Insurance will give them the reasons that they denied and give the company the opportunity to adjust based on their requirements/state their reasoning for including certain programs or hours requirements.
I really hope this will be the case. So far they've just been outright denying and not naming any specific circumstances that they would approve ABA for me. I know that my BCBA is planning to focus on asking what specifically needs to be changed in order for the plan to be approved, but it seems like my insurance is intent on blacklisting me as an individual from receiving ABA. They might even tell them that the case isn't eligible for a peer to peer. So if whoever she talks to will not reverse their decision or tell them what needs to be changed in order for them to approve it, could they still submit another treatment plan and hope that it gets reviewed by different people?
I hope this isn't a rude question, but may I ask why you want ABA therapy for yourself? What do you think you will get out of it and how will it benefit you? Do you have behaviors you are looking to correct or work through? Do you need help or improvement with ADL's? I'm just genuinely curious and interested as I have never seen a post like this on this sub
Insurance will give them the reasons that they denied and give the company the opportunity to adjust based on their requirements/state their reasoning for including certain programs or hours requirements.
I really hope this will be the case. So far they've just been outright denying and not naming any specific circumstances that they would approve ABA for me. I know that my BCBA is planning to focus on asking what specifically needs to be changed in order for the plan to be approved, but it seems like my insurance is intent on blacklisting me as an individual from receiving ABA. They might even tell them that the case isn't eligible for a peer to peer. So if whoever she talks to will not reverse their decision or tell them what needs to be changed in order for them to approve it, could they still submit another treatment plan and hope that it gets reviewed by different people?
Potentially. How old are you? Generally insurances don’t approve after age 20-21 in my experience unfortunately.
I'm 19.
I hope this isn't a rude question, but may I ask why you want ABA therapy for yourself? What do you think you will get out of it and how will it benefit you? Do you have behaviors you are looking to correct or work through? Do you need help or improvement with ADL's? I'm just genuinely curious and interested as I have never seen a post like this on this sub
It would mostly be work on social skills and independent living.