What "covered" actually means.
Coverage is not one yes. It is a diagnosis, a medical-necessity letter, an authorization for a number of hours, and a renewal date. Here is each piece, and which ones we handle for you.
The four pieces.
The diagnosis
A documented autism diagnosis from a qualified evaluator. If you do not have one yet, that comes first, and we can tell you where to go.
Medical necessity
A prescription or letter saying ABA is medically necessary. Usually your pediatrician. We can send them the form.
The authorization
Your plan approving a number of hours for a period of time. This comes from the assessment, which is why the assessment happens before therapy.
The renewal
Authorizations expire. Ours is the job of tracking that date and submitting before it lapses, so your child's hours do not stop.
Where each plan stands, today.
This list comes from our own system and changes as contracts close. "In credentialing" means exactly that — not yet billable, and we will not pretend otherwise.
If you are denied
A denial is not the end of it, and it is frequently a paperwork problem rather than a clinical one — a missing letter, an expired evaluation, a code mismatch. We appeal on your behalf, and we tell you what the denial actually said rather than sending you the letter and wishing you luck.
If you have no coverage
Say so early. Florida has routes that do not run through private insurance, and some of them have waiting lists measured in years — which is a reason to start the paperwork now rather than after you have exhausted everything else. The Florida resource directory lists them, including Early Steps and the state programs.
Ask us anything before you commit to anything.
The benefits check costs nothing and does not sign you up for anything. English and Spanish, Monday – Friday, 9:00 AM – 5:00 PM.