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The ABA Therapy Intake Process

Updated: Apr 24, 2023

If your family is embarking on the process of initiating ABA therapy services, know that ABA therapy is unlike other treatment options available and may take more time to initiate than you expect.

If you are interested in starting ABA services, there are many (60+) ABA therapy providers available in the Dallas-Fort Worth area. You may want to reach out to a few providers and schedule a tour or meeting with the clinical/program director to ensure the company you choose will be a good fit for your family. Questions you may want to consider asking during your tour might include:

- Where are services provided (in-home, clinic, community)?

- What are your center hours of operation? (if a family is interested in center-based services)

- Do you offer weekend sessions?

- Do you require an RBT certification for direct care staff?

- Do you offer caregiver training/support?

- With what insurance companies are you credentialed?

- What is your current wait time to access services?

- What are your attendance policies for clients and staff?

- Do you offer any social skills groups (for older children with social skill deficits)?

- Will the provider offer services for the desired number of hours your family is seeking?

- Will the provider be flexible with your child’s school schedule?

Once you find an ABA provider that is the best fit for your family, you will probably speak with an intake coordinator or operations assistant to have your child added to their prospective client list. The intake coordinator will typically ask you to send over copies of your insurance card, your child’s medical diagnosis of autism, and to complete intake paperwork, which may include several forms. *If your child does not have a medical diagnosis of autism (an evaluation completed outside of the school system), you will need to obtain this before an ABA provider can move forward with ABA services as insurance requires a medical diagnosis of autism to approve and cover ABA services. Read more about obtaining a medical diagnosis of autism on our blog title The Autism Diagnostic Evaluation Process.

Most ABA providers in the area have some sort of waitlist, which means your child may not be able to start ABA services immediately. Ask the ABA provider what their waitlist times currently are so you know what to expect.

When there is an opening for your child, the ABA provider will then submit an authorization request to your insurance to complete an initial assessment. This initial assessment is required by all insurance companies. With some insurance plans, the initial assessment authorization may be immediate or be obtained within 24 hours of the request; with other companies it could take up to two weeks or longer to receive approval. If there are any issues with the documentation submitted (e.g., lack of medical diagnosis of autism, incorrect insurance information), the assessment approval could be delayed.

After the authorization request is obtained, the ABA provider will have a Board Certified Behavior Analyst (BCBA) reach out to the family to schedule the initial assessment. The initial assessment may occur in 1-2 appointments across a couple of weeks. One session may include extensive interviews with the caregivers, and the second part of the assessment typically involves direct observation and testing with the child. The BCBA will also typically ask caregivers to complete several questionnaires. Caregivers should complete those questionnaires as quickly as possible because that information is often required by insurance.

After all the testing has been completed, the BCBA must create the initial treatment plan. Writing treatment plans is a lengthy process as the plans are typically 20 or more pages of information and goals. The plan may take a BCBA one to two weeks to write. Once the plan is complete, the BCBA will typically have to submit the finalized plan to a clinical director for review before the plan can be shared with a family. After the plan is finalized, the BCBA will schedule a time to review the plan with the family before submitting for an initial ABA services authorization.

During the review of the treatment plan, families should be sure to ask any questions they have about the assessment results as well as ensure that the plan includes any goals the family wants the provider to focus on for the next three to six months (most ABA authorizations last six months; however, Texas Medicaid currently authorizes only three months at a time). Additionally, the BCBA is going to discuss their recommendation of service hours per week. Most ABA providers require families to commit to a majority of the recommended hours (e.g., 80 percent or more). If a family cannot commit to the hours recommended, the BCBA should be able to discuss other service options available that may be a better fit for your family. Knowing that, depending on a child’s skill levels, service hour recommendations may be up to 40 hours a week.

Once the plan is signed and approved by the family, it, along with other required documents, is submitted to the family’s insurance plan. Initial ABA service authorizations can also occur very quickly (within a couple days) or take weeks. The ABA provider, as well as the family, can reach out to the insurance provider regularly to check on the status of the authorization, but most companies have general authorization timelines that do not change.

Once the authorization is submitted to insurance, the ABA provider may need to start the hiring process for your child’s direct care staff (RBTs). Depending on the number of hours recommended, this might require hiring multiple staff. The process of hiring and training staff can take weeks if there are not staff already available at the ABA provider who fit your child’s schedule. It will be helpful for families to ask questions about the provider’s staffing process so they know when their initial service start date might take place.

Once the initial service authorization is received, services can begin, given that staff are fully trained and available. This authorization process will begin again approximately four-five months into services to ensure an ongoing service authorization is obtained and no gaps in services occur. Re-authorizations will continue to occur every six months for as long as the child is in ABA therapy. Insurance also requires that families obtain an updated autism diagnosis every three years.

While the onboarding process for ABA services may seem daunting, knowing what to expect from the start can be helpful in managing caregiver expectations. Dr. Hoppe can offer your family ongoing support while you are completing the intake process for ABA. If you have more questions about a medical diagnosis of autism or ABA therapy services, check out our previous blogs on What is ABA Therapy? or contact Dr. Hoppe to schedule an evaluation or consultation today! NTX Psychological Services is located in McKinney, Texas.

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Apr 22, 2023

This explanation of the ABA Therapy Intake Process was extremely helpful, giving me answers to many questions I had about insurance, time factors, and the overall process itself.

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