Our Process

The process is started when a parent contacts our office. Reach us by phone, email or click here. During our first introduction, we will ask a few brief questions to include: age and gender of child, location, concerns, and your contact information.

We can assist you with verifying benefits with your insurance provider. To do so, complete the New Client Application here.  We strongly encourage that you also call your member services representative to inquire about your coverage for ABA assessment and therapy. Please verify coverage for ABA, not just autism services. ABA is most often covered under a member’s behavioral health plan, where as speech therapy and occupational therapy for children with autism are covered under medical.

Once we have checked with your insurance regarding reported benefits, we will contact you within 24 hours to let you know the summary of what your provider has indicated.

Please note: a quote of benefits and/or authorization does not guarantee payment or verify eligibility. Payment of benefits are subject to all terms, conditions, limitations, and exclusions of the member’s contract at the time of service.

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Once we have all of your information, we will submit for a prior authorization or pre-certification for the initial assessment with your insurance company. Depending on the insurance carrier and their internal processes, this may take 10 -15 business days. Once the authorization has been received, we will contact you to schedule your assessment.

At this point, we are now able to schedule the initial assessment.  Please provide us with a few days and times that might work so we can accommodate your requests and also work with our staff availability. If there is more than one setting you would like for us to conduct the assessment in (i.e. home, school, day care), please let us know at the time of scheduling.  The assessment may take between one and three sessions to complete.

A board certified behavior analyst (BCBA) is assigned to come into your home or designated settings to conduct the assessment.  This individual will likely be the case manager for your child’s case moving forward.  The assessment will cover the concerns you have previously expressed while also looking at development across domains.  This assessment will be conducted via caregiver interviews, direct testing, and observation. Please note that part of the authorization or billed time is preparing a comprehensive report and treatment plan for your child which will provide details of the assessment and therapy recommendations.

Upon completion of the assessment and summary report, we will send you a copy.  At this time, we like to follow best practice and schedule a time to sit down and review it with you so that you fully understand how goals are generated and how therapy will be structured.  We also want to give you an opportunity to ask any questions that you may have so you feel comfortable with the plan moving forward. This review usually takes an hour and will be conducted in your home or center.

While the review is occurring, Pathways administration will complete the necessary paperwork and steps to request and obtain an authorization for therapy and treatment. Depending on the insurance carrier this may take 10-15 business days. Your insurance company should send you a copy of the authorization information.  Please note, the authorizations are generally allowed for a 6-month period at the conclusion of which we will update assessment and performance information and submit a request for another authorization so therapy can continue.

We are now ready to schedule your treatment and therapy sessions!  Please provide us with your availability and preferences for the sessions.