Are you ready to start ABA for your child?
Although referral and authorization is dependent on your insurance company, there are some general steps to get started.
Step 1
Most insurance companies require a medical diagnosis of autism from a psychologist or physician within the previous 24-36 months. Although this is insurance specific, we can review your evaluation and insurance requirements and direct you to the next step in obtaining an initial or updated diagnosis.
Step 2
Once your child’s diagnosis has been obtained, we can begin verifying your benefits to see if your insurance requires a referral from your primary care physician. If you have a Texas Medicaid plan, you must obtain a referral from your primary care physician. For plans not under Texas Medicaid, a referral may not be necessary. We will contact your health insurance company to figure out the estimated costs (i.e. deductible, out-of-pocket costs, and copays) for your plan.
Step 3
After we’ve verified your insurance plan, we’ll determine if you need preauthorization for the initial assessment. We’ll give you a digital or hard copy of our client handbook and get your consent to start the assessment. This assessment usually requires two or three face-to-face meetings. During this time you’ll complete questionnaires, behavior checklists, and a skills assessment with our Licensed Behavior Analyst. This will help us formulate the plan we’ll submit to your insurance company for approval.
Step 4
After your insurance company has approved the treatment plan, a start date will be established and the schedule developed. The number of hours per week is decided based on skill deficits, behavioral issues, and caregiver requests.