ICMS is building Florida's standards-based network of ABA providers — groups and independent BCBAs. Peer-to-peer with actual analysts, published documentation standards, one credentialing file honored across plans. Free to join. We never charge providers, ever.
¿Prefieres hablar en español? Nuestro equipo es bilingüe — escríbenos.
ICMS administers utilization management and credentialing for health plans covering pediatric ABA in Florida. That means when your authorization request is reviewed, the person reviewing it holds the same certification you do.
Reviews and pre-denial conversations happen analyst-to-analyst. No more defending clinical decisions to someone reading a checklist who has never written a behavior plan.
One primary-source-verified credentialing file — BACB, Florida Medicaid, exclusions — maintained by us and honored across every plan delegation ICMS wins. Each new payer contract we sign increases the value of already being in.
No participation fee. No exclusivity. Terminable without cause on notice. The agreement asks for standards and data hygiene — it takes nothing from you.
Published documentation standards mapped to Florida's BA Coverage Policy: what a complete CDE package, behavior plan, and reassessment look like — before you submit, not after a denial.
Transparent authorization status through the provider portal and decision timelines aligned to plan contract standards, NCQA/URAC, and 42 CFR §438.210.
In a market where hundreds of behavior analysts were blocked from Medicaid enrollment over fraud concerns, membership in a standards-based network tells plans and families you operate differently.
ICMS never charges providers for anything, and never sells services to the providers whose authorization requests we review. Network participation is standards-based and free — permanently. This separation is required by the NCQA/URAC utilization management standards we operate under and by the BACB Ethics Code our reviewers are bound to. It's also what makes our clinical decisions credible to the plans that delegate to us — which is what makes the network valuable to you.
Email us your organization info (or your individual BCBA certification) and service counties.
We run primary source verification — BACB, Florida Medicaid enrollment, OIG/SAM exclusions — at no cost to you.
One participation agreement covering documentation standards, data sharing, and peer-review procedures. Groups sign once with a staff roster.
Your verified file is honored across ICMS plan delegations as they launch — you're in the panel plans see from day one.
Now enrolling: ABA groups and independent BCBAs serving Medicaid-enrolled children across Florida, with priority onboarding for Miami-Dade, Broward, Tampa Bay, and Orlando service areas. Spanish-speaking and school-based providers: your capabilities are directory-listed — plans ask for them.
No. Never. Our independence commitment is contractual: ICMS is paid by health plans for delegated administration, and we do not accept money from providers in any form. If anyone ever asks you to pay to be in this network, it isn't us.
No — and be wary of any network that implies otherwise. Participation gives you a verified credentialing file, published standards, and analyst-level review. Authorization decisions are always based on medical necessity under the applicable coverage policy.
Completely non-exclusive, in both directions. You keep every plan contract and network relationship you have. You can leave ICMS's network without cause with notice.
Credentialing consent, a current staff roster (BCBA/BCaBA/RBT) you keep updated, adherence to the documentation standards manual, and timely notice of certification or enrollment changes. That's the substance of the agreement.
A BCBA — always. BCaBA reviewers work under BCBA supervision consistent with BACB requirements, and adverse determinations are co-signed by a licensed medical director as plan contracts and 42 CFR §438.210 require.
No. We use AI tools to check submissions for completeness and to organize documentation — which means fewer bounce-backs for you — but every clinical determination is made by a BCBA, the program is led by BCBA-D/BCBA clinicians, and adverse determinations are co-signed by a licensed medical director. No AI system at ICMS generates or recommends denials.
ICMS builds modern AI models into its operations the way a good clinician uses an instrument: to see more, sooner. But instruments don't make clinical judgments — certified professionals do. That line is bright, contractual, and non-negotiable.
With SMMC 3.0 (February 2025), Florida's nine MMA plans took over authorization, network, and payment for Behavior Analysis. ICMS provides the four delegable functions of that benefit — under one delegation agreement, structured for 42 CFR §438.230 oversight, and clinically led by certified behavior analysts.
Prior and concurrent authorization under Rule 59G-4.125: CDE verification, Vineland-3/BASC-3, six-month cycles. AI-assisted intake and completeness checks; every determination made by a BCBA and adverse decisions co-signed by a licensed medical director.
Primary source verification and cyclical re-credentialing to NCQA CR standards, across the ABA provider base plans inherited with the carve-in.
Continuity of care, IEP/504 school coordination, and documented EPSDT compliance for members under 21.
Pre-pay review of high-risk claims, post-pay audit, billing-pattern analytics, EVV cross-checks. Flat fees plus quality bonuses — never commissions on denials.
Policies, files, and UM committee designed on NCQA standards; URAC HUM accreditation in progress.
Delegation agreement, reporting, annual audit, clinically appropriate adverse determinations.
BAAs, security risk assessment, encryption, incident response for pediatric PHI at scale.
Reviewer pay never depends on denials. AI is human-in-the-loop with full audit trails — no algorithmic determinations.
A measurable 6-month pilot: fee-per-review, no minimums, contracted metrics, scale decision at month six.
Five minutes, no fee. We use this information to run primary source verification (BACB, NPI, Florida Medicaid) — submitting is your consent for us to verify. Fields marked * are required.