How to Get ABA Started
For Medicaid Clients that are diagnosed with autism or suspect autism:
Step one: Go to pediatrician and get Nero referral
(honestly I would go ahead and call Nemours or Kid's Neurology and get an appointment because they book months out. Remember though to cancel if they don't write you a script!)
Step two: go to Nero appointment and BEG for a CARS or GARS assessment stating the child must have it or ADOS to get ABA ASAP.
Step three: after they agree to do your assessment ask them for the following
- Dr referral for ABA
- Letter of medical necessity for ABA
"It is medically necessary for _____ to receive ABA therapy to treat maladaptive behaviors that interfere with daily functioning"
3. Letter stating problem Bxs and diagnosis
"______ is a client of ours who is diagnosed with Autism f840. They have many problem behaviors that happen daily as observed during my observation or by caregiver report including but not limited to aggression, self injury, property destruction, tantrums, screaming, spitting, non compliance, cussing, stripping, and eloping" (remove or add behaviors as needed)
4. Bonus letter that makes Medicaid move things along faster
"I believe ABA is Medically necessary at the maximum amount of hours the insurance allows. Research shows it is most effective at 30-40 hrs a week. I believe my patient ______ would benefit from the services being provided intensely in their home, school, and community settings. I believe a BCBA should make a determination on how many hours the child should be seen a week based on their problem behaviors."
All 3 (or 4) need to be signed BY THE DOCTOR not the nurse practitioner and include the child's name, dob, and Medicaid id number. (if any 1 of those are missing Medicaid will deny!)
Step four: gather the child's other information
- Copy of your child's IEP or 504 plan
- Medicaid id card
- If the child has ever received ABA from another company a letter stating last day of services and last initial assessment.
- Copy of child's ADOS, CARS, or GARS assessment stating ASD
Step five: get on the wait list (you will not be picked up and will be skipped over if your missing any of those documents!)
To join the wait list click on the " Wait List" tab