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ABA Ops Compass

Comprehensive Due Diligence

Baseline assessment for Coastal ABA Therapy. Answers drive the recommended consulting package and identify gaps for remediation.

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Section 3 of 16

Insurance, contracting, and credentialing

  1. List all contracted payers

  2. Which Medicaid MCOs are contracted?

  3. Are contracts direct or through third-party entities?

  4. Who manages credentialing?

  5. Is CAQH maintained and updated?

  6. Are provider credentials monitored routinely?

  7. Describe process for tracking expirations (licensure, BACB, liability, background screening)

  8. Any payer sanctions, suspensions, or terminations within the last 5 years?

  9. When did the company first obtain insurance contracts and payer credentialing approvals?

Consultant notes