Insurance Coverage for ABA

Texas

Under current Texas law, state-regulated health plans are required to cover the diagnosis and treatment of autism, including behavioral health treatment, such as Applied Behavior Analysis (ABA), as well as speech, occupational and physical therapy. Companies with self-funded insurance plans are not required to provide this coverage; however, you may ask your company’s Human Resources Department to provide this coverage. Please note that services must be prescribed by a licensed physician or psychologist to be eligible for insurance reimbursement.

If CARE is not a participating provider with your insurance carrier, we will collect the fee for services up front and provide you with detailed treatment records you may submit to your insurance for reimbursement (upon request).

Other States

Many other states have insurance mandates.  Not sure what is available in your state?  Contact us!  If we aren’t clear on your state, we will assist you in finding out!

How do I know if my insurance will cover ABA services?

shutterstock_85920487We are a full-service agency and provide assistance with the following details for our clients who have coverage by plans CARE participates in:

  • Pre-authorization for services
    Contact your insurance provider to verify benefits and complete the initial paperwork.
  • Re-authorization for services
    Provision of comprehensive assessment, progress and treatment program information to your insurance company for extension of services through required re-authorizations.
  • Billing claims and submissions
    Completion of billing and insurance claim submission.
  • Correcting denied or unpaid claims
    Correction of denied, unpaid or incorrectly paid claims.

If you have questions about funding, we can help guide you through the process of determining your child’s eligibility for ABA services under your health insurance plan.

  1. Download the CARE Insurance Eligibility form
  2. Print and complete the form.
  3. Fax the form to CARE at 702-924-2561.

Please contact us at info@educatorscare.com for assistance.