The basic process for insurance authorization is as follows:
- Family submits current insurance card, proof of diagnosis within 6 months, and physician recommendation for ABA services to RCS.
- RCS submits information to insurance company for initial assessment authorization.
- Insurer authorizes or rejects submission.
- If authorized, RCS completes an initial assessment which includes direct observation and assessment and parent interview.
- RCS writes a treatment plan which includes proposed objectives and recommended number of hours.
- Treatment plan is submitted to insurance.
- Insurance authorizes or rejects request for services.
- Once services are authorized, a service re-authorization request, including an updated treatment plan, can be submitted to insurance prior to the authorization end date.
- Insurance authorizes or rejects continued services.