![]() ![]() In the event that a member disagrees with a coverage determination, member may be eligible for the right to an internal appeal and/or an independent external appeal in accordance with applicable federal or state law. Medical necessity determinations in connection with coverage decisions are made on a case-by-case basis. Please note also that the ABA Medical Necessity Guide may be updated and are, therefore, subject to change. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. The member's benefit plan determines coverage. The conclusion that a particular service or supply is medically necessary does not constitute a representation or warranty that this service or supply is covered (i.e., will be paid for by Aetna) for a particular member. Members and their providers will need to consult the member's benefit plan to determine if there are any exclusions or other benefit limitations applicable to this service or supply. Members should discuss any matters related to their coverage or condition with their treating provider.Įach benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Treating providers are solely responsible for medical advice and treatment of members. The ABA Medical Necessity Guide does not constitute medical advice. The Applied Behavior Analysis (ABA) Medical Necessity Guide helps determine appropriate (medically necessary) levels and types of care for patients in need of evaluation and treatment for behavioral health conditions. In her free time, Lauren loves taking her dog to farmer’s markets because he has a “smiling” face that helps her make friends.By clicking on “I Accept”, I acknowledge and accept that: She is excited to provide compassionate, personalized care to WelbeHealth participants with a goal to “do what makes you happy.” Lauren has worked in many clinical settings including the cardiovascular ICU, cardiac transplant ICU, PACU, orthopedics and internal medicine. She’s also an Adult-Gerontology Nurse Practitioner, which means she treats people from adolescents through adulthood and into advanced age. It makes everyone’s life easier and healthier, because we take care of them.”Īs a Doctor of Nursing Practice, Lauren brings dynamic skills and experience that help her care for a diverse population of seniors. “I am grateful when I take stress off the family and the patient. Laura loves bringing her children to her parent’s farm to see the chickens and goats, “teach them to care for creatures other than themselves.”Įducation: Kent State University, Rush University She is honored to serve a diverse population of participants. Her experience in the PACE model has reassured Laura of how coordinated, quality care can make a huge difference in the lives of the elderly. Continuing her education, she became a Licensed Nurse Practitioner in 2019 and proudly stepped into her new role at WelbeHealth. She began her nursing career as a Registered Nurse at a California nursing home. Laura has been serving seniors since 2015. ![]() I also want to incorporate what they do in their own cultures and just set limits to what we can and cannot do with their thoughts in mind.” It’s not just all about Western medicine. “I try to incorporate my patients’ values and goals. Education: Grand Canyon University, United States Universityīoard Certification: American Academy of Nurse Practitioners ![]()
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