Single Case Agreement Information
The info you need when calling for a Single Case Agreement
- Practice Name: Center for Autism, Assertiveness & Social Skills (CAASS) ltd.
- Place of service/Mailing: 4041 N HIGH ST, SUITE 300N, COLUMBUS OH 43214-3200
- NPI Type 2 (CAASS) 1790259109
- Direct Confidential Cell 614-209-0428
- Fax 614-437-1554
- Provider Name: Kenneth Smith, MA, LPCC-S, Certified Autism Spectrum Disorder Clinical Specialist (CASDCS)
- Ohio License # E. 1800883-SUPV
- Ken’s (NPI-1) 1487105144
Steps to asking for a Single Case Agreement
1. Call number on card and state you want to see an out of network (OON) provider because there are no in-network providers who can help, so you want to see this OON under in-network provisions (this is called a Single Case Agreement).
2. Tell why you want to see CAASS (eg, what problems you/your child is having, any diagnosis, that you/child has had). Mention the complexity of the case. Make sure to mention the following issues if you/your child has them: Autism/Asperger’s (Dx code F84.0), Suicidal thoughts/actions, self-harm, how your case is complex or hospitalization. Also if you are an adult with Autism/Asperger’s tell them that you know of no other providers for people with issues related to Autism in adulthood as services are only focused on people age 23 and below.
YOU ARE NOT ASKING FOR ABA (CAASS does not offer ABA, but sometimes when reps hear Autism, they will try to send you to the ABA desk).
3. State if you/your child has seen other in-network providers in the past who were not able to help. If necessary, remind your insurance that they (likely) legally obliged to provide care at in-network agreements if no in-network provider can be found.
4. State the clinician (Ken) is an expert in the problem (eg. Autism, OCD/Scrupulosity, Catholic issues, etc.). Point out that Ken is the only provider you can find with this expertise who is taking new clients.
5. You are asking for 60-minute psychotherapy sessions,this is referred to as CPT Code 90837. Additionally request 1 intake session CPT 90971.
If possible also request the following service codes: CPT 90833 (Psychotherapy add on 30 minutes) and CPT 90838 (Psychotherapy add on 60 minutes).
7. Inform them that clinician can be contact to discuss the single case agreement at the contact info above.
8. MAKE SURE when they approve the SCA to write down how many sessions are approved (ask for between 26-52), the dates they are approved to and from, and the authorization number. Ask them to fax or mail the authorization ASAP to CAASS (insurance companies are bad about doing this, please be persistent in asking them to do it). If they will not mail it to CAASS ask them to mail the SCA/preauthorization to you. Without this information, CAASS is unable to bill your insurance for services. Example of information needed:
- Authorization #/Code: 19080000495, 4RE34600-06, 8JP004H, etc.
- Authorized dates: 1-1-18 to 7-1-18
- Number of sessions authorized: 26, 52, 18, etc.