BCBA or BCABA therapists recommendations please (Broward) for 3 yr old son

[Guest guest]

I have a 3 yr. old son who has been getting ABA for a yr or so now. Our

insurance will now only cover therapy that is done directly by the certified

therapist. (This has been hard to find as they are usually the ones overseeing

the company and not actually doing the therapy.)

[Guest guest]

Insurance have an appeal process for declined claims. By

insisting that the degree person do the actual instruction is not a customary

practice. You might try and get something in writing denying what is customary.

This may go nowhere but if you don't try you know it won't. You would

think there are some class action lawsuits going on for this very same thing.

That sounds like a good group to join to me.

From:

sList [mailto:sList ] On Behalf

Of klc8785

Sent: Monday, July 19, 2010 10:10 PM

To: sList

Subject: BCBA or BCABA therapists recommendations please

(Broward) for 3 yr old son

I have a 3 yr. old son who has been getting ABA

for a yr or so now. Our insurance will now only cover therapy that is done

directly by the certified therapist. (This has been hard to find as they are

usually the ones overseeing the company and not actually doing the therapy.)

[Guest guest]

This is a case of an insurance company taking the Law literally.

In practice the actual ABA therapy is typically provided by people trained and

supervised by a BCBA or BCABA. This is the model most agencies use to provide

ABA services.

When the State Legislature passed the not so wonderful 2008 autism / insurance

Bill there was a clause:

http://laws.flrules.org/files/Ch_2008-030.pdf

( Treatment of autism spectrum disorder through speech therapy, occupational

therapy, physical therapy, and applied behavior analysis. Applied

behavior analysis services shall be provided by an individual certified pursuant

to s. 393.17 or an individual licensed under chapter 490 or chapter 491.

I had heard that some insurance companies (BCBS) were taking this route to deny

services because there aren't enough BCABA's to work directly with our kids.

Interestingly, the Florida Association for Behavior Analysis were active in

lobbying for certain parts of this Bill. I can't confirm if they were a party to

this language. I have asked them and was told only that they were happy to lend

their expertise to the process.

You can contact the Office of the Insurance Commissioner and talk with Monte

s who may be able to help. I last spoke with him a year ago he was very

familiar with this issue 850 413-2571

Steve Moyer

>

> Insurance have an appeal process for declined claims. By insisting that the

> degree person do the actual instruction is not a customary practice. You

> might try and get something in writing denying what is customary. This may

> go nowhere but if you don't try you know it won't. You would think there

> are some class action lawsuits going on for this very same thing. That

> sounds like a good group to join to me.

>

>

>

>

>

>

>

> From: sList [mailto:sList ] On

> Behalf Of klc8785

> Sent: Monday, July 19, 2010 10:10 PM

> To: sList

> Subject: BCBA or BCABA therapists recommendations please

> (Broward) for 3 yr old son

>

>

>

>

>

> I have a 3 yr. old son who has been getting ABA for a yr or so now. Our

> insurance will now only cover therapy that is done directly by the certified

> therapist. (This has been hard to find as they are usually the ones

> overseeing the company and not actually doing the therapy.)

>