Petition updateFlorida Medicaid Coverage Stalled for ABA Services for our Most Vulnerable People

ABA Provider Enrollment Backlogged or Closed?

Trinity ABA, LLC | Behavior Analysis Services for Challenging Behaviors
Apr 11, 2018
Almost 5,000 have signed this Petition. This issue affects so many Floridians, I hope this gets resolved effectively and soon! More on Transition from Beacon to eQHealth :... Currently we have been given provisional authorizations for 30 days for half of the hours we potentially can request. However, Recipients who were approved for services through Beacon are required to start the process all over with eQhealth. First submit admission for H0031 (initial assessment), which is immediately approved, then request behavior service hours and in 24-48 hours services are approved and a PA# is generated. And, for some there is a gap of about a month for services that were requested around the beginning of February, were approved by Beacon but did not receive a PA number. Which, for the Provider, means we cannot bill for those hours. How does this get rectified? Once we receive provisional stop-gap hours for clients, without needing to provide any clinical information, how do we then request services beyond that 30 days. If we begin services based on provisional authorization, we have no guarantee additional services will be approved. It is difficult to run a business on provisional hours, maintain staff or to provide good continuous services for the client and their families in this situation. When will this be resolved? We realize this is a transition but we need to know more of what is actually happening. There is no information available on the websites or through contacts at Medicaid, ACHA, eQhealth, not Beacon. We urge you to PLEASE PROVIDE A TIMELINE AND INFORMATION to assist Florida ABA providers and families, statewide to determine next steps in providing services. Provider Enrollment also stalled ... We have been attempting to find out how come we have a staff member that has been in State Review with all documents verified now for 2 months, where it would typically only take 1-3 weeks for the last year. And we are unable to receive information on the delay, except “backlog”. This gives pause to the idea of hiring anyone who is not already credentialed with such uncertainty about when they could be credentialed. When I spoke to one gentleman, he indicated that some providers it takes up to 365 days ... that is not what we have become used to over this last year when this was a new requirement. I recently received a message from a Miami firm who is experiencing the same delays in processing provider enrollment and was told it can take up to 365 days as well. When contacting ACHA - I was not able to find out what is going on either but here is the email I received from Karen Wessel, behavior services liaison for ACHA, of where to call. Begin forwarded message: From: "Wessel, Karen" Date: April 2, 2018 at 10:56:18 AM EDT To: Shelly Lynn Henry Subject: RE: Medicaid BA Provider Enrollment Delays The individuals answering the phone have always been kind and informative. Please explain your question and I’m certain they can take of you or connect you with someone else. Thank you, Karen From: Shelly Lynn Henry Sent: Monday, April 2, 2018 10:54 AM To: Wessel, Karen Subject: Re: Medicaid BA Provider Enrollment Delays Is there a specific person because they don't know who I should speak to. On Mon, Apr 2, 2018 at 10:48 AM, Wessel, Karen wrote: Shelly: Please contact our Medicaid Fiscal Agent Operations (MFAO) at (850) 412-2000. They may probably provide you with the same information attributing the backlog to staffing and the requirement for more in-depth reviews. Thank you, Karen From: Shelly Lynn Henry, BCBA | CEO Sent: Friday, March 30, 2018 12:43 PM To: Wessel, Karen Subject: RE: Medicaid BA Provider Enrollment Delays Who would be the person I should contact in Tallahassee?
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