How to Access ABA Therapy Service

Medicaid Funded Plans (CMS, Sunshine, Aetna Better Health, Humana Healthy Horizons, Simply/Carelon)

📬 Welcome & Next Steps for ABA Therapy Services

Welcome to Behavior Basics! 🌟 Thank you for reaching out to Behavior Basics regarding our Applied Behavior Analysis (ABA) services. We're honored to support your family and guide you through every step of this journey 💙.

🛠 What to Expect Next

We understand that gaining initial authorization for ABA services can feel overwhelming. To make this process easier, we’ve included a step-by-step list of Medicaid-mandated requirements and helpful documents to get you started ✅.

📎 Attached Documents

1. 🧾 Welcome Flyer – Overview of our services + helpful tips
2. 📥 Referral Form – Includes a QR code for easy submission
   
3. ✍️ Consent Forms – QR code included for your convenience
   
4. 📑 Intake Packet – Helps us gather essential information

📌 Medicaid Requirements for ABA Authorization

To access services via Medicaid-funded insurance (Sunshine, CMS, Humana Healthy Kids, Aetna, Simply/Carelon), the following are required:

1. 📝 Prescription

   • Must be on an official script pad
   • Signed by an in-network MD/DO
   • Must state: “ABA services are Medically Necessary”
   • Must include a specific mental health diagnosis

2. 🧠 Comprehensive Diagnostic Evaluation (CDE)

   Conducted using evidence-based tools, this includes:

   • Parent/guardian interviews
   • Teacher assessments
   • Diagnostic tools (e.g., ADOS-2, CARS2, M-CHAT-R, CSBS, etc.)
   • Hearing & vision screenings
   • Genetic or neurological testing as needed

   CDE must be led by qualified professionals such as:

   • Developmental Pediatricians
   • Child Neurologists
   • Child Psychologists or Psychiatrists

   Required content in the CDE report:

   • A. Clinical findings
   • B. Diagnostic recommendations
   • C. Tools/tests used
   • D. Summary and next steps
   • E. F-code for diagnosis

3. 🖊 Behavior Basics Forms

   • Signed Referral & Consent Forms (using QR codes)

4. 🪪 Insurance Card

   • A copy of the front and back

⏳ What’s Next?

Once we receive all the required documentation, we will:

• Add your child to our waitlist
• Begin authorization review
• Contact you if anything is missing or requires clarification

📞 Need Help?

We’re here for you! If you have questions or need help completing forms, don’t hesitate to reach out:

• 📧 Email: [email protected]
• 📞 Office: 772-463-0444
• 📠 Fax: 772-219-1339

Thank you again for choosing Behavior Basics. We look forward to partnering with you and supporting your child’s growth and success 🌈✨.

Warm regards,
The Behavior Basics Team

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Commercial/Private Insurance Plans (Aetna, BCBS, ChampVA, Cigna, Tricare)

📬 Welcome & Next Steps for ABA Therapy Services

Hello and Welcome to Behavior Basics! 👋

Thank you for contacting Behavior Basics. We appreciate your interest in our ABA therapy services and look forward to partnering with your family on this important journey 💙.

🧾 Let’s Get Started

To begin, we’ve attached a set of documents for you to complete. Once we receive the necessary forms from you and the referring physician, your child will be placed on our waitlist.

📎 Attached Documents

Please review and complete the following:

1. 🧾 Welcome Flyer – Overview of our services + helpful tips
2. 📥 Referral Form – Submit using the attached QR code
   
3. ✍️ Consent Forms – Submit using the attached QR code
   
4. 📑 Intake Packet – HGathers essential information
5. 💳 Payment Policy & Credit Card Authorization Form – Required once your case is opened

📌 Insurance Requirements (Private Insurance)

Most private insurance providers require the following for ABA service approval:

• An F84.0 (Autism) diagnosis
• Proof of diagnosis documentation

📤 What You Need to Send

Along with the completed forms, please submit the following as per your carrier's guidelines:

1. 🪪 Copy of the front and back of your insurance card
2. 📚 Detailed developmental & medical history, including:
   • Records from previous clinicians
   • Most recent pediatric visit summary
3. 🧠 Developmental, Cognitive & Neurological evaluations
4. 💊 List of current medications + prescribing physician
5. 🧩 Adaptive behavior assessment (if available)
6. 🏥 Medical history, including:
   • Injuries, hospitalizations, surgeries
   • Co-morbid diagnoses & allergies

⏳ Next Steps

Please complete and return the documents at your earliest convenience. Once we receive all necessary paperwork, we will begin reviewing and preparing your child’s case for services.

📞 Questions or Need Help?

We’re here to help! If you need assistance with any part of the process, don’t hesitate to reach out:

• 📠 Fax: 772-219-1339
• 📞 Office: 772-463-0444
• 📧 Email: [email protected]

Thank you for choosing Behavior Basics. We look forward to working with you and supporting your child’s growth 🌟.

Warm regards,
The Behavior Basics Team