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ACAP: Resources

Network Provider Directory

As part of our comprehensive services and supports, we have compiled a directory of service providers that belong to the Adult Community Autism Program (ACAP) Provider Network. This directory is easy to use and allows you to search for and select the provider of your choice. All of our providers have received educational training about Autism Spectrum Disorder.

Our network of providers includes primary care physicians and family medicine, and specialty services. To find a provider near you, select a service, the county, or both from the drop down menus. Your Supports Coordinator will arrange all of your behavioral health and medical health services, as well as arrange transportation to and from services, when needed.

If you don’t see your preferred service provider on the list, you can request that Keystone Autism Services contact them about becoming part of our network. Please advise an ACAP staff member (Community Supports Professional, Supports Coordinator, Behavioral Health Specialists, or other team member) of the provider name, practitioner name, and phone number. You can also contact the Director of Provider Relations at 717-220-1465 ext. 423 or the Medical Claims Processor at 717-220-1465 ext. 421.

Network Provider Directory

Become an ACAP Provider

Keystone Autism Services (KAS) continuously searches for in-network providers to increase and maintain access to care. The ACAP network is made up of both behavioral health and physical health providers. Both of these services are covered benefits. In addition to in-network providers, KAS can also have out-of-network agreements in order to improve access to care that is not available through an in-network provider option.

Requirements

Requirements of In-Network Providers with ACAP as MA Providers

• Submit documentation of Medical Assistance status (e.g. letter from DHS)
• Complete and sign a Provider Agreement
• Complete and sign a Business Associate Agreement (BAA)
• Submit proof of liability insurance (usually a declaration page)
• Submit copies of applicable practitioner/facility licenses. Attestations and electronic listings can be used for compliance with this requirement as well.
• Submit W-9 (if not billing on standardized claim form)
• Confirmation of no exclusions
• For Respite and Habilitation services, understanding/implementing training requirements

Requirements of Out-of-Network Providers

Out-of-network agreement requirements are the same as in-network procedures, with the exception of submitting MA status documentation.

Vendors & Other

In some cases, the above two contract options do not apply. Agreements for those types of services are managed using vendor procedures. The requirements to be a vendor service provider with ACAP are:

  • Complete and sign a Business Associate Agreement
  • Submit proof of liability insurance (usually a declaration page)
  • Submit copies of applicable service type licenses and certifications (e.g. chemicals for lawn treatment). Attestations and electronic listings can be used for compliance with this requirement as well.
  • Submit W-9 (if not billing on standardized claim form)
  • Confirmation of no exclusion

Other Requirements
Depending on the type of service being rendered, requirements as a provider can include but are not limited to:

  • Provision of encounter forms (unless billing on standard claim form such as UB-04, 1500, Dental Claim Form
  • Submitting clinical documentation regarding progress toward goals quarterly (at minimum)
  • Timely billing (within 45 days of service delivery)

Provider Manual

KAS has a Provider Manual with important information. It’s important for you to review this document. For the services you are providing, resources, guidelines, and procedures regarding clinical documentation will be reviewed in a separate meeting.

Documents

Documents
To access provider-related documents, please select from among the links below.

Provider Manual 2019
Provider Autism Training Procedure
Provider Autism Training Procedure Signature Template
Encounter Form – Multiple Dates
Encounter Form – Single Date
Encounter Form Single Date with Clinical Summary
Provider Treatment – Plan Template
Provider Treatment Plan Template Guideline/Example
Provider Autism Resources