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Writer's pictureMuhammad Sair Khan

How ASAM Certification May Help Your Behavioral Health Facility Increase Reimbursement




The new Level of Care certification from the American Society of Addiction Medicine has completed its first pilot phase, giving seven addiction treatment centers certification.


Though this certification process is in its early stages, working quickly to get your treatment center ready to achieve this distinction could help you attract new patients—and even increase your reimbursement rates.

What is the ASAM Level of Care Certification?


This certification, created in partnership with CARF International, offers an independent assessment of your services. The comprehensive assessment ensures that you are providing evidence-based care to all your patients. The certification will be available for all levels of care, from outpatient treatment and partial hospitalization to full inpatient care. It is a complement to existing accreditation's, such as Joint Commission Accreditation.


The first phase tested the certification process and scoring method to ensure treatment centers understand the requirements the requirements and are providing the correct services for each level of care. Moving forward in Phase Two, ASAM will make some changes, such as clarifying different training requirements and including what FDA-approved medicines must be offered to patients at each level of care.


Phase Two of the pilot is has already begun and and features 30 additional treatment centers and programs for evaluation. During this phase, ASAM and CARF will test the new criteria and process changes in different programs. Once this phase is complete, by the end of 2019, ASAM and CARF will open up the certification process nationally. They will offer training and publications to help your facility achieve certification and ensure that your care aligns with the ASAM Criteria standards.


You can start getting your facility ready now by using ASAM Criteria in your patient assessments and in all areas of patient care. You can also start organizing patient outcomes data and other assessment data so it’s ready for submission. You may also need to provide information on staff training, what medicines you offer, and any other services you provide at your facility.


What This Certification Will Mean to Patients and Payors


Once you achieve certification, you’ll be listed in an online database to make it easy for patients to find your services. You can also use certification information in all your marketing materials, on your website, and in advertisements. This information will help patients and their family members know they can rely on your services and that you offer evidence-based care.


Payors can also feel greater confidence in your services. You can use your newly achieved certification in negotiations for in-network contracts, along with patient outcome data, to prove you offer effective care. Any data or certifications you can provide strengthen your argument that you deserve higher reimbursement for your treatment. You may also be able to negotiate reduced prior authorization requirements, simplifying the billing and claims process.


At Datapro, our experienced team can help you negotiate in-network contracts and work toward better reimbursement. Contact us today to learn more about our services and how we can help you increase revenue.

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