Step 1: The Initial Phone Call

Your first step is reaching out to an ABA service provider, often referred to as a Board Certified Behavior Analyst (BCBA) or a company employing BCBAs. During this call, you'll typically discuss:

1. Basic Information: The intake coordinator will gather essential details about your child, including their age, diagnosis, and any previous treatments.
2. Insurance Verification: The provider will ask for your insurance information to verify coverage for ABA services.
3. Preliminary Questions: You may be asked about your child’s behaviors, strengths, challenges, and any specific goals you have in mind.

This initial call usually lasts about 30 minutes to an hour. It's helpful to have your insurance card, any relevant medical or educational records, and a list of questions handy.

Step 2: Verification and Pre-Authorization

Once your initial call is complete, the provider will proceed with verifying your insurance benefits. This process involves:

1. Insurance Verification: The provider contacts your insurance company to confirm coverage details, including any copayments, deductibles, and coverage limits for ABA services.
2. Pre-Authorization: Some insurance plans require pre-authorization before services can begin. This involves submitting documentation of your child's diagnosis and the proposed treatment plan to the insurance company for approval.

This phase can take anywhere from a few days to a couple of weeks, depending on the responsiveness of the insurance company.

Step 3: Assessment and Initial Meeting with a BCBA

Once insurance approval is secured, the next step is scheduling an assessment with a BCBA. During this assessment:

1. Comprehensive Evaluation: The BCBA will conduct a detailed assessment of your child's behaviors, skills, and areas of need. This may involve direct observation, standardized assessments, and interviews with you and other caregivers.
2. Goal Setting: Based on the assessment, the BCBA will collaborate with you to set specific, measurable goals for your child’s ABA program.

This assessment usually takes place over one or more sessions and can last several hours in total.

Step 4: Developing the Treatment Plan

After the assessment, the BCBA will develop a customized treatment plan tailored to your child's needs. This plan will include:

1. Goals and Objectives: Specific, measurable goals that your child will work towards.
2. Intervention Strategies: Detailed descriptions of the interventions and techniques that will be used to achieve the goals.
3. Schedule of Services: Recommendations for the frequency and duration of therapy sessions.

The development of the treatment plan typically takes about one to two weeks.

Step 5: Scheduling Therapy Sessions

With the treatment plan in place, it's time to schedule therapy sessions. Here are some key considerations:

1. Therapist Availability: The provider will match your child with a therapist (or therapists) based on availability, experience, and compatibility.
2. Family Schedule: Flexibility in your schedule can facilitate quicker initiation of services. Therapy sessions often need to be scheduled multiple times a week.
3. Consistency: Regular, consistent sessions are crucial for the effectiveness of ABA therapy.

Finding a suitable schedule might take a few days to a week, depending on therapist availability and family flexibility.

Step 6: Commencing Services

With the schedule set, therapy sessions will begin. During the initial phase of therapy:

1. Baseline Data Collection: The therapist will collect baseline data to understand your child’s starting point in various skill areas.
2. Building Rapport: Establishing a positive relationship between your child and the therapist is essential for successful intervention.
3. Initial Interventions: The therapist will start implementing interventions as outlined in the treatment plan.

Step 7: Ongoing Services and Adjustments

As therapy progresses:

1. Regular Assessments: The BCBA will conduct regular assessments to monitor progress and adjust the treatment plan as needed.
2. Family Involvement: Active participation from family members is encouraged to reinforce skills and strategies at home.
3. Team Meetings: Periodic team meetings involving the BCBA, therapists, and family members will ensure everyone is aligned on goals and progress.



Billing Statements

Regarding billing, here's what to expect:

1. Initial Billing: The first billing statement typically arrives within the first month of starting services. This statement may include charges for the initial assessment, treatment plan development, and therapy sessions.
2. Insurance Claims: The provider will submit claims to your insurance company. You’ll receive an Explanation of Benefits (EOB) from your insurer detailing what has been covered and any remaining balance.
3. Out-of-Pocket Costs: Depending on your insurance plan, you may be responsible for copayments, coinsurance, or deductibles. These out-of-pocket costs will be itemized in your billing statement.

Final Thoughts

Navigating the authorization process for ABA services can be complex, but understanding each step helps make the journey smoother. From the initial phone call to ongoing services, clear communication with your provider and active involvement in your child’s therapy are key to success. Remember, your provider is there to support you every step of the way, ensuring that your child receives the best possible care tailored to their unique needs.

If you have any questions or need further clarification, don't hesitate to reach out to your ABA provider. They are there to help you navigate this process and ensure your child’s success in their ABA therapy journey.