Nationwide, increasing numbers of private insurance companies and other employee benefit plans are covering autism therapies. Yet many insurance companies continue to refuse coverage for applied behavior analysis (ABA), which is considered the standard of care for autism treatment, on the basis that it is "experimental" or "educational."
Let us help you! We handle all insurance claims, you will not be required to fill out and submit claims.
There are many factors that can cause denied claims, the most common are:
- Self Funded Insurance - Many large companies now provide self funded insurance to their employees as a way to reduce costs. Self funded insurance is not covered in the state mandates.
- Insurance Provider is located in a state with-out an autism coverage mandate.
- Age restrictions on insurance coverage.
- Lack of a diagnosis.
Corner Piece LLC is currently in network with the following insurance providers:
- Anthem BCBS
- Blue Shield of California
- BCBS Premera
- Care First
- BCBS of Massachusetts
- Kaiser Permanente
- United Health Care
We also work with Aetna & Cigna out of network
How does insurance coverage work?
Most insurance companies follow the same steps for ABA therapy coverage (Response times may vary case to case and company to company)
Step 1. Request Pre Authorization for an Assessment
The Assessment must be approved before any services will be covered. Typically the assessment is 10-15 hours of sessions. Pre authorization approval times vary and can take 5-15 business days depending on the insurance provider. Our BCBAs and BCaBA will complete the assessment based on areas of concerns and level of care.
Step 2. Assessment submission
Once the assessment is complete Corner Piece will submit it along with Pre Authorization for On-Going ABA Therapy. Typically this can take 1-2 weeks to get approval after the assessment has been received. While waiting for this any sessions provided will not be covered by instance and will be an out of pocket expense.
Step 3. Approval of On-Going ABA Therapy
Once the insurance provider approves on-going services we can start providing direct ABA services. This can be anywhere from 2-20 hours a week depending on the level of need. On-going services are subject to review and progress updates are required by all insurance providers.
If you are interested in insurance coverage we require the following information to request Pre authorization
- Front and Back of your insurance card
- Diagnosis and referral from the diagnosis physician or psychologist
- DOB of Child
All information can be uploaded in our New Client Application
For more information click here to see autism speaks.org state initiative information
| Corner Piece LLC | 8870 Rixlew Lane Manassas Virginia, 20109 | Phone: 571-336-2221| Fax: 571-522-2705 |