Understanding Medical Necessity
Instructor: Amelia Dalphonse, MA, BCBA
Amelia Dalphonse, MA, BCBA
Medical Necessity
Understanding medical necessity is critical when working with insurance companies to provide ABA services. This course provides an overview of what medical necessity is and how to use language the reviewers at the insurance companies understand to justify your services. Learn how to get your plan approved!
Get treatment plans approved
Comply with funder guidelines
Streamline your treatment planning
Failure to meet medical necessity in your treatment plan leads to:
Denials
Delays
Frustration
What you will learn:
Basics
Learn the fundamentals of medical necessity when using the medical model to provide ABA services.
How to Document
Accurately document medical necessity in your treatment plans.
Examples
Review examples to help you get started right away.
Your Mission
Understand why treatment plans often get rejected, and learn to include the language insurance companies are looking for.
This course includes 2 free downloads including:
Understanding Medical Necessity-a downloadable version of the first lesson for easy reference
Sample Treatment Plan-see how to incorporate medical necessity throughout your document to get your treatment plans approved
The course includes many examples of language you can use to describe how different common skill acquisition goals meet medical necessity criteria.
Meet the Instructor
Amelia Dalphonse, MA, BCBA
Amelia Dalphonse, MA, BCBA, co-founded Master ABA with her twin sister, Dianna Kelly, bringing over 13 years of expertise in Applied Behavior Analysis (ABA). Passionate about prioritizing client needs, Amelia earned a Master’s degree in ABA and became a Board Certified Behavior Analyst (BCBA).
At Master ABA, Amelia and Dianna lead with innovation, emphasizing client-centered care to drive meaningful change. As an ACE provider, they’ve established the institution as a hub for progressive ABA practices, inspiring others to adopt compassionate and ethical approaches.
Through her role at Master ABA, Amelia advocates for advancing the ABA field with empathy and integrity. She stays abreast of the latest research, continuously seeking opportunities for professional growth.
