As if its not enough to just process what it means for your child to be diagnosed with autism, parents often must navigate insurance which can be tiring. Since insurance coverage for ABA is still relatively new, it can be difficult to find out if insurance will cover the costs. Additionally, there are questions like are there limits to the coverage and do I have to get approval before starting. At Trusty Behavioral, we hold your hand through the process but here is an outline of what to expect from us along with some tips for you regardless of which provider you choose.
Getting Started
Fortunately now most major insurance plans cover ABA therapy for a diagnosis of autism. If you are uncertain, you can call the member services number often found on the back of your insurance card. Ask them if ABA therapy is covered for a diagnosis of autism and also ask them for a list of in-network providers.
If you are still uncertain about your benefits and provider network, you can always contact us at Trusty Behavioral and we will be happy to verify your insurance benefits and let you know if we are in your network.
Verifying Benefits
The first step before starting services is to always verify that your insurance plan covers the therapy. When starting with Trusty Behavioral, we will always verify your benefits and can let you know what your expected out of pocket costs may be if there are any. Most insurance plans have different benefits for in-network and out-of-network providers. This just means that certain providers have been vetted by your insurance company and have reached a special agreement to provide the services to you at a cheaper cost. Fortunately, we are in-network with most major insurers.
Authorization Process
While verifying your benefits, we will also find out if your insurance requires our services to be pre-approved or pre-authorized before getting started. Most plans to require a pre-authorization for services.
The good news is that we usually handle all of that paperwork so that you don’t have to worry about it. It is useful to know that some insurers can take up to two weeks to approve these authorization requests. Typically they require an authorization for an assessment and then a separate authorization to actually begin treatment. We usually have to wait to request the treatment authorization until after the assessment. Be prepared to wait up to two weeks before insurance approves an authorization request.
Intake Assessment
As soon as insurance has authorized an ABA assessment, we will schedule and complete that assessment as soon as we can. Our intake and assessment process typically involves two steps. First we will sit down with the parents to explain more about our service and process. During that first intake appointment we will review the child’s history and discuss the parent’s goals and objectives for treatment along with all concerns you might have about your child. The second part of the intake process usually occurs on a different day and is focused on working 1:1 with the child to directly assess their skills and needs.
A comprehensive and individualized treatment plan is developed specifically and uniquely for your child based on what we learned during the intake assessment. Once insurance approves the treatment plan, we will aim to start therapy right away.
Contact us to learn more or get started today!
