Access a Multitude of Autism Care Demonstration Resources at www.tricare-west.com

Tuesday, November 29, 2022

Did you know that Health Net Federal Services, LLC (HNFS) has a catalog of Autism Care Demonstration (ACD) resources for you and your patients on our website? Information for providers includes ACD frequently asked questions, TRICARE Operations Manual (Chapter 18, Section 4) guidelines and requirements and HNFS-specific policies and procedures. Resources and information available for your patients cover eligibility, referrals, copayments and cost-shares, and more.

For Providers

Visit our Additional Resources and Information page to download our suite of quick reference materials.

Quick Reference Downloads 

(List is not all-inclusive.)

• A Guide to Treatment Plan Goals
  These guidelines are for assisting applied behavior analysis (ABA) providers with submitting compliant treatment plan goals.
  
  
• Clinical Necessity Reviews: Evaluating Treatment and Outcome Measure Progress
  Information for applied behavior analysis (ABA) providers on what HNFS’ clinical reviewers look at and consider when performing clinical necessity reviews.
  
  
• Treatment Plan Requirements
  Overview of what’s required in each treatment plan submitted to HNFS for ABA treatment authorizations. Because omitted or missing requirement content can cause treatment delays or denials, providers can use this guide as a checklist to ensure they have satisfied all treatment plan requirements.
  
  
• Medical Documentation Requirements
  A table of medical documentation requirements for ABA services provided under the ACD. Content provided can aid providers with meeting regular audit requirements.
  
  
• Outcome Measures
  Descriptions and due dates for required outcome measures: 
  • Pervasive Developmental Disorder Behavior Inventory (PDDBI) 
  • Vineland Adaptive Behavior Scales, Third Edition (Vineland-3)
  • Social Responsiveness Scale, Second Edition (SRS-2)
  • Parenting Stress Index, Fourth Edition Short Form (PSI-4-SF)
  • Stress Index for Parents of Adolescents (SIPA)

News Updates

ACD-related articles are available at our News Articles page. Check out recent articles, including Providing Timely Responses to Treatment Plan Requests, The Importance of Discharge Summary Reports and Successful Discharge Planning.

Also Available 

Visit our Annual Provider Training page to access the printable version of the Autism Care Demonstration: Annual Provider Training for Applied Behavior Analysis Providers. We encourage you to share the printable version with all group ABA providers and staff. Note: We also provide a self-paced module as well as a printable version of this training.

For Your Patients

If you have patients enrolled in the ACD, direct them to www.tricare-west.com/go/ACD > Resources and Education, where they’ll find our New to the Autism Care Demonstration parent toolkit and other HNFS- and Defense Health Agency-developed materials.