Resources & Accepted Insurance
Can I go through insurance without my child having a diagnosis?
Unfortunately, the answer to that is no. At this time, in California, it is required for any child or adult receiving ABA services through their insurance provider to have a diagnosis which is covered by their specific insurance.
How many hours will my child be receiving?
When starting ABA services, we complete an initial Functional Behavior Assessment (FBA). After the FBA, we will develop a treatment plan and based on that treatment plan, we will have a specific recommendation for your child.
What is a Functional Behavior Assessment (FBA)?
A functional behavior assessment, or an FBA, is an assessment that allows us to interview the caretaker and any additional stakeholders in the child’s/adult’s life to learn more about the behaviors which may impact daily living. We obtain information on different areas of life including self-help, socialization, communication, safety, etc. We then observe the child/adult in conditions where the behaviors typically arise. This will happen across one session or multiple sessions depending on the behaviors and overall need for the assessment. Once these are completed, we utilize the information you provided, the observations, previous records and reviews, and any additional indirect or direct assessment we recommend, to complete the full treatment plan. This plan includes goals, behavior intervention plans, and a full recommendation of ABA services.
How much will it cost us?
Co-payment/co-insurance is individually based on every individual insurance policy. Once you reach out to ABAE to inquire about services, ABAE will send an insurance document to you for you to fill out. Once this is completed, ABAE will reach out to your insurance provider and obtain this information for you, so you have all the information up front before starting the process. You can also obtain this information by contacting your member service department directly.
How long does the whole process take?
From start to finish it could take four to eight weeks. This depends on three factors:
- Your availability. The more availability you have, the quicker the assessment and the sooner we can submit the information to your insurance company.
- Your insurance provider. Depending on what insurance provider you have, starting the assessment may take longer, or obtaining the authorization for direct services may take longer.
- Availability of clinicians. Due to current regulations in place, some insurance providers are limiting the assessors to only those who have been vaccinated. This will limit the number of assessors on staff who can complete the assessment for you and your family.
ABAE does our best to get the FBA completed within four to six weeks to get you set up with in person services within six to eight weeks.
Who do we contact?
You can start by contacting our Intake Coordinator Sean Esquivel for additional information at IntakeCoordinator@abaenhancement.com or by calling 951-317-5950
- Accepted Insurance:
CalOptima, Inland Empire Health Plan, Cigna, Beacon HealthCare, Tricare, Anthem, Blue Shield, Blue Cross, Aetna, Magellan, and out of network providers
- Regional Center: Inland Regional Center
The Department of Developmental Services website is located at: www.dds.ca.gov/complaints.
- The Department of Developmental Services
The Department of Developmental Services can be reached by phone at: (916)654-1987.
ABAE works with most insurances. For uninsured individuals who would like to work with ABAE, please contact our office directly to make arrangements for service. Clients should be aware that most insurance providers, except for Medicaid, sometimes require out-of-pocket payments (deductibles), depending on the language of each individual plan. If ABAE is an out-of-network provider for your insurance carrier, the client will be responsible for any service charges that are not covered by their plan.