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  • Information for TRICARE Providers

    Posted on July 24, 2018 by in Private Practice

    ATTENTION ALL HUMANA (TRI-CARE) PROVIDERS!
    Member Craig Marrer recently had two re-authorizations denied by Humana as the clients did not have updated Vineland 3 or SRS-2 assessments. After seeking clarification, he was informed that it was his responsibility (as the BCBA) to acquire and complete these assessments. If you are serving clients with Humana coverage and have not yet done so, you can purchase these assessment tools here:

2 Responses so far.

  1. liz2930 says:

    It is not necessarily the BCBA’s responsibility to complete these.
    As per the TOM: 8.2.5 As required in paragraph 8.1.1.2, the outcome measures shall be completed/submitted by the specialized ASD diagnosing provider.
    This can be the BCBA but not necessarily. We are completing the PDDBI but not the Vineland and SRS-2.
    I have talked this through with Humana and am encouraging that parents contact their diagnosing providers to get these assessments completed as per the required schedule.

  2. christinemunoz says:

    Hello, is anyone able to provide information about how to bill for these tests if the BCBA can complete them and/or decides to complete them? I would like to know which T-codes to use. Thank you in advance for your help.

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