• If you would like your child to receive ABA services at Appleseeds, please contact our team. Our Case Manager will send you a Welcome Email with a link to complete our intake form. We will need the following background information to get started:

    • Electronic Intake Form

    • Proof of Diagnosis 

    • Applicable Records 

      • IEP​ & 504

      • FBA & Behavior Plan

      • Speech & Occupational Evaluations

      • Previous ABA Evaluations

      • Psychological Reports

      • Proof of Diagnosis

      • Prescription for ABA services written AND signed by a Physician, Pediatrician, etc (anyone with a M.D. or PhD)

    Step 1: Intake Paperwork

  • Our Team needs the following information:

    • copy of current insurance card

    • policy holder's first and last name

    • child's first and last name

    • child's date of birth

    • a current address

    • current phone number


    Our Team will contact your insurance carrier to find out if you have coverage for ABA services. This process can take 5-7 business days.
    After we obtain your Notification of Benefits (NOB), our team will contact you. They will provide you with the following information so you can make an informed financial decision: 

    • ABA Coverage 

    • In-Network or Out of Network 

    • Deductible (Individual & Family)

    • Co-Pay or Co-Insurance Amounts 

    • Out of Pocket Maximum

    • Plan Type (HMO, POS, PPO, HSA, HRA)

    Step 2: Verify Benefits

  • If you have ABA benefits and you would like to use your insurance to pay for services, our Team needs to authorize an assessment with your insurance provider. 


    Our Team needs the following information:

    • Proof of Diagnosis*

    • Prescription for ABA services written AND signed by a Physician, Pediatrician, etc (anyone with a M.D. or PhD)


    *The diagnosis letter should be dated 2015 or after with new coding (F84.xx instead of 299.xx).

    Our Team will then call the insurance company back. The insurance company will give us permission to start an assessment with your child. We can not start services until we have an authorization.

    Step 3: Authorize an Assessment

  • After our team has an authorization from your insurance provider, it is time to schedule the Assessment!Our Case Manager will reach out to schedule an initial parent meeting and several consecutive days for your child to come to the clinic.

    • The Assessment can take up to 10 hours.

    • Assessment Appointments are typically scheduled in 2 hour blocks.

    • At the first appointment, the child does not need to be present. The BCBA will meet 1:1 with Parents & Caregivers to learn about your child and your goals for enrolling your child in an ABA program. 

    • The next several appointments, your child will work 1:1 with a BCBA (Board Certified Behavior Analyst) until the Assessment is complete.

    Step 4: Assessment

  • After the Assessment is complete, the BCBA will need time to review the results and write an individualized treatment plan for your child.  Our Case Manager will reach out and schedule a Treatment Plan Review Meeting. 

     

    During this meeting:

    • The BCBA will present the results from the Assessment

    • The BCBA will review the Treatment Plan and goals for ABA. Parents & Caregivers will receive a copy of the final Treatment Plan for their records. 

    • The BCBA will recommend the number of hours your child should receive ABA per week 

    • Parents & Caregivers will sign the Final Treatment Plan. This Treatment Plan will be send to your Insurance Company.

    • If the Caregivers decide to move forward with ABA services, the child's weekly schedule will be determined at the end of the meeting. 

    Step 5: Caregiver Meeting

  • Before your child can begin ABA services, our team needs to obtain an Ongoing Authorization from your insurance provider. 

    Our Team will submit the signed Treatment Plan and to your insurance provider and a request for on-going services. Once we have received an Ongoing Authorization, your child can begin services. 

    How ongoing treatment works:

    • Your BCBA has a team of 10 Registered Behavior Technicians. These RBTs are trained on your child's Treatment Plan, they meet weekly with the BCBA to review progress, and always have access to their BCBA to ask questions or seek support. 

    • Your child will work 1:1 with RBTs. If your child receives ABA multiple times a week, 

    • Your child will receive regular supervision of their program by your BCBA

    Step 6: Ongoing Services

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    Step 7: Caregiver 

    Involvement

  • Every 6 months, insurance companies require an updated Assessment. 
    Our Team needs the following information:
    NEW prescription for ABA services written AND signed by a Physician, Pediatrician, etc (anyone with a M.D. or PhD)
    Our Team does NOT need a new Proof of Diagnosis. 
    Our Team will then call the insurance company back. The insurance company will give us permission to start an assessment with your child. We can not start services until we have an authorization. 
    You will need to schedule the Assessment with our Patient Care Coordinator. The Assessment can take up to 8 hours. Sessions are typically scheduled in 2 hour blocks. Your child will work 1:1 with a BCBA (Board Certified Behavior Analyst) until the Assessment is complete.

    Step 7: 6 Months Later...

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