Insurance Approval Process
Before we start ABA services
Auth 1: ABT requests insurance approval to assess your child
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Auth 2: ABT requests for services. Authorization typically last 6 months before they need to be renewed.
Step 1 - Initial Inquiry & Eligibility
Give us a call or click the "Enroll" button at the top of our webpage. Upon insurance verification, we will reach out to determine the next steps.
Step 2 - Insurance Info
Submit the patient's diagnostic evaluation or referral (for IEHP) & complete our new patient paperwork.
Step 3 - Request Authorization
1st Authorization request sent to primary insurance. Timeline: Approximately 1 week but varies by insurance carrier.
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IEHP skips this step if referral sent
Step 4 - Approved Authorization
Complete the medical history paperwork & Vineland assessment. Schedule an in-person observation.
We will submit the patient's report to obtain Auth #2
Our First Visit
In-person observation/assessment meeting
The BCBA assigned to our prospective client will come to your home for the first visit. The BCBA will make observation notes and run an indirect assessment with the parent including a questionnaire, records review, & answer and ask any necessary questions.
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Throughout this visit, the BCBA will directly observe and assess the prospective client, your child. S/he may run some preliminary targets within a variety of assessments (i.e., VB-MAPP, Vineland, etc.) to obtain any data on current responding. These measures are not conclusive but show us what responding looks like at baseline levels and will be included in our request for treatment.
Starting ABA Services
This process begins after the second authorization for medically required service hours has been approved by your insurance carrier
Step 1 - yay! We were approved
Once we receive the authorization, we give you a call to confirm any schedule changes and let you know the staffing process has begun.
Step 2 - Staff the Case
If we have not found someone yet, we will continue to look for a staff member who is available and fits the needs of the client and family.
During this time, the assigned BCBA will do 1:1 sessions for the first few sessions to get to know their client/patient.
Step 3 - Start Date
We set up a start date with the behavior technician and family!
Step 4 - First Day of ABA!
This is the day we've been waiting for! We will work on rapport for the first 2-3 sessions (less or more depending on the client) and modify treatment plan weekly with the Clinical Supervisor or Manager.