Our ABA Intake Process
Feeling overwhelmed on how to receive help for someone you love? Read the following to learn what to do to receive services!
Step one: Diagnosis
Prior to receiving ABA services a child will likely need to receive a formal diagnosis of Autism Spectrum Disorder (“ASD”) from a licensed diagnostician. Parents who are concerned that their child may have autism should ensure that a formal diagnostic assessment, such as the Autism Diagnostic Observation Schedule (“ADOS”) or Child Autism Rating Scale (“CARS”), is conducted by someone who can provide the diagnosis, such a their child’s pediatrician, a developmental psychologist, or other qualified healthcare professionals. In order to receive ABA the individual requires a formal “F84.0” diagnosis of ASD, including an indication of the severity level (Level 1: Requiring Support, Level 2: Requiring Substantial Support, Level 3: Requiring Very Substantial Support), and a prescription/referral for ABA services from an MD or PhD.
Step two: Applying for Services
What you need to proceed:
- Insurance Card
- Diagnostic Report
After formally receiving a diagnosis of autism you can apply for ABA services on our website. When applying you’ll want to provide information about your child, information on current insurance, and the best way for us to contact you back. After receiving your application a member of our team will reach out to you to continue the process and can help you find any missing information and answer any questions you might have. At this point we will also collect copies of the documentation needed, namely the clinical diagnosis and proof of insurance.
Step three: Verifying Coverage and Pre-authorization of the Initial Assessment
Once we’ve received all documents that we require we will verify your insurance benefits with your commercial insurance and/or Medicaid payor(s) to confirm that your child has coverage for ABA services. If there are any limits or restrictions to coverage we will discuss them with you and will also provide you information on any applicable copays, deductibles, or coinsurance, per your insurance plan. When this step is complete and we have reviewed the information with you we will request pre-authorization for the initial assessment.
ABA treatment typically requires pre-authorization from commercial and/or Medicaid payors prior to conducting an initial assessment. Once we have reviewed the information with you we will submit a request for initial authorization to your insurance provider. This authorization is what a Board Certified Behavior Analysts (“BCBA”) uses to conduct the initial assessment with your child.
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Step four: Initial Assessment and Developing the Plan of Care
After receiving the Initial Authorization from the insurance provider, we will set up a time with you to come in for your child’s initial assessment with one of our BCBA’s. The initial assessment will consist of a BCBA speaking with you to determine what the purpose and goals of therapy will be, such as what abilities your child has or is missing and if there are any behavioral issues such as sensory tolerance or socialization. While talking to the BCBA a specialized staff member will be observing your child inside of the clinic so that they can record what skills the child engages in in the natural environment as well as what preferences or preferred items in the clinic might be. Through this the BCBA will work together with you and your family to develop goals based on what the highest priority needs for the child are, as well as developing goals to help you work on yourself with your child. We will also work with you to determine an appropriate medically recommended schedule of therapy to ensure that the needs of your child can be met.
Step five: Beginning Treatment
Once your child’s plan of care is complete and all parties approve we will submit it and any required documentation to your insurance payor(s) to request the treatment authorization for provision of ABA services. Authorizations generally cover a 6 month period and provides pre-approval for the medically recommended number of hours of services to be provided in a week, typically ranging from 15-to-35 hours of direct service per week depending on the plan of care.
Once insurance approves therapy can begin! Your child’s clinical team will be made up of the BCBA and one or more Registered Behavior Technicians (“RBT”) who will work in tandem to provide treatment laid out in the plan of care. The BCBA supervises sessions so they can continuously and rapidly modify treatment so that they are ensuring the best quality of care and that your child is able to succeed and make progress towards their goals. The BCBA also works closely with you to help provide family training so that you can ensure the generalization of your child’s successes across different environments and different individuals. The clinical team works together with your family to ensure that there are meaningful, positive outcomes for your child and your family.
At Triangle ABA, we firmly believe in fostering strong partnerships with families to enhance the quality of care we provide. Recognizing the importance of effective communication in ABA therapy, we are committed to working closely with families to identify and secure suitable translators for all our clients. By actively engaging with families to locate appropriate translators, we uphold our dedication to comprehensive and accessible care for all.
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Address
1600 Hillsborough Street, Raleigh, NC, 27605
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