Understanding your insurance coverage for ABA therapy can be very confusing, and we provide full insurance service to our families.
Insurance claims procedures vary significantly among different insurance companies because ABA treatment has only recently received standard Current Procedural Terminology (CPT) codes from the American Medical Association.
Optima has a team of experienced insurance specialists who help families navigate the process to receive their maximum allowable benefits.
What we do before the start of ABA services?
Provide information on what your insurance plan covers and requires, so you have a realistic assessment of the coverage.
If required by your insurance carrier, we will directly work with the Primary Care Physician to obtain referrals and authorizations.
Next, on our clients’ behalf, OPTIMA files claims biweekly to insurance companies according to your insurance carrier’s protocols.
We follow the process of insurance payments to ensure accurate and timely reimbursement. The family is not billed their portion until any issues are resolved.
What we do for continuation of services for existing OPTIMA-families?
We provide your insurance carrier with required documentation such as progress reports, new treatment plans, your BCBA goes through a live interview with the care advocate per your insurance requirements.
What if OPTIMA is not in-network with my insurance carrier?
Please contact us as we are often able to obtain in-network benefits granted.
The cost of co-payments is too high for our family.
- Visit our Grants page and call our office to learn more about funds that might be available for you.
To make a payment through our online processing site, click here.