the health care industry this is known as "Revenue Cycle Management," and there is crucial information about the topic ABA business owners and providers will need to understand. This presentation will feature a summary of the progress of the KY-ABA Insurance Billing Task Force thus far and its future directions, as well as an introduction to the difference between successfully funding behavior analytic services through waiver programs and commercial insurance/Medicaid.

Becky Nastally, Ph.D., BCBA-D, LBA
Owner & Founder, Bloom Behavior Therapy

Dr. Becky Nastally is a Board Certified and Licensed Behavior Analyst practicing in Western Kentucky. Since relocating here in 2010 Dr. Nastally has worked diligently to advocate for greater proliferation of applied behavior analytic services in the western part of the state. As a business owner she has been at the forefront of securing increased sources of funding for ABA, including Kentucky Medicaid and commercial insurance. Dr. Nastally has collaborated with school districts, community foundations, local medical providers, and other human service organizations to increase awareness of behavior analysis and its important application to children with autism spectrum disorders. She has close to 15 years of experience working with children with ASD and their families, practicing in several different states and positions. She served as a Visiting Assistant Professor in the Behavior Analysis and Therapy Program at Southern Illinois University from 2010 to 2013 where she received her M.S. in 2008 and Ph.D. in Rehabilitation in 2010. Her current interests lie in early and intensive behavioral intervention for autism and she also has several years of research experience in the field of behavioral addiction. She has authored 14 peer-reviewed journal articles, a book chapter, and 26 professional presentations in the field of applied behavior analysis.

Keith Hersh, M.S., BCBA, LBA
Owner & Founder, i-ABA

Keith graduated with a Master of Science in ABA from FIT’s campus in Melbourne, Florida in 2004.  His clinical training was provided at one of Orlando’s first center based ABA programs for children with Autism at Quest Kids under Dr. Eb Blakely and Dr. Jose Martinez Diaz.  In 2012, Keith opened his own practice, i-ABA Center for Autism in New Albany, IN.  The focus of the center was on early intervention, with emphasis on utilizing the Verbal Behavior approach.  The center also has a unique aspect of assessing and teaching skills that will be utilized in classrooms to facilitate transitions back to a classroom setting.  Keith and the Floyd County school district have worked together to collaborate on transition planning and the IEP process.  The collaboration has resulted in numerous transitions back to classrooms with appropriate supports.  In addition to offering clinical services, Keith was also involved in providing input into Kentucky’s House Bill 159, and collaborating with Autism Speaks on implementation of the parameters set forth in the bill.  Put into effect in January of 2011, the bill mandated requiring insurance companies to cover ABA treatment, as well as licensure for behavior analysts.  Keith’s overall goal in his career in ABA over the past 13 years has been to promote awareness of Applied Behavior Analysis by consulting, training, and educating others to implement effective behavior change programs.