Insurance
Most commercial insurances accepted
Contact us for any questions regarding coverage or plans. we’ll be happy to provide you with the clearest guidance as to your best options.
Understanding ABA Therapy Coverage Through Insurance
The Behavior Blueprint is committed to making high-quality Applied Behavior Analysis (ABA) therapy accessible to families by working with major insurance providers, including United Healthcare (UHC), Aetna, MVP, Cigna, Medicaid, and Blue Cross Blue Shield (BCBS). We understand that navigating insurance coverage can be complex, and we are here to help guide families through the process to ensure that their child receives the necessary services with minimal financial burden.
We are in-network with most insurances that offers comprehensive coverage for ABA therapy under many of its plans. As ABA therapy has been recognized as a critical treatment for children with Autism Spectrum Disorder (ASD), insurance companies have structured policies that allow families to access services that support developmental progress. Our ABA administrative team is well-versed in insurance coverage nuances and works closely with parents to ensure a smooth and stress-free experience.
The Importance of Insurance for ABA Therapy
Insurance plays a vital role in ensuring access to high-quality ABA therapy. The cost of ABA therapy can be significant, but private insurance helps mitigate these costs by covering a substantial portion of the expenses. Our in-network insurances has a strong track record of supporting ABA therapy, often covering assessments, individualized therapy sessions, parent training, and progress evaluations.
At The Behavior Blueprint, we emphasize the importance of insurance in ensuring continuity of care so that children can receive therapy as frequently as needed, maximizing their progress and developmental outcomes.
Before beginning ABA therapy at The Behavior Blueprint, families must go through an insurance verification process to determine their specific coverage details. Our team assists with this process by:
Insurance Verification Process
Confirming Eligibility
We check whether the child’s insurance plan includes ABA therapy benefits and determine any applicable deductibles or copays.
Understanding Plan Details
Not all insurance plans are the same, so we work with families to outline their specific plan’s coverage, including session limits, provider networks, and authorization requirements.
Preauthorization Assistance
Some insurance plans require prior authorization before ABA services can begin. We help gather the necessary documentation, including a medical diagnosis and treatment plan, to ensure swift approval.
Explaining Out-of-Pocket Costs
We provide a detailed breakdown of potential out-of-pocket costs, helping families understand what to expect in terms of copayments, deductibles, or coinsurance amounts.
The Role of Insurance in Covering Therapy Sessions
Once insurance approval is secured, families can begin ABA therapy at The Behavior Blueprint. Insurance typically covers a range of therapy services, including:
Direct Therapy Sessions: One-on-one sessions between the child and a therapist, focusing on skill development, behavior modification, and social engagement.
Parent Training: As part of our commitment to comprehensive care, we offer 60 minutes of parent training per week, either in person or virtually. Insurance often covers these sessions, as parent involvement is crucial to long-term success.
Ongoing Assessments and Progress Monitoring: Regular evaluations ensure that therapy remains effective and adjustments can be made as needed.
School Readiness and Transition Support: If a child is ready to transition into a school setting, we work with families to develop strategies that facilitate a smooth integration.
One of the biggest concerns for families seeking ABA therapy is managing insurance claims. At The Behavior Blueprint, we streamline the billing and reimbursement process by:
Managing Claims and Reimbursements
Direct Billing
In most cases, we bill insurances directly, minimizing the administrative burden on families.
Claims Processing
Our experienced billing team ensures that claims are submitted accurately and promptly, reducing the likelihood of delays or denials.
Appeals Support
If a claim is denied, we assist families in appealing the decision by providing necessary documentation and advocating for their child’s needs.
Transparent Communication
We keep families informed throughout the billing process, ensuring they understand their financial responsibilities and any updates on claims.
Addressing Common Insurance Challenges
Despite insurance’s strong coverage for ABA therapy, families may occasionally encounter challenges, such as:
Coverage Limitations: Some insurance plans have annual or lifetime limits on ABA therapy. We help families navigate these restrictions and explore options for extended care if needed.
Network Restrictions: Certain insurance plans require therapy to be provided by in-network providers. The Behavior Blueprint works to maintain strong relationships with insurance to remain within their preferred provider networks.
Authorization Delays: Insurance approvals can sometimes take time. Our team proactively follows up with insurance to expedite the process and avoid treatment delays.
Policy Changes: Insurance policies can change annually. We assist families in reviewing their coverage during open enrollment periods to ensure continued access to services.