A&C Behavioral Solutions offers private pay and insurance funded options for treatment. In the state of Michigan we have a mandate providing treatment specifically for persons diagnosed with autism from age 0 through age 18.
Getting started with BCBS or BCN funded services:
- Please schedule an initial appointment (telephone or in-person options are available free of charge) with Alicia Kendall by using the schedule below or clicking here. Be sure to bring your new patient documentation.
- Complete the required documentation so that an authorization can be secured.
- Provide your child’s availability for participation in sessions. Be sure to let us know if you would like center-based or home-based services.
- Discuss supplies required for your child’s treatment to begin.
- Once there is authorization for treatment and payment of services, schedule your child’s initial evaluation. The evaluation will include the following:
1. Functional Analysis or Functional Behavior Assessment
2. Skills Assessment (via VB-MAPP, ABLLS or other clinically appropriate variations).
3. Parent-focused developmental history interview”
- Goals will be developed in collaboration with you based on goals that are socially valid to your family and your child’s level of functioning.
- Treatment will begin in an agreed upon schedule
In order for your child to receive an authorization for ABA services, he/she must first have had a diagnosis of Autism Spectrum Disorder from an approved Autism Evaluation Center. A copy of this report, giving a diagnosis and recommending ABA, must be given to your insurance carrier.
To locate a diagnostic center or determine if your child’s assessment is from an approved center please click the following link:
Insurance Services Description & Rate Sheet
AUTISM AND ABA SERVICES: Insurance is billed for ABA services only after an authorization has been secured for the child.
It is important to note that the authorizations people state clearly that services are not guaranteed for payment when authorization is secured. If services provided are rejected by the insurance company, then the family will be billed if the insurance carrier will not reverse their payment decision.
The insurance companies put the following parameters on BCBA services that cannot be avoided by us:
1. Patients are responsible for their own co-pays, coinsurance and deductibles to the provider.
2. 1 hour of BCBA time is allowed per 10 hours of Behavior Therapist (aka “Line therapy”) per week
5 hours per week 2 BCBA hours per month
10 hours per week 4 BCBA hours per month
15 hours per week 6 BCBA hours per month
20 hours per week 8 BCBA hours per month
25 hours per week 10 BCBA hours per month
3. BCN requires that no more than 3 hours per week are delivered by a BCBA within a rolling 7-day week. In addition, no more than 25 hours per week can be delivered by the behavior therapist in this rolling 7-day week.
4. BCBS and other insurance companies require that no more than 3 hours are delivered within a 7-day calendar week of Sunday through Saturday. In addition, no more than 25 hours per week can be delivered by the behavioral therapist in this rolling 7-day week.
5. Parent consultations / training are allowed where relevant to the child’s ABA treatment program
6. IEP meetings or meetings with other service providers are not covered.
- Cancelled or returned check fee – $25 + amount owed
- BCBA or Behavioral Therapist NCNS session – $25 per session, per day
(family failed to notify that the session was cancelled and we traveled to the session)
- Short notice cancellation – $25 per session, per day
DISCLAIMER: Scheduling an initial appointment does not constitute a patient – provider relationship.
Now Accepting New Patients
We strive to meet the unique needs of each family to not only mitigate deficits, but to teach pivotal skills, language, play and other developmental milestones.
Questions call us at (734) 466-5021