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Licensed behavior analysts (LBAs) and certified behavior analyst assistants (CBAAs) cannot diagnose and are only permitted to provide applied behavior analysis (ABA) services pursuant to a diagnosis of autism and autism spectrum disorders and related disorders and prescription or order from a person who is licensed or otherwise authorized to provide such diagnosis and prescription or ordering services. Thus, LBAs and CBAAs should verify a patient’s/client’s diagnosis of autism spectrum disorders to ensure that they are providing services within the scope of practice prior to providing ABA services. Insurance companies may provide additional stipulations about verifying diagnosis.
LBAs and CBAAs who provide ABA services to patients/clients are expected to keep an accurate record of their evaluation and treatment services. A written evaluation, data collection, and treatment record is the best way for a LBA or CBAA to make professional decisions about the patient's/client’s needs, for the patient and/or authorized caregiver to have access to an accurate assessment and treatment file, and for the LBA or CBAA to reference if complaints are made about the patient's/client's treatment.
Patients and/or authorized caregivers have a right to expect that the LBA's or CBAA's records will contain the information needed to support claims made to third party insurers if the basis of their payment arrangement includes insurance reimbursement. When that is the case, the information that is commonly sought by third party insurers for their subscribers includes a treatment plan that is appropriate to the patient/client. Third party insurers usually seek information regarding the frequency and length of treatment, method of treatment, treatment plan, functional assessment data, and treatment data.
LBAs and CBAAs would be wise to be aware of the usual treatment approaches in the community in which they practice, even if they provide a different method of treatment. This will enable the LBA or CBAA to address questions regarding treatment approaches and may also help to prevent unnecessary complaints against the LBA or CBAA.