Insurance

There are many types of health insurance policies that support coverage required to cover ABA services. This depends on what kind of insurance you have, and what state you live in.

Please contact Heart & Soul ABA to assist with support with what coverage you may need or have.  

In-Network Payer's 

• UPMC 
• Highmark 
• Optum
• Community Care Behavioral Health
• Medicaid 

1. Do you have a wait list?
2. What insurance do you accept? 
3. Who will be working with my child?
4. What sort of training do your BCBA / therapists receive? 
5. How much direct supervision will my child / individual need weekly?
6. What does a typical ABA session look like?
7. Do you offer home-based or clinic-based therapy?
8. How do you determine goals for my child? 
9. Do you consider input from parents when providing services?
10. How often do you re-evaluate goals?
11. How is progress evaluated?
12. How do you manage safety concerns?

After inquiring about services, Heart & Soul ABA team will meet with guardian / client or may email guardian / client an intake application which includes important information about our services, all documents to include an application for services, and a verification of benefits form.  

Once the intake application is completed, our team will verify guardian / client insurance benefits and reach out to guardian / client  to schedule a time for an initial consultation. 

At this time we will meet the guardian / client, discuss details to include history,  current concerns or barriers, and future goals / desires.  

Once the intake consultation is complete, we will work with guardian / client insurance company to request an authorization for an initial assessment.  Typically, it takes up to 14 business days for your insurance company to provide authorization for assessment.  

Once the authorization is received, we will reach out to guardian / client to schedule an intake assessment.  This assessment occurs over 1 / 2 sessions in the home or community setting.  During this time, we may ask to sit with you to review some questions regarding guardian / client development.  BCBAs conduct all assessments but may be accompanied by a behavior technician.

Following the assessment, one of our BCBAs will set a time to review outcomes of the assessment, the treatment plan, and recommended service hours and treatment goals.  Treatment recommendations are based on evaluation outcomes and medical necessity. Once the plan is finalized, a request for treatment hours based on medical necessity is submitted to your insurance company for authorization.

Once our team has reviewed the treatment plan with guardian / client we will share this plan along with request to begin ABA services to guardian / client insurance company.  Typically insurance companies respond with approval and authorization to begin services in 7-14 business days.  

While we wait for authorization, our team will work with guardian / client to create a schedule based on the guardian / client's availably and recommended treatment hours.  Based on the outcomes of the assessments and guardian / client scheduling needs, we will create a team of behavior therapists and assign a BCBA to supervise your child’s program.

Services will start with the Heart & Soul ABA team members getting to know the client.  The first couple of sessions will consist of building rapport, exploring the clients interests, and learning the clients high preferred items, people, and activities. Additionally, through this process we will begin the focus on the treatment plan and implementing services. The BCBA will overlap with each registered behavior technician to ensure they are the right fit and that they are building a trusting relationship.