Thank you for your interest in services with Pathways!
Whether you are brand new to receiving ABA therapy or have received therapy in the past, we know that the steps to getting started can be a little overwhelming! We are here to help you through the intake process to help make it go as smoothly and as quickly as possible.
The process is started when a parent contacts our office via phone or email. During our first introduction, we will ask a few brief questions to include: age and gender of child, location, concerns, and your contact information.
Within 24 hours of our first call, we will send you the intake packet. The intake packet has information that includes the service description, service agreement, financial agreement, and notice of privacy acts.
While you are completing the packet, we can go ahead and begin the process to verify benefits with your insurance provider. We strongly encourage that you also call your member services representative to inquire about your coverage for ABA assessment and therapy. Please verify coverage for ABA, not just autism services. ABA is most often covered under a member’s behavioral health plan, where as speech therapy and occupational therapy for children with autism are covered under medical.
Once we have checked with your insurance regarding reported benefits, we will contact you within 24 hours to let you know the summary of what your provider has indicated.
Please note: a quote of benefits and/or authorization does not guarantee payment or verify eligibility. Payment of benefits are subject to all terms, conditions, limitations, and exclusions of the member’s contract at the time of service.
As soon as you are able to return the completed intake paperwork packet to us along with supporting documents (i.e. psychological evaluation report with diagnosis and recommendation for ABA services) we will initiate scheduling with you within 24 hours.
Once we have all of your information, we will submit for a prior authorization or pre-certification for the initial assessment with your insurance company. Depending on the insurance carrier and their internal processes, this may take a few days. Once the authorization has been received, we will contact you. If your insurance does not provide coverage for ABA therapy and you will be a private pay client, the receipt of the initial $300.00 as outlined in our financial agreement will be required for services to commence.
At this point, we are now able to schedule the initial assessment. Please provide us with a few days and times that might work so we can accommodate your requests and also work with our staff availability. If there is more than one setting you would like for us to conduct the assessment in (i.e. home, school, day care), please let us know at the time of scheduling. The assessment may take between one and three sessions to complete.
A board certified behavior analyst (BCBA) is assigned to come into your home or designated settings to conduct the assessment. This individual will likely be the case manager for your child’s case moving forward. The assessment will cover the concerns you have previously expressed while also looking at development across domains. This assessment will be conducted via caregiver interviews, direct testing, and observation. Please note that part of the authorization or billed time is preparing a comprehensive report and treatment plan for your child which will provide details of the assessment and therapy recommendations.
Upon completion of the assessment and summary report, we will send you a copy. At this time, we like to follow best practice and schedule a time to sit down and review it with you so that you fully understand how goals are generated and how therapy will be structured. We also want to give you an opportunity to ask any questions that you may have so you feel comfortable with the plan moving forward. This review usually takes an hour and will be conducted in your home.
While the review is occurring, Pathways administration will complete the necessary paperwork and steps to request and obtain an authorization for therapy and treatment. Depending on your insurance company this may take a few days. Your insurance company should send you a copy of the authorization information. Please note, the authorizations are generally allowed for a 6-month period at the conclusion of which we will update assessment and performance information and submit a request for another authorization so therapy can continue.
We are now ready to schedule your treatment and therapy sessions! Please provide us with your availability and preferences for the sessions.