7 Stages of Starting Autism Services
If you are just starting the process of your child receiving insurance-provided behavior intervention services for an autism diagnosis, it can be difficult to know where to start and what to expect. Below are seven key parts of starting intervention services to help familiarize yourself with the process.
What You Will Need
As with any application process, there is paperwork to gather prior to starting ABA services. You will need to have a recent (within the last 2 years) diagnostic report from a doctor (MD) or diagnostician that specifies your child was diagnosed with autism. In addition, a prescription or referral from your child’s doctor is required by most insurance companies. Have these ready prior to beginning the assessment in order to help speed up the process.
Submit Paperwork to Insurance
Autism Learning Partners, or any agency you choose, will likely request financial information, insurance information, your family’s availability, etc. While it is hard to cut down on time once paperwork is turned over to an insurance company, you can significantly speed up the process by turning in your paperwork as quickly as possible. If you need help or do not understand something that is asked of you, do not be afraid to call and ask for help! We’re here to help guide you through the entire process, answering any questions you may have along the way.
The FBA Process
The functional behavior assessment (FBA) will be completed by a Board Certified Behavior Analyst (BCBA) as soon as authorization is received from your insurance company. There will be several observations completed including parent interviews, observations of your child, and assessments of your child’s current skill levels. There is a chance that the BCBA conducting your assessment will ask you to collect some data outside of this observation. This is an important step to prioritize to keep the assessment process moving. When the observations are completed, the assessor will write the report and make a recommendation of therapy hours. The writing process can take some time to complete as the assessor is creating the treatment plan that includes goals, behavioral strategies, etc. that needs to be approved for by your insurance. Once the treatment plan is reviewed by your insurance company, a treatment authorization will follow allowing for the start of intervention services.
Hour Recommendations = Prescriptions
Therapy hours recommended by the assessor are treated similarly to a medical prescription given by a doctor. After reviewing any previous reports, information from the parent interview, observation notes, assessment results, the assessor makes a clinical recommendation for the direct hours that your child will need to receive to make adequate progress toward behavior reduction and skill development. These recommendations include hours that your child will receive directly, supervision hours, and parent education hours. This recommendation will be reviewed with you by the assessor at the end of the assessment process. Since these are viewed as a medical prescription for progress, once approved by your insurance, you will be expected to agree to a schedule within your given availability to fulfill these hours. Any disagreement to fulfilling these hours will likely delay the start of services.
Circle Back with Autism Insurance Company
Once the assessment is turned in by the assessor, there is typically a 15-business day timeline where we must wait for approval from your insurance company. Each insurance company has a different timeline.
It’s Schedule Time!
The good news is that while your insurance is working on approving your child’s prescribed hours, we’re able to continue working on getting everything ready for your services to begin. The scheduling department will reach out to you and propose a schedule to fulfill the recommended hours (prescription) as well as discuss a start date for services. It is imperative that you are very responsive during this stage of the process as the staff planned for your child will likely be reassigned if the department does not hear from you to confirm the start date. If it is easier for you to communicate in a specific way (i.e. email, text, phone call, etc.) make sure to let the assessor know early on in the process so that we can document it in your child’s program as the preferred
Congratulations! Now you’re ready to officially start services.
Continuing Services: Communicate and Ask Questions
No matter how prepared you are, it is completely understandable that you will have questions throughout this process. Don’t hesitate to ask questions and communicate specifics to anyone involved in your process. Over-communicating with the team helps to avoid delays in the future once approval is received and everyone is ready to get started. No question is too big or too small – our team looks forward to helping your child make progress ASAP.
No matter where you are in your journey, we’re here to answer any questions you may have. Call us at (800) 805-0759 Ext. 276 or contact us on our website.