ABA Prior Authorization Requirements – Initial PA

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Patient Name*
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Insurance Company
This insurance company requires prior authorization for ABA therapy. Here are the details to help your clinic complete the prior authorization process.
Prior Authorization Requirements
What information/forms does clinic need to submit to insurance company?
Where does clinic submit the prior authorization documents?
Please let us know the date when you have submitted your prior authorization documents to this insurance company. We will then confirm with the insurance company that they have received your prior authorization request, and that it is in process.
Prior Authorization Approval
How long until clinic receives confirmation from insurance company of what care is approved?
How will clinic receive confirmation from insurance company of what care is approved?
Additional Comments
When you receive your prior authorization approval from insurance company, please upload the prior authorization approval letter to us in Teamwork.
Comments
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